Table 1.

Inventory and description of all study variables and of the risks to competence and supports to competence identified in the literature

Area	Risk/support category	Description
A. Type of health profession	Physician	One of four health professions in study. Other words for this profession include ‘doctor’ and ‘medical doctor’. Refers to individuals at any stage of the physician competence life-cycle (eg, medical student, resident, practising physician)
	Other health professions (eg, dentists and nurses)	Other health professions were only included when the study also discussed one or more of the four professions of primary interest.
	Pharmacist	One of four health professions in study
	Occupational therapist	One of four health professions in study
	Physical therapist	One of four health professions in study Another word for this profession is ‘physiotherapist’.
B. Competence life cycle	Practice	Working in the health field as an autonomous practitioner
	Resident	Postprofessional education of physicians, called residency education or graduate medical education, leading towards a certification or specialty designation; If education of another profession was not postprofessional, it was considered field- based education.
	Field-based education	The practical education of one or more of the health professions of interest; includes clinical-based training for physiotherapists and clerkship or internship education for physicians
	Other	Articles where the competence life-cycle was not specifically mentioned
C. CanMEDS roles15	Medical expert	Demonstrating clinical knowledge, skills and abilities required for effective patient care.
	Communicator	Communicating with patients and providing appropriate written documentation.
	Professional	Demonstrating ethical practice, high personal standards of behaviour, accountability to the profession and society, profession-led regulation and maintenance of personal health.
	Scholar	Demonstrating commitment to life-long learning, utilising evidence-informed decision-making, teaching and research
	Collaborator	Working effectively with other health professions including teamwork, managing differences and resolving conflict
	Manager	Managing time, resources and priorities, including supervision of learners
	Health advocate	Advocating for care or services for individual patients, the community or the patient population
D. Risks to competence	Transitions	Dyscompetence or differences in performance associated with change(s) in work or professional status, in focus of practice and/or as experienced by new graduates
	International graduate	Dyscompetence or differences in performance associated with health professionals that were educated in a different country than where the study took place
	Lack of clinical exposure/experience	Dyscompetence or differences in performance associated with knowledge/competence gaps in certain clinical areas arising from insufficient volume of procedures and patients with a particular condition to attain or maintain competence
	Age	Dyscompetence or differences in performance associated with the person’s age including youth and older age
	Gender	Dyscompetence or differences in performance between men and women
	Practice features	Dyscompetence or differences in performance associated with geographical or office features of the practice
	No certification	Dyscompetence or differences in performance associated with presence/absence of specific specialty certification
	Wellness	Dyscompetence or differences in performance associated with physical or mental health related issues
	Resources	Dyscompetence or differences in performance associated with resources, including people, money and time
	Adequacy of practice or education	Dyscompetence or differences in performance associated with a previous educational programme that did not adequately prepare learners with particular skills or with specific knowledge due to brevity or low quality
	Area of specialty/certification	Specialty or certification-based variations in dyscompetence; certification and specialty are often used interchangeably
	Previous disciplinary activity	Impact of previous complaint or discipline matter by a regulatory authority, specialty organisation or health facility on dyscompetence
	Other	Differences related to risks to competence not included in the higher-volume defined topics
E. Supports to competence	Continuing education participation	Involvement in an educational activity such as a course, workshop or conference during the practice competence life-cycle (ie, postspecialty/programme-specific training)
	Educational information/programme features	Actions or interventions included in a pre-existing educational programme that are designed to improve the learning, knowledge translation and application of the material
	Personal support and feedback	Mentorship and feedback provided or available to individuals to inform or improve clinical skills and/or knowledge
	Adequate clinical exposure/experience	Time spent in specific rotations or at specific clinical sites, with a particular patient/client population.
	Quality assurance participation	Formal activities within a structured organisational quality assurance programme, in the workplace
	Support through structure or organisation	Employer or site-specific structures or processes that develop or maintain individual or professional competence
	Professional organisation participation/systems	Mandatory participation in formal personal activities to develop or maintain competence as established through regulatory, association or specialisation requirements
	Technology	Mechanical or electronic means to develop or maintain competence via simulation, eLearning opportunities and electronic decision support rules
	Reflection and self- assessment	Approaches to developing or maintaining competence that include introspection, personal analysis and consideration of adequacy of competence or demonstration of competence
	Assessment and feedback through tools	Approaches that employed a specific tool to measure professional competencies to determine the adequacy of performance and/or to provide information and motivation for improvement
	Performance review	A formal or structured work-based process whereby a practitioner is provided with information on the adequacy of performance and/or provided with information and motivation for improvement; This information is generally formative and intended to assist in performance improvement.
	Other	Approaches to developing or maintaining competence not included in other high-volume defined topics.