Overview
A competency indicates what a birth-breastfeeding professional is competent in, or can do to the expected level. Competency develops from acquiring knowledge, developing understanding and building skills, and adopting attitudes and behaviors that demonstrate best practice. Competency can be established from education or experience. IBBA has developed a competency framework that outlines the expected level of competency for a birth-breastfeeding professional.
The advantages of this approach include:
- Enables a developing birth-breastfeeding professional to track their progress of acquired knowledge, understanding and skills
- Enables a developing birth-breastfeeding professional to identify areas that would benefit from further study or experience
- Identifies what is expected of a developing birth-breastfeeding professional throughout their training
- Training materials and activities become goal-oriented
- Ensures that there is a clear purpose to each aspect of a training program
- Provides recognition of the key knowledge and skills required to competently carry out the role
- Provides a consistent and relevant structure to training curricula
- Competency standards lead to greater motivation and engagement
When designing a training curriculum using a competency framework, the organization begins with the end in mind– what should a birth-breastfeeding professional be competent in once they have finished their training? These are the competencies. They can then determine how they might measure that, and finally, look at how they might teach it. Every teaching activity and assignment is designed to develop or measure a competency. In order to build competency, a birth-breastfeeding professional requires core knowledge, a contextual understanding of how that knowledge affects them and their clients, skills that enable them to think critically about different situations, and attitudes and behaviors that reflect and demonstrate competency.
Essential Knowledge
Knowledge is the information needed for carrying out the role of a birth-breastfeeding professional. For example, a student can describe the stages of labor, or list the main symptoms of mastitis. You either know it, or you don’t. Underpinning knowledge is necessary to help develop understanding and skills. For example, if a professional cannot explain the role of the pelvic floor, it is then difficult to explain to a client how an epidural might affect the ability of a baby to rotate during labor.
Understanding and Skills
Understanding happens when a student makes connections between pieces of knowledge and a real-life context. For example, a student knows the hormones that influence the progress of labor and then can understand how those hormones might be affected when the birth environment is disturbed, or the optimum environment to establish for breastfeeding to be successful. It is through developing the skills of critical thinking and reflection that knowledge can be translated into understanding.
Competencies
Competencies are the attitudes and behaviors that result from the knowledge acquired together with the contextual understanding and skills developed.
For example, a birth-breastfeeding professional knows the difference between active listening techniques and competitive listening (knowledge). They recognize that active listening can help someone to feel heard and validated, and how to use active listening in a variety of contexts (understanding). They can then use these active listening skills to demonstrate valuing the importance of conflict resolution (attitudes) with a colleague or provide emotional support to a client who is grieving (behaviors). In this case, the competency is to “use active listening to ensure a client feels heard.”
The IBBA Competency Framework is simply a way of showing how a birth-breastfeeding professional will develop their knowledge, understanding and skills, and attitudes and behaviors. The framework consists of domains, competencies, indicators, and examples.
How were the competencies identified?
Identifying the competencies was done using a structured process. First, the job of each birth-breastfeeding professional was analyzed and defined using industry norms together with feedback from professionals working in the job, and clients who used the services of those professionals, through surveys and interviews. The outcomes of this analysis were sorted from those tasks perceived as most important down to least important. An analysis of the training organizations working within the industry was also carried out to determine the definitions that they used and the skills being taught.
These definitions were then broken down to determine what specific knowledge, skills, attitudes, and behaviors were required to successfully carry out the role. The competencies were then grouped together into domains or broad categories. The final step was to look at each competency and the knowledge and skills that were necessary to achieve that competency, and identify how the knowledge or skill could be assessed and evaluated. Where appropriate, the competencies and indicators were evaluated with available research to ensure they were evidence-informed.
Domains
Our competency framework groups competencies together into domains. Domains are the overarching areas that characterize a key aspect of the work of a birth-breastfeeding professional. The order they are displayed in does not relate to their importance. There are six domains:
- Ethics and Professionalism
- People
- Practical
- Leadership
- Wellbeing
- Cultural Humility
Domain 1: Ethics and Professionalism
This domain provides the competencies that relate to professional practice. It includes the legal responsibilities of the birth-breastfeeding professional, ethical behavior, safety, and client-centered care.
Domain 2: People
These are the skills related to communication with clients, their families, healthcare providers & peers. This domain includes communication skills, collaboration, conflict resolution, and reflective practice.
Domain 3: Practical
These are the skills related to carrying out the job of a birth-breastfeeding professional. They include the knowledge, understanding, and skills related to supporting clients, teaching and counseling.
Domain 4: Leadership
These are the skills related to effecting change within the industry. They include recognition of the challenges that affect the ability for system change, the birth-breastfeeding professional’s own role in being a change agent, their capacity to mentor and guide new professionals and pass on knowledge and skills.
Domain 5: Wellbeing
This domain includes the importance of self-care and developing a sustainable business. It covers how a birth-breastfeeding professional manages stress and seeks out support and mentorship within their own community. Developing a sustainable business means it has to be financially sustainable, as well as meeting the needs and respecting the values and beliefs of the business owner.
Domain 6: Cultural Humility
This domain is fundamental for all professionals. Having the ability to provide non-judgmental support to all clients and to recognize that socio-cultural influences impact the choices available to us, and the decisions we make, is a core part of providing support to clients and their families, and to establishing healthy relationships with healthcare professionals.
Standards & Competencies
Within each domain are a number of standards. Standards group together competencies that are related (e.g., “Practice within the law”).
Each standard is broken down into several competencies that outline what would be expected for a birth-breastfeