Collective competence: Moving from individual to collaborative expertise

Individuals with multi-faceted health issues are being managed within healthcare systems that have become increasingly fragmented, often with a focus on specialization within single-disease paradigms, an approach that challenges a more holistic, patient-centred response [1–3]. Specialized professionspecific proficiency is required to deliver excellent care; however, with growing complexity comes the additional need to consider collective, team-based expertise. Yet, within education, healthcare practice settings, and professional organizations individual professional performance is often valued over collective team competence [4]. In health professions educational programs, a competency-based approach outlining desired performance and outcomes, has been gaining momentum. These profession-specific competencies, such as the CanMEDS framework outlined by the Royal College of Physicians and Surgeons of Canada [5] and a similar framework used by the Canadian Association of Occupational Therapists [6], guide education, practice, and continuing professional development in their corresponding professions. Despite the inclusion of the Collaborator role in both frameworks cited, competence in this domain is typically based on individual performance, even when measured in scenarios addressing collaborative practice (e.g. [7]). With emerging team-based assessment tools, healthcare delivery in some settings is beginning to see a shift to consideration of a collaborative focus to ensure optimal approaches and holistic care [8].