Towards the Development

of Core Competencies for

Residency Training Coordinators
Teri-Marie P. Laude
of Family Medicine in the
Erlyn A. Sana
Philippines
This descriptive study was conducted to formulate a framework
ABSTRACT towards the development of core competencies for the role of family
medicine Residency Training Coordinators (RTCs) in the Philippines.
Initial data was obtained from participants using a cross-sectional
survey. Delphi were conducted among experts to obtain a consensus
on the RTC competencies. Content analysis was done. Results showed
that all respondents are aligned with the Philippine Academy of
Family Physicians (PAFP) setting the RTC qualification to be at least
a diplomate, active member and in good-standing. As the head of the
residency training committee, the RTC needs to balance personal and
professional attributes- assertiveness, fair judgement, trustworthiness
and ethical while evaluating residents and providing counsel. They
have identified their training needs to be in organizational management
and administration. The study showed that the role of the RTC is
complex and identified the core competencies of RTCs as manager or
administrator, clinical teacher, evaluator, educational planner, and
researcher. The final competency framework developed for family
medicine RTCs follows the competency-based curriculum (CBC) track.
It is most appropriate for RTCs as it sets the acceptable standards where
professionals will be evaluated and clarifies the set of expectations
focused on professional development programs and drives assessment
of performance of RTCs. Training institutions can thus use the proposed
framework as a guide in selecting, training, and evaluating the RTCs.

Keywords: core competencies, family medicine residency program,

residency training coordinators

Volume 5 Number 1 21
INTRODUCTION
Worldwide, effective systems for training family
doctors have evolved and vary from country to
country. Although core curriculum guidelines
have been established in many countries,
family doctors are best prepared through
training programs that tailor their educational
goals to fit the needs and resources of local
environments (Boelen, et al., 2002).
Since 1972, the Philippine Academy of Family
Physicians (PAFP) has been working as a
specialty organization that aims “to provide
every Filipino a family physician to attain
optimum family health.” Its mission includes
establishing opportunities for high standards
of family medicine education; providing
comprehensive, accessible, and relevant
continuing medical education programs; and
establishing residency training programs
relevant to the changing needs of the people
(PAFP, 1999).
Recognizing the vital role of educators in the
training of Family Physicians, the World Health
Organization (WHO) and the World Organization
of National Colleges, Academies and Academic
Associations of General Practitioners or
World Organization of Family Physicians
(WONCA) inspired the Philippine Academy of
Family Physicians (PAFP) to prepare family
physicians for the task of teaching. Hence in
1986, the Philippine Society of Teachers in
Family Medicine (PSTFM) was organized to
address educational issues in the discipline
with the growth of Family Medicine training
programs in the country. The society provided
a venue for interaction among trainers and
trainees in Family Medicine geared for the
advancement of the discipline and for the
subsequent development of undergraduate and
postgraduate programs. Moreover, it provided
programs for faculty development through
various meetings, seminars, workshops,
fellowship grants, faculty exchange programs
and other related activities (Leopando, 1988).
The PAFP is continually developing training
programs that are largely clinic or practice-
based through the innovative pathway to
address the growing need for Family Medicine
22 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016
specialists who are providing continuing,
comprehensive, and holistic care to patients
and their families, always considering issues
that are relevant to them and their communities
(Leopando, et al., 2014; Leopando & Olazo,
2003).
The competencies of the faculty have a
significant role in the accreditation of any
residency training program. Present rules only
indicate the minimum requirements for any
residency training program: that the chairman
be an active Fellow of the PAFP and in good
standing; at least two faculty or consultant staff
be Diplomates or Fellows of Family Medicine,
active, and in good standing; and the residency
training coordinator at least a Diplomate in
Family Medicine, active, and in good standing
(Maglonzo, et al., 1998). Though the PAFP
has set the criteria for the qualifications of
faculty, formulation of competencies to perform
the different roles and responsibilities of the
family medicine teacher remains a task of the
residency training program. The focal person to
run this program refers to the residency training
coordinator (RTCs).
Family medicine RTCs come from different
backgrounds with varied degrees of capabilities
and work hours. Some are full-time faculty
rendering the required 40 hours per week.
Others are part-time rendering less than 20
hours per week in fulfilling their responsibilities.
They are set to do multi-tasking of roles
requiring flexibility as a clinical teacher, mentor,
and friend to reach out to the varied learning
and even personal needs of the resident
trainees without compromising the training
curriculum. They also seek administrative
balance implementing the rules and regulations
set by the training committee especially in
handling problematic trainees.
As the need for family medicine has grown
nationally, it is imperative that a new and
expanded family medicine residency training
program be developed. This task requires
a strong core of well-prepared and highly
effective residency training coordinators.
The role of the residency program director
or training coordinator is unique in medicine competencies for RTCs to effectively perform
and medical education. Most RTCs learn their roles. The results of the study can help
from the job through trial and error, with a the different faculty and training institutions
fortunate few benefiting from the wisdom and to define the skills and identify the needs
experience of their predecessors and mentors. necessary for the subsequent planning
Recent studies show that the role of RTCs of faculty development programs, faculty
being professional administrators, pragmatic evaluation, mentoring and advancement in the
teachers, clinician role models, political field of family medicine in the Philippines.
activists, and standard bearers for academe
carries with it appreciable job-related stress,
professional isolation, and the threat of a high
rate burnout (Pugno, et al., 2002).
The PAFP and PSTFM have been constantly
innovating programs and adapting to the
changes taking place in medicine and to
the demands of society. The tools of family
medicine have moved to the forefront in
providing a dynamic and responsive curriculum
for family physicians in the future. To maintain
that momentum, there is an increasing
need for expert leadership and guidance for
individual residency training programs. These
responsibilities are carried out by the RTCs.
This study aimed to formulate the framework
(Figure 1) towards developing the standard Figure 1. Conceptual framework of the study
core competencies of RTCs by determining
the dynamic combination of attributes,
qualifications, and responsibilities in fulfilling
their roles for the advancement of the family
medicine discipline in the country. This study
specifically aims to: a) describe the perceived
general attributes, qualifications, role-related
expectations and areas for further training
of residency training coordinators in Family
Medicine; b) identify the core competencies
of residency training coordinators that will
form the framework; c) organize the identified
core competencies of residency training
coordinators into different domains using task
analysis. Recognizing this spectrum of roles
performed by the RTCs will provide guidance to
the subsequent faculty development programs
and residency training institutions in addressing
the educational issues in family medicine
training.

