Adoption of a public health leadership competency framework in Albania

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Orjola Pampuri1, Katarzyna Czabanowska2,3, Bajram Hysa4, Enver Roshi4, Genc Burazeri2,4

1Institute of Public Health, Tirana, Albania;

2Department of International Health, CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands;

3Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Krakow, Poland;

4University of Medicine, Tirana, Albania.

 

Corresponding author: Orjola Pampuri;
Address: Rr. “Aleksander Moisiu”, No. 88, Tirana, Albania;
Telephone: +355672066183; E-mail: o.pampuri@yahoo.com

 

Abstract

There is an urgent need to develop robust leadership skills among public health professionals. From this point of view, competencies in the area of public health leadership are an important dimension which should be fostered among public health professionals at all levels. To date, there have been developed several competency frameworks in the area of public health leadership as well as medical leadership, which bring together the main principles and concepts of leadership and have been also considered useful for planning professional training and continuous professional development.

Notwithstanding the laudable amount of work for the development of leadership competencies in the public health and medical area, the existing frameworks are deemed quite generic and not specific enough to support and strengthen the educational curriculum and training models for public health professionals. From this point of view, recent attempts were made to develop a specific public health leadership competency framework which is meant to significantly strengthen and support the competency-based European public health leadership curriculum. This framework was designed in the context of the Leaders for European Public Health (LEPHIE) Erasmus Multilateral Curriculum Development Project, supported by the European Union Lifelong Learning Programme.

This recently established framework will be adopted in the Albanian context. The adoption process will undergo several steps including the procedures of translation and back-translation of the instrument, as well as assessment of validity and reliability of the tool in a pre-test exercise involving a sample of public health professionals in Tirana.  

Keywords:  adoption, competency, framework, leadership, public health.

Introduction

There is an urgent need to develop robust leadership skills among public health professionals. From this point of view, competencies in the area of public health leadership are an important dimension which should be fostered among public health professionals at all levels (1).

To date, there have been developed several competency frameworks in the area of public health leadership as well as medical leadership (2-5), which bring together the main principles and concepts of leadership and have been also considered useful for planning professional training and continuous professional development (6,7).

A newly developed public health leadership competency framework

Notwithstanding the laudable amount of work for the development of leadership competencies in the public health and medical area, the existing frameworks are deemed quite generic and not specific enough to support and strengthen the educational curriculum and training models for public health professionals (1).

From this point of view, recent attempts were made to develop a specific public health leadership competency framework which is meant to significantly strengthen and support the competency-based European public health leadership curriculum (1). This framework was designed in the context of the Leaders for European Public Health (LEPHIE) Erasmus Multilateral Curriculum Development Project, supported by the European Union Lifelong Learning Programme (1).

The newly established leadership competency framework consists of 52 items grouped into the following eight competency domains (subscales) (1):

  • Systems thinking
  • Political leadership
  • Collaborative leadership: building and leading interdisciplinary teams
  • Leadership and communication
  • Leading change
  • Emotional intelligence and leadership in team-based organizations
  • Leadership, organizational learning and development
  • Ethics and professionalism 

As mentioned above, the public health leadership competency-based curriculum was developed in the framework of the LEPHIE project (1). Each domain (subscale) corresponds to one educational session within public health leadership curriculum (1,8). The description of the competencies supports the curriculum design and it can be used as a self-assessment instrument for students and public health professionals, helping them to reflect and identify gaps in their knowledge, skills and competencies (1).

Adoption of the public health leadership competency framework in Albania

This recently established framework will be adopted in the Albanian context. The adoption process will undergo several steps including the procedures of translation and back-translation of the instrument, as well as assessment of validity and reliability of the tool in a pre-test exercise involving a sample of public health professionals in Tirana. In addition, the questionnaire will include demographic data (age and sex of participants), district and location (urban areas vs. rural areas), working institution, type of working institution (public institution vs. private practice), main university degree and other specializations/qualifications, as well as current job position and duration (years of working experience) in the current job position. 

