Quality improve ment competenc y gaps in primary care in alban ian, pol ish and sloven ian conte xts: A study protocol

Background: Nowadays, general practitioners (GPs) and family doctors (FDs) face increasing demands, as a consequence of complex patients' expectations, developments in science and technology, and limitations within healthcare systems which can result in competency gaps. Therefore, there is a need to identify which competencies in quality improvement (QI) are most important for GPs and FDs to possess in order to meet the demands of contemporary health care practice. To date, however, little information is available on the self-assessment of competencies related to QI among GPs and FDs. To deal with these issues, a project on QI in continuous medical education was launched in 2011. The project aims to broaden the GPs'/ FDs' continuous education offer, its quality and attractiveness, as well as provide them with opportunities for vocational advancement and enable the development of common, European frame of reference for GPs'/FDs' occupational competencies. The third work package of the project consists of the validation research of the questionnaire developed on the basis of the competency framework in QI for GPs/FDs in Europe. Methods: A cross-sectional study will be carried out using the self-assessment QI questionnaire which was originally developed in English and subsequently it was crossculturally adapted in Slovenian, Albanian and Polish settings by use of a pilot study on a conveniently selected group of FDs/GPs (N=10) in each participating country. The final version of the questionnaire will be administered to large samples in each country involved in the survey. Two weeks after the first administration of the questionnaire, a second round, with the same procedure and including the same group of respondents, will follow. Psychometric tests will be conducted including internal consistency (after the initial and subsequent application of the instrument) and stability over time (two-week test-retest reliability). Discussion: This self-assessment study will demonstrate the complex environment in which general practice/family medicine operates and, eventually, this gap analysis will set out strategically important areas for collaborative efforts related to QI in primary care. The authors consider that the study should be extended to other European countries to help identify most required competencies that GPs/FDs should possess in Europe and thus stir system and educational debate around QI curricula and training for primary care in Europe.