The study offers a new look at advancing

the field of family medicine in the Philippines
through developing the framework of core
Volume 5 Number 1 23
METHODOLOGY
This study utilized the descriptive research
design which is one of the commonly used
research designs in health professions
education (Sana, et al., 2010). Descriptive
studies in educational research are aimed to
determine “what is,” such that observational
and survey methods are frequently used to
collect descriptive data (Borg & Gall, 1989).
The population for the initial survey included
the current 38 residency training coordinators
(RTCs) and chief residents (CRs) from different
accredited departments of family medicine in
the Philippines. The respondents were asked
to answer a survey questionnaire to reflect on
various aspects of being effective in the role in
training residents.
Purposive sampling was conducted to
identify the expert faculty needed towards the
development of core competencies of RTCs
using the Delphi process. As accomplished
and experienced individuals in the discipline,
they were considered highly knowledgeable
to identify those competencies critically
successful for the role of an effective RTC
in family medicine. The participants were
selected by their peers who are familiar with
their performance in their current and past
responsibilities as chair of department, leader
in the PAFP, teacher, and / or researcher. The
expert respondents who participated in the
Delphi Technique were selected from among
the ranks of previous officers and senior
members of the PAFP who were experienced in
education; past and present department chairs
and RTCs of family medicine.
The selection criteria included willingness and
consent of respondents to participate in the
study; accessibility of the expert respondents
by email and mobile phone; and proximity of
geographic location that could be accessible to
the researcher.
The survey questionnaire was developed and
subjected to construct and validity testing.
The survey was conducted among the RTCs
and CRs of the 38 accredited departments
of family medicine. The respondents were
24 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016
given consent forms for participating in the
study, and pre-oriented via email and mail
with return stamped-envelope. Open-ended
questionnaires to allow a greater range of
responses were distributed to them by email
and mail. Their responses composed the listing
and checking the items for the preliminary
data of the general attributes, qualifications,
role-related expectations and areas for future
training of RTCs. This was advantageous,
because it completes the phase in a relatively
short period of time reaching as many
respondents as possible regardless of their
location. Furthermore, the survey instrument
used was a combination of a multiple-choice
and open-ended questionnaire to obtain items
on demographics profile, characteristics,
and role-related expectations and to explore
training needs of RTCs. A reminder for
participants was posted every week through
email and SMS to ensure adequate time for
return of answered questionnaires. Dropouts
were considered after 4th week of no response
to questionnaires.
The review of documents of RTC competencies
involved a comprehensive search for published
and unpublished materials pertaining to the
attributes, characteristics, qualities, roles,
competencies of RTCs in family medicine,
health professions education, and general
medical education. Data from related literature
on the principles, concepts, frameworks, core
values, attributes and characteristics, roles and
responsibilities, faculty training, and program
development were also obtained to identify
core competencies expected in performing the
role of RTCs.
Included in the document review process were
11 materials from annual reports, residency
training manuals, dissertation papers,
brochures, and minutes of committee meetings
from selected programs in the Philippines.
Furthermore, related articles from various
established programs in other countries were
reviewed. All the documents retrieved were
synthesized and organized to form a set of
professional roles and competencies of RTCs.
These data were integrated and organized to
categorize the roles based on the identified
competencies of RTCs in family medicine,
which was utilized in following Delphi
technique. The Delphi technique was used
since it is a practical way of generating a group
consensus to develop the list of competencies
for the role of a RTC. It was conducted in two
rounds until a final agreement was obtained
from the expert respondents.
The Delphi process initially involved a
checklist based on the preliminary data from
the survey together with a literature review
which was provided for opinion among the
expert respondents (Delphi 1). They were
asked if they agree with the list of preliminary
characteristics and needs assessment areas
of RTCs as identified by the CRs and RTCs
themselves. The experts then generated a set
of competencies for RTCs. They were able to
identify the core competencies and categorize
them into various roles of a residency training
coordinator of Family Medicine, i.e., as clinical
teacher, educational planner, manager/
administrator, evaluator, and researcher. This
checklist was also used to confirm which
among the documented attributes and role-
related responsibilities of RTCs are effective in
the Philippine setting.
This was followed by a second questionnaire
(Delphi 2) for which the experts were requested
to rate each competency in order of importance
using the rating scale 1 to 3; i.e., 1=not
essential to 3=most essential. The experts then
achieved a consensus with the master list of
RTC competencies. Once the different core
competencies were derived from the experts,
they were then organized and content-analyzed
into specific domains of learning which
essential to the formulation of the framework
for the role of residency training coordinators.
A detailed description of the functional task of
the RTC or task-analysis was then conducted.
The data obtained from the survey of RTCs
were analyzed using descriptive statistics,
frequencies, and percentages. The items
obtained from the initial results of the survey
were tabulated. On the other hand, findings
from the literature review had been content
analyzed and matched with the list given by
the RTCs. From these data, the tentative list of
core competencies was derived.
Data from the Delphi technique were content
analyzed using relevant constructs that have
been derived until a final framework for the
core competencies has been obtained. Content
analysis is an approach to qualitative data
analysis which involves a set of techniques for
identifying categories or themes and concepts
from the gathered text, and linking these
concepts to make sense of the data collected
and emphasize key features or findings
(Bernard, 2006).
Texts and information from the respondents
were transcribed, collated, and read through.
The potential categories or themes were then
identified. Data from the categories were
pulled together and compared. Collected
categories or themes were linked together and
further examined for fit and relevance.
Relations among the categories or themes were
used to construct theoretical models. Lastly,
the presentation of the results of the analysis
using exemplars or quotes from interviews was
conducted to highlight the theory (Bernard,
2006). Figure 2 presents the overall flow chart
of the study.
Informed consent forms were obtained from
all respondents of the study. The informed
consent stated the study objectives and
described the study design and its relevance to
the field of Family Medicine residency training.
Furthermore, personal information privacy
and data confidentiality was strictly observed.
Utility of the data gathered was likewise
disclosed among respondents for subsequent
planning of curriculum development programs
for aspiring RTCs.
Volume 5 Number 1 25
 Profile of Respondents

There were a total of 43 (56%) respondents out

of a total of 76 resident training coordinators
and chief residents from all residency training
programs. The 54% of RTCs were fellows with
an average of 5-year experience in clinical
teaching and performing the role of an RTC for
an average of 3 years. The most junior of the
RTCs was only 1 month into the role, while the
most senior had 12 years of experience (Table
1).

Figure 2. Overall flowchart of the study.

Table 1. Demographic profile of survey respondents from the different departments of family
medicine in the Philippines
Respondents (N = 43)
Variable Chief Residents Residency Training
( n = 21) Coordinators (n = 22 )
Age Range 32 - 44 32 - 49
Sex
Female 13 19
Male 8 3
Educational Attainment
MD 21 14
MSc 0 2
Others 0 6
Academic Rank
Diplomate 1 9
Certified Family Physician 4 2
Regular Member 16 0
Fellow 0 11

26 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016

Residency Training Institution Origin
University Based
Private
Public
Hospital Based
Private
Public
Seventeen faculty members, fellows by
professional rank in the PAFP, composed
the panel of experts in the Delphi Technique.
Seventy-nine percent of them are females.
They are either past or present chairs, and
members of the residency training committee
of the PAFP affiliated in the various residency
training programs in Luzon (72%), Visayas
(14%), and Mindanao (14%). These findings
are consistent with predominance of female
in the practice and training of family medicine
in the Philippines. Those who progress to the
faculty and eventually RTC role are likewise
predominantly female. This can also be
attributed to the nurturing and multi-tasking of
roles that women are more likely expected to
perform also in the family being an organization
of its own.
Survey Results
Perceived General Attributes of Residency
Training Coordinators in Family Medicine
The survey showed that 90-96% of CRs and
RTCs initially identified the key personal
attributes of RTCs: being innovative,
resourceful, approachable, and having fair
judgement. Being innovative and resourceful
are essential in performing the role of the RTC
as a clinical teacher especially in creating
teaching strategies in instructional design
and developing resource materials that would
enhance the competencies of the resident
trainees. Another attribute recognized by the
respondents is the ability of the RTC to achieve
administrative balance in implementing rules
and regulations set by training committee
in handling problematic trainees, as well as
exercising fair judgment. The attribute of being
5 8
3 5
2 3
16 14
5 8
11 6
approachable makes the RTC an effective
liaison to the residents and the faculty as
well. Being assertive, as identified by CRs and
experts, may have an advantage in performing
the administrative functions of the RTC as they
often would be the front liner of the department
in negotiations to both internal and external
affairs and representing the chair on some
occasions.
These findings are consistent with existing
literatures that describe RTCs as being
resourceful and innovative and as using
technology relevant to one’s job as well as
possessing facilitative personal characteristics
such as approachability (Harris, 2007; Morada,
2003). It was also shown that similar to any
residency training program, the RTC is the
only member of the residency program team
whose time is 100% dedicated to the program.
This full-time role has been brought about
by the increasing scope and complexity of
program requirements and documentation
including, resident concerns, accreditation and
institutional requirements (Otterstad, 2003).
Oftentimes, RTCs are faced with a myriad of
tasks within their medical institutions as part-
clinician, part-teacher, and part-administrator.
They commonly share certain personal and
professional attributes that enable them to
drive their role effectively (Molodysky, 2006).
According to the respondents, the key
professional attributes that RTCs should
possess is being organized. An effective RTC
is referred to as a faculty who organizes and
manages time efficiently, sustains one’s well-
being, balances work and personal needs.
The organized RTC sets the priorities for the
different stakeholders of the residency training
Volume 5 Number 1 27
program. It is during this time that efficient and
systematic delegation of activities would be
critical and as equally important as fostering
collaboration within the department.
Both attributes need not be innate as they
can be learned through doing the job of an
RTC. Accepting the responsibilities that
go with the job of an RTC must take the
necessary measures to develop and improve
the competencies as the head of the residency
training committee. Furthermore, review of
literature has shown that the RTC often creates
a balance in developing trust between the
trainees and trainers without compromising
the implementation of values, culture, and
philosophy of the department (Beresin, 2002).
This also holds true locally as RTCs are guided
by the principles and core values of family
medicine in training such as community-
oriented and culturally-sensitive in addressing
not just patients but the professional
organization, colleagues and other related
health organizations; comprehensive in the
context of the biopsychosocial approach; and
consistent in building trusting relationships.
Just like their trainees, they are expected
to model the values of punctuality, honesty,
integrity, compassion, caring, and humaneness
in dealing with their colleagues and trainees
(Maglonzo, 2014; PAFP, 1999).
Table 2. Identified qualifications of residency training coordinators in family medicine based on
CRs, RTCs, and experts
Qualifications CRs ( n = 21 ) in %
Diplomate, active, and 100
in good standing in the
PAFP
Minimum of 2 years as 71.43
active clinical faculty
With master’s degree, 38.10
units, or its equivalent
Junior to senior rank 38.10
as a faculty
28 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016
Identified Qualifications of Residency Training
Coordinators in Family Medicine
The qualifications both groups (CRs and RTCs)
identified for an RTC are shown in Table 2.
This set of qualifications is consistent with that
defined by the Philippine Society of Teachers
in Family Medicine (PSTFM, 1986) now
Foundation for Family Medicine Educators, Inc
(FAMed). The FAMed states that RTCs should
have at least a diplomate, be an active member
of the academy (PAFP), and be in good
standing as defined by the PAFP (91-100%)
(Maglonzo,1998).
Moreover, the experts all agreed that a qualified
RTC must be a graduate of an accredited
Family Medicine program and must be willing
to take the responsibility as an RTC. Perhaps
this has been the need and highly regarded in
residency training as observed by the experts
having been educators through the years
and respected in the academe. Furthermore,
ensuring a qualified and committed RTC in
the Family Medicine discipline, just like any
faculty, who spends longer and quality time
with trainees are associated with higher
ratings for perceived degree of preparedness
for professional practice of trainees (Atienza,
2001).
RTCs ( n = 22 ) in % Experts ( n = 14 ) in %
90.91 92.86
59.09 71.43
36.36 42.86
22.73 42.86
Role-related Expectations of Residency Training
Coordinators in Family Medicine
The data gathered from the documents
review showed that the RTC as a full-time
consultant faculty in family medicine is
primarily responsible for organizing the
residency training program in their respective
departments. Subsequently, the RTC is
appointed as the head of the residency training
committee. This also encompasses the RTC’s
role as trainer and administrator to address
attaining the competencies and standards
needed to perform in medical school,
residency and practice that have been well-
defined. The 21 experts of the Faculty Futures
Initiative developed a document delineating
the competencies required for successful
faculty including the role of the RTC. These
competencies were developed in parallel with
the movement to define the competencies of
trainees which were eventually categorized into
seven domains.
The classification comparison and analysis
of the set of competencies against the
Figure 3. Development of the list of roles of residency training coordinators as identified by
experts
locally established 5-star role of the Family
Physician as defined by the PAFP yielded the
development of 5 domains specific for the role
of RTCs as validated by the experts (Figure
3). These same domains were supported
by survey data in which respondents broke
down the core competencies according to
importance. Respondents identified managing
/ administration equivalent to 35 percent of
value among the core competencies. This was
followed by that of clinical teaching (20-30
percent), educational planning and evaluation
(10-15 percent each), and research (5 percent).
Despite widespread use of competency
frameworks to define and assess competencies
for family medicine faculty, no current
document exists to define the terminal
professional competencies for the role of RTCs
crucial to the implementation of the residency
training programs in the country. Once
established, these derived competencies would
be the foundation to set objective performance
indicators, identify content areas for continuing
professional education programs, and guide
the evaluation of RTCs.
Volume 5 Number 1 29
Identified Training Needs of Residency Training
Coordinators in Family Medicine
Resident training coordinators who are in
their novice and early career stages with less
than 10 years of teaching as well as those
in mid-career stage with clinical teaching
experience beyond 10 years said that an
RTC must be active in FaMed and should
attend regular train-the-trainor-training or
continuing medical education (CME) courses.
Respondents explained that these are needed
to be updated with the foundational courses
in training family and community medicine
while continually embracing the 5-star role of a
family physician, i.e., as a teacher, counsellor,
researcher, manager / administrator, and leader
/ social mobilizer. Furthermore, they have both
identified evaluation and curriculum planning
and managing skills linked to administrative
Table 3. Identified training needs of residency training coordinators ( n = 43 )
Role of RTCs
Clinical Teaching
Educational Planning
Managing and Administration
Evalution
Research
30 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016
responsibilities valuable in performing their
role.
The RTCs in the novice to early academic
stages, especially those who are less than
a year into the role, admitted that they are
unaware of an existing training program for
RTCs’ learning and development. They likewise
appreciated the value of an established manual
and / or curriculum for RTCs which are very
helpful in their inductive training while learning
on-the-job. The more experienced RTCs in
the mid-career stages, on the other hand,
were more interested in learning leadership
and managerial skills as well as organizational
culture and skills enhancements. Table 3
summarizes the identified training needs of
residency training coordinators for future
faculty development programs.
Identified Training Needs of RTCs
Teaching and learning skills and strategies
Adult learning and motivation
Presentation skills
Updates on best practices in family medicine
and foundational courses in family medicine
Test construction
Teaching and learning skills and strategies
Program implementation
Instructional design and developing training
modules
Curriculum planning
Leadership skills
Organizational management skills
Orientation to RTC duties and responsibilities
Developing support groups for RTCs
Developing standards for family medicine
training and practice
Program evaluation
Evidence-based family practice
Quality assurance cycle
The training needs of RTCs for continuing
professional education vary from educational
or instructional, organizational, and personal
development. Novices are mostly preoccupied
professionally with balancing mastery of
teaching including familiarization to the
institutional culture and clinical practice, while
undergoing personal changes with new family
responsibilities and financial obligations.
Those in the early career stage are more
concerned with mastery of role and institutional
recognition, publication, and research as
well as family obligations (Sana, et al., 2010;
Baldwin, 1991; Mortensen, 1983). This explains
why most of the RTCs are expecting the
PAFP to provide opportunities for continuing
professional education, such as in areas of
clinical teaching, evaluation, test construction,
curriculum planning, counselling, and research
capability enhancement.
The PAFP through the FAMed has regularly
conducted a series of workshops to address
the identified training needs since 1986.
Despite these initiatives, the respondents
have highlighted these topics relevant to be
addressed to perform the effective role of the
RTC. Though workshops and seminars have
been conducted, these may be insufficient
to address the specific needs of the RTC
in performing each competency. Baseline
knowledge, skills, and attitudes would also
depend on their institution of origin; i.e.,
training faculty and learning environment in
a university based training institution where
resources are more compared to the limited
resources in a private, non-university training
institution; and a traditional-hospital based
training program compared to an innovative-
practice based program.
Furthermore, there has been a transition of
roles with delegation of professional tasks
of an RTC among novice and early career
faculty along with evolving changes brought
about by a constant demand to improve
residency training and higher standards in
fulfilling accreditation requirements. Having
recognized the impact of RTC career stage
as basis for program planning, the faculty or
RTC must regularly assess his or her training
needs. Hence, the training needs have to be
updated annually to meet the growing demand
for competent RTCs well equipped for their
respective training institutions. Also, feedback
and monitoring are essential to determine if
training objectives and expectations of RTCs
are met as conducted by the PAFP. The core
curriculum or “must-know” topics addressing
the baseline training needs of a novice RTC
could be considered prior to getting on-board
or during the first months of assuming the role
of an RTC. The awareness of the common
training needs and concerns of the RTC in the
various stages of their career can also guide
the PAFP and institutional administrators in
program planning as well as in future individual
faculty interactions.
The PAFP has initially addressed training the
RTC and some faculty on the accreditation
of residency training programs. Some
annual conferences conducted have been
focused on family medicine as a discipline to
integrate clinical and behavioural sciences;
core curriculum for family medicine residency
training; and clinical teaching and teaching
strategies (Leopando, 1998). The recent
updates on the core knowledge, skills, and
values required of a family physician has placed
greater demands on all training programs
especially RTCs to upgrade and appraise
their curricula based on the new manual of
competencies in 2008. The established 14
Foundation Courses in family medicine includes
14 academic domains namely: family medicine
principles, primary and secondary care,
acute care, preventive care and promotion of
wellness, communication and relational skills,
evidence-based medicine (EBM), research,
quality assurance, community oriented primary
care, medical ethics and professionalism,
information technology, legislation in health and
the family, practice management, and health
administration (PAFP, 2013). It is with these
changes that RTC and faculty competencies
must be updated.
While standards for all family medicine
residency training programs are being
established, the competencies of the RTC who
is responsible for organizing the residency
Volume 5 Number 1 31
training program has yet to be established by
developing a curriculum to address training
needs of the faculty. This must be a primary
consideration in the development of the core
curriculum, one that is up-to-date to directly
address the RTCs professionally equipping
them with a set of standard competencies to
perform their roles effectively.
Formulating the Framework
overlapping or proximate to each other as they
refer to health professions education based on
the identified essential competencies for each
role. However, the role of the RTC as manager-
administrator is quite different from the rest
with several noted essential competencies
related to being one of the leaders in the
training institution. The researcher highlights
the RTC providing support for evidence
generating activities.

Identified Core Competencies of Residency
Training Coordinators in Family Medicine using
the Delphi Technique
The Delphi technique yielded the list of core
competencies essential to the RTC to perform
their professional responsibility for each of
the 5 validated roles as shown in table 4. The
roles, professional responsibilities, and core
competencies had mean ratings of ≥ 2.5 where
3.0 is equivalent to “most essential.”
The roles of the RTC as clinical teacher,
evaluator, and educational planner are
It is important to highlight the role of the RTC
as a manager-administrator as this sets one
from the other training faculty of the residency
training program. Since the RTC is observed to
be a full-time dedicated faculty performing as
head of the program, it is expected that focus
is on the tasks of organizing the residency
training program and attending to and fulfilling
the increasing scope and complexity of
program requirements. Furthermore, the RTC
is known to ensure that all residents achieve
the required competencies and facilitate and
liaise the requirements for accreditation, annual
reports, and curricular schedule.

Table 4. Identified professional responsibilities and core competencies of residency training

coordinators in family medicine corresponding to their 5 roles
Role Professional Responsibilities Competencies ( rated > 2.5 )
Clinical Teacher Provides information to
support resident learning
Servers as role model family
physician to residents
Facilitates adult learning
among residents
• shares information and other
learning activities
• updates & provides on new
diagnostics and therapeutics
during teaching rounds
• on-the-job role model during
in-clinic or out-patient and ward
rounds;
• mentors or tutors resident/s
& challenges them to take
responsibility for their learning
• utilizes various teaching-learning
strategies such as problem-based
learning in clinical or practical
settings
• provides wise counsel to the
various difficulties encountered
professionally and personally by
residents

32 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016

Educational Planner Facitates program planning
Conducts instructional
planning
Assesses residency training
curriculum and clinical
competence
Professional attributes of RTCs related to
performing the manager-administrator role were
identified by the respondents as being effective
in communication and interpersonal skills
(both oral and written) to motivate residents
and colleagues as active members of their
respective teams; resolve conflicts or negotiate
trainee needs with the program requirements;
foster networking and collaboration. The
attributes were similarly highlighted in the UP-
PGH DFCM Residency Training Manual (2004)
and by Otterstad (2003). Equally important to
communication skills are organizational skills
to effectively manage time as in prioritizing
objectives, scheduling of activities, and
assigning tasks to resident trainees without
compromising the RTCs own well-being, such
as balancing work and personal needs.
• applies principles of program
planning based on PAFP
residency training program
guidelines, specifically-
• identifies residency training
program problems or
organizational issues, formulates
goals & objectives, selects
appropriate strategies, writes
program plan together with the
residency training committee of
faculty
• applies principles of instructional
design, specifically-
• identifies issues on domains of
learning- Knowledge, Skills, and
Attitude, formulates objectives
(KSA), select appropriate adult
learning strategies, constructs
instructional design
• responsible for the
implementation, and evaluation of
residents’ curriculum including
• training needs assessment,
evaluation/update of learning
resource materials, regular
resident evaluation based on
accreditaion standards of the
PAFP
Organized Core Competencies of Residency
Training Coordinators into Different Domains
using Task Analysis
The second round of Delphi showed the
identified essential set of competencies
belonging to each of the role categories of
the RTC being clinical teacher, manager and
administrator, evaluator, educational planner,
and researcher. Tables 5 to 9 show those
professional responsibilities and their related
tasks that ranked most essential for each of
the 5 roles of an effective RTC which utilized
the task analysis to construct the framework
showing the different competencies with
specific domains of learning; i.e., knowledge,
skills and attitudes.
Volume 5 Number 1 33
The set of competencies gathered and
validated during the Delphi process are
referred to as learning goals which will serve
as components for the subsequent curriculum
for career development, program planning, and
evaluation of RTCs.

Table 5. Task analysis of the residency training coordinator as clinical teacher

Competencies of Knowledge Skills Attitudes
Clinical teacher
As Information Provider
Updates with new Applies evidence Critical appraisal; Flexibility in doing the
diagnostics and based medicine in clinical decision multi-tasking roles
therapeutics during clinical cases; applies making as clinical teacher,
teaching rounds clinical practice mentor, friend
guidelines
Shares information Knows the residency Applies teaching- Resourceful;
by lectures and other curriculum and context learning strategies in progressive teaching-
learning activites of FM as a discipline; Small or Large groups; learner
knows and applies integrates information
Family Medicine on FM principles
principles and tools and shares personal
reflections and views
illustrating the process
of sound decision
making
As Role Model
On-the-job role model Applies Family Demonstrates proper Approachability,
during in-clinic or Medicine principles patient care during competence,
out-patient and ward and tools bedside teaching respectful, confident,
rounds rounds orderly and caring;
honest; good advocate
As Facilitator/Counselor
Mentors or tutors an Provides alternatives Conducts teaching Empathizes with
individual or a group and clarifies issues; rounds effectively patients and their
trainee in small groups families and trainees
challenges residents
to take responsibility
for their learning (self-
directed learning)
Utilizes various Applies teaching- Assists residents in Approachable and
teaching-learning learning strategies in preparation for case considerate
strategies Small or Large groups, presentations by
problem-based providing constructive
learning in clinical or feedback
practical settings

34 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016

Provides wise Utilizes active
counsel to the listening skills; applies
various difficulties catharsis, education
encountered and action (CEA),
professionally and counselling techniques
personally by residents
Most of the competencies for the RTC as
clinical teacher were on development of
skills to both cognitive (knowledge) and
functional (skills / motor) abilities. Referred
to as occupational competencies, there are
competencies required for performing the
specific aspects of the occupation as clinical
teacher. Since the role of the RTC as clinical
teacher is to provide assistance in a spectrum
of competencies whenever necessary from
information provider to role-model to examiner
and facilitator / counsellor, the knowledge
and motor abilities necessary to perform
these responsibilities must be made available
for the RTCs. Apart from the occupational
competencies required for a clinical teacher
Figure 4. Tetrahedron model to organize RTC competencies adapted from Milner (2011)
Manages difficult Trustworthy, sensitve;
learners and patient
dysfunctional
beahaviour in one-to-
one and small group
sessions
is the ability to communicate effectively and
to project professionalism. Hence, RTCs
should be approachable, confident, caring and
empathic to patients or trainees, and honest.
They also need to serve as as a role model
to the trainee, which is referred to as social
competency. Social competencies include, the
abilities, attitudes, and behaviors necessary
for effective interaction with others, whether
patients or residents at bedside or any clinical
setting. These competencies are closely
linked with functional competencies described
above as operational competencies which are
required for external effectiveness as an RTC.
Volume 5 Number 1 35
Majority of the role of an RTC has previously
been related to performance of managerial
tasks. Table 6 shows the domains of the
RTC as a manager-administrator. Most of the
competencies were more on functional and
social competencies focusing on development
of effective communication skills. These
are linked as operational required external
attribute to become effective as representative
of the department to other departments and
institutions. Likewise, personal competencies
reflecting internal attributes such as
industriousness, disciplined, and assertiveness
all contribute to this competency which is also
required for all faculty.

Table 6. Task analysis of the residency training coordinator as manager / administrator

Competencies of Manager/ Knowledge Skills Attitudes
administrator
Ensure that all service residents achieve the required competencies
Conducts meeting for the residency Knows and Communicates Organized;
committee and/or attend Residency applies principles effectively; applies collaborative;
Committee meetings of organizational negotiation skills when assertive;
management necessary disciplined;
idustrious;
Provides training assistance when Understands and Conducts appropriate
clear grasp of
necessary shares the entire training if necessary
institutional
curriculum and
policies; ethical
instructional design
of modules
Prepares and delivers regular/periodic Understands the Constructs and reports
progress reports to residency training residency program residency training annual
committee report process and progress reportss
Prepares accreditation requriements Understands the Prepares the residents Organized;
residency training during the accreditation collaborative;
accreditation process assertive;
process disciplined;
idustrious;
clear grasp of
institutional
policies; ethical
Motivates and fosters a collaborative Undestands the Motivates and fosters a Organized;
process that is characterized by value of leadership collaborative process collaborative;
participation, respect for differences, and motivating the assertive;
freedom of expression and consensus rest of the team disciplined;
linking faculty and trainees, and training idustrious;
programs clear grasp of
institutional
policies; ethical
Manages time efficiently and conducts Understands Practices effective time
effective meetings the value of time management
management
Demonstrates effective oral and written Understands the demonstrates effective
communication skills advocates of FM value of effective oral and written
in their respective institution communication in communication skills
the organization advocates of FM in their
respective institution

36 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016

Both role-related responsibilities of an RTC
in evaluating clinical or care management
and educational planning would require
cognitive and functional competencies related
to program or curriculum plan as well as
reflective practice. Furthermore, personal and
professional attributes such as practicing fair
judgement and being organized have been
identified as relevant in performing these role-
related responsibilities (Table 7).
Table 7. Task analysis of the residency training coordinator as evaluator
Competencies of Knowledge Skills Attitudes
Evaluator
Facilitates evaluation of residents’ performance
Assesses residents’ Developes evaluation Implements different Organized;
competence regularly tools to assess and evaluation methods sensitive culturally
monitor residents (self- assessment; when dealing
Gives residents positive
as well as residency peer, preceptor, staff with colleagues,
and negative feedback
program and patient evaluation) residents and staff;
on their progress toward
fair judgement; clear
achieving course
grasp of institutional
objectives;
policies
Councels residents to
help and develop self-
evaluation skills
Evaluates instruction
and translates
learning objectives to
competecny
Designs rewards,
incentives for good
performance
Facilitates evalution of residency training
Facilitates the Developes evaluation Implements different Organized;
evaluation of the tools to assess and evaluation methods sensitive culturally
residency curriculum monitor residents (self- assessment; when dealing
as well as residency peer, preceptor, staff with colleagues,
Revises instruction as
program and patient evaluation) residents and staff;
appropriate
fair judgement; clear
Uses evaluation grasp of institutional
information to make policies
changes in the program

Volume 5 Number 1 37
Table 8. Task analysis of the residency training coordinator as educational planner
Competencies of Knowledge Skills Aattitudes
Educational Planner
Facilitates program planning
Identifies program Understands program Facilitates fomulation and Collaborative,
problems of goals, formulates its review of program and organized
organizational issues objectives, selects its goals as relevant to
appropriate strategies trainees, writes program
to implement tasks/ plan together with
activities, understands the residency training
program management committee or faculty

Conducts instructional planning

Applies principles of Identifies issues on Conduct various adult
instructional design domains of learning- learning activities
Knowledge, Skills, and
Attitude, formualtes
objectives (KSA),
selects appropriate
adult learning
strategies, constructs
instructional design
Assesses residency Understands the
training curriculum and residency training
clinical competence curriculum and
accreditation
requirements
Innovative,
resourceful
Facilitates Innovative;
implementation industrious
and evaluation of resourceful
residency curriculum,
conducts trianing
needs assessment,
evaluation/update of
learning resources
material, regular resident
evaluation (exam &
requirements) based
of PAFP accreditation
standards

Though identified as a core competency, the
role of an RTC as a researcher is considered to
be least of the priorities. Similarly, it has been
highlighted in literature that the research role of
the RTC constitutes 10-15% of the time spent
by an RTC (Harris, 2007). This can be attributed
to the RTC being expected to perform and
prioritize implementing and looking after the
program as manager.
The RTC’s role in research at a minimum
essentially entails teaching the residents the
38 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016
skills in assessing, analyzing, and applying
latest scientific evidence into clinical decision
making. The RTC also guides residents
in adhering to published guidelines and
regulations as they conduct their own research
in fulfilment of their residency training. At the
very least the RTC is expected to perform the
competencies of a researcher whenever she is
needed to facilitate in clinical teaching rounds
or consulted by residents for their respective
research.
Table 9. Task analysis of the RTC as researcher
Competencies of Knowledge Skills Attitudes
Researcher

Demonstrates the Applies evidence Teaches skills of Organized, resourceful

practice of evidence- based medicine in accessing, analyzing,
based medicine clinical cases; applies and applying medical
clinical practice literature to clinical
guidelines practice

Creates supportive Undestands the Discovers “problems“ Organized, resourceful

research environment research principles of opportunities to
(research question learn
methods and designs)

Demonstrates good Understands good Adheres to guidelines Organized, resourceful

clinical practice clinical practice (GCP) and regulations
regarding the ethical
conducts of research
and use of human
subjects

Framework Development for Family Medicine
Residency Training Coordinators
The final competency framework developed for
family medicine RTCs follows the competency-
based curriculum (CBC) track. This curriculum
trend follows the basic patterns of curriculum
planning. Each educational question
corresponds to an educational decision
enumerated below (Sana, et al., 2010).
This study conducted a survey of all RTCs and
chief residents to determine their perceived
needs and training gaps. The survey served as
the needs assessment of target respondents.
The same survey asked respondents of the
kinds of continuing professional development
programs, continuing medical education
courses, and related support activities that
would capacitate them and meet the identified
training needs and competencies gaps. Based
on these results, the panel of experts, and
supported and complimented by documents
review identified the roles, professional
responsibilities and competency standards that
RTCs must be able to have. The same data
collection procedures were used in breaking
down these competencies into knowledge,
skills, and attitudes components. The whole
process refers to task analysis.
In competency-based curriculum, the task
analysis is done in order to distinguish not only
the terminal outcomes that the program must
achieve. By enumerating the actual knowledge,
skills, and attitudes for each role and
responsibilities, both the curriculum planners
(in this case referring to the FAMeD and the
PAFP) and the target learners (the RTCs) will
likewise be guided on inputs that must be given
to prepare the RTCs for their roles. The task
analysis also enumerates the same standards
where the RTCs can be evaluated.
RTC competencies are also congruent with and
build on those competencies set for resident
trainees in family medicine. This implies that for
the RTC learning activities and environments or
learning while on-the-job should be designed
in a way that they fully experience and practice
the knowledge, skills, and attitudes as applied
to everyday problems they encounter in
Volume 5 Number 1 39
implementing the residency training program.
Various training institutions would have
different ways of organizing for each RTC.
Consequently, a set of core competencies as
translated in the core curriculum “must-know”
should be reflected to address differences in
backgrounds of RTCs.
The competency-based curriculum has clearly
been established and supported by the PAFP
in developing the curriculum for the family
medicine residency training in the Philippines
(PAFP, 2013; STFM, 2010). Subsequently,
Article VII of the Constitution on Family and
Community Medicine Education and Training
states that the academy shall promote the
establishment of Family and Community
Medicine Residency training programs in
areas where there are existing chapters of
the organization. It shall set and uphold
the standards of training through constant
study, evaluation, and innovation. The well-
articulated curriculum learning objectives
gives a comprehensive description of many,
if not most, of the desired competencies of
a family physician which are necessary to
provide care to patients of all ages from various
backgrounds. This would eventually serve as
basis for evaluation guiding both residents and
faculty / curriculum planners to which the entire
training program and trainees are measured
against.
The PAFP follows the track of the competency-
based curriculum specifically as it strives
to attain and maintain the accreditation
standards set by the society. The academic
society continues to evolve with the demands
of the educational milieu. It also needs to
address the health care needs of the country
by establishing and expanding family and
community medicine in hospitals run by the
Department of Health (DOH). This endeavor
seeks to enhance service delivery network
with improved referral system and effective
gate-keeping in reducing the cost of health
care and rehabilitation towards the attainment
of the Sustainable Development Goals
(SDGs). It entails training competent qualified
physicians in the care of families effectively
utilizing primary care benefits focused in
40 J O U R N A L O F H U M A N E C O L O G Y : : January - December 2016
providing quality family-oriented approach. A
key element in the implementation of this DOH
partnership with the PAFP is strengthening the
competencies of the RTCs in implementing
this innovation apart from the established
PAFP residency training sub-committee on the
innovative track.
CONCLUSION AND
RECOMMENDATIONS
Based on the results of the study, from the
identified qualifications and attributes to role-
related competencies, the final competency
framework developed in performing the role
of an effective RTC follows the course of the
competency-based curriculum congruent
to that of the residency training program
established by the academic society PAFP.
This competency-based curriculum framework
is most appropriate for the RTCs, since it sets
the acceptable standards where the RTC as a
professional will be evaluated. This framework
sets the minimum competencies, in both
traditional or hospital-based and innovative
or practice-based residency training program
track, for the RTC to perform effectively the
specific role which is yet to be presented and
discussed among the various stakeholders
of the residency training program including
the PAFP Residency Family and Community
Medicine Training Committee, the residency
training institution employing the RTC, and the
RTC themselves.
The competency-based curriculum has
clearly been established and supported by
the PAFP in developing the curriculum for
the family medicine residency training in the
Philippines (PAFP, 2013; STFM, 2010). The
well-articulated curriculum learning objectives
gives a comprehensive description of many,
if not most, of the desired competencies of
a family physician which are necessary to
provide care to patients of all ages from various
backgrounds. This would eventually serve as
basis for evaluation guiding both residents and
faculty / curriculum planners to which the entire
training program and trainees are measured
against.
While traditional residency training programs
in DOH hospitals continue to provide hospital-
based family medicine residency training, the
innovative or practice-based training program
seeks to further enhance the competencies
of government rural physicians through their
practice in their respective communities
without disrupting the service delivery in their
areas.
The proposed framework can thus be used
by training institutions as a guide in selecting,
orienting, and identifying the faculty to be
groomed fit to perform the role of an effective
RTC. In the future, professional development
programs for RTCs should be designed using
this competency framework; i.e., translating
the defined five competency domains into
curricular topics to support RTCs’ attainment of
knowledge, skills, and attitudes. Consequently,
there should be policy reforms to standardize
the residency training programs including a
well-defined set of competencies for RTCs and
other faculty.
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