Translation and back-translation of the instrument

The original English version of the leadership competency framework will be translated into the Albanian language by experts following the standard methods of translation and cross-cultural adaptation of the questionnaires (9,10). As it has been convincingly argued, the aim of the cross-cultural adaptation is to provide a version of the instrument that is conceptually as close as possible to the original questionnaire, considering nevertheless the perspective and understanding of the Albanian public health professionals (9,10). In any case, there will be no major changes from the original version of the leadership competency framework.

Pre-test (validation) process

The pre-test (validation) of the instrument will be conducted in a convenient sample of 50 public health professionals in various leadership positions and different levels of care operating in Tirana. The inclusion in the sample of public health professionals in various leadership positions will enable the assessment of potential differences regarding specific dimensions of the leadership competency framework. The instrument will be applied twice in the validation sample: test (first application of the tool) and retest (second application of the same instrument after two weeks). Cronbach’s alpha will be used to calculate the internal consistency of the instrument for both the test and the retest procedures (11). On the other hand, Spearman’s correlation coefficient will be employed to assess the reliability (stability over time) of the instrument.Furthermore, the background information on study participants (demographic data, current job position, work experience, and specializations/qualifications) will enable, to some extent, assessment of construct validity of the instrument – that is the association of the overall leadership score and the subscale (domain) scores with the background information (independent variables). This is a commonplace procedure employed in similar validation studies (12). 

Next steps

After the initial validation (pretesting) of the leadership competency framework in a convenient sample of public health professionals in Tirana, the instrument will be administered to a large nationwide representative sample of public health professionals in Albania. The ultimate goal will be to assess the level of the current leadership competencies possessed by public health professionals, as well as the required level of leadership competencies for their current job position. This will enable identification of the potential gaps in the level of acquired leadership competencies and the required (desirable) leadership competencies, as well as will inform the public health curricula about necessary content adjustments.     

Conflicts of interest: None declared.

Acknowledgement: The authors thank colleagues and partners from the LEPHIE project and the members of the ASPHER’s WGIGP.

 

References

  1. Czabanowska K, Smith T, Könings KD, Sumskas L, Otok R, Bjegovic-Mikanovic V, Brand H. In search for a public health leadership competency framework to support leadership curriculum-a consensus study. Eur J Public Health;2013 Oct 11 [Epub ahead of print]. DOI: 10.1093/eurpub/ckt158.
  2. Greiner AC, Knebel E, editors. Health Professions Education: A Bridge to Quality. Washington, DC: Institute of Medicine; 2003.
  3. Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: The National Academies Press; 2001.
  4. Accreditation Council on Graduate Medical Education. General Competences for Residents. Chicago, IL: Accreditation Council on Graduate Medical Education, 2007.
  5. Maintenance of Certification Competencies and Criteria. American Board of Medical Specialties, (USA). Available at: http://www.abms.org/Maintenance_of_ Certification/MOC_competencies.aspx (accessed: 10 May 2014).
  6. ASPHER. Provisional Lists of Public Health Core Competencies. Brussels: Association of Schools of Public Health in the European Region; 2008.
  7. Tier 1, Tier 2 and Tier 3 Core Competencies for Public Health Professionals. Washington, DC: Council on Linkages Between Academia and Public Health Practice, Public Health Foundation; 2010.
  8. Czabanowska K, Smith T, De Jong N, et al. Leadership for Public Health in Europe. Nominal Plan. Maastricht: Maastricht University; 2013.
  9. Jovic-Vranes A, Bjegovic-Mikanovic V, Marinkovic J. Functional health literacy among primary health-care patients: data from the Belgrade pilot study. J Public Health 2009;31:490-5.
  10. Sperber AD, Devellis FR, Boehlecke B. Cross-cultural translation: methodology and validation. J Cross Cult Psychol 1994;25:501-24.
  11. Cronbach LJ. Coefficients and the internal structure of tests. Psicometrica 1951;16:297-334.
  12. DeVon HA, Block ME, Moyle-Wright P, et al. A psychometric toolbox for testing validity and reliability. J Nurs Scholars 2007;39:155-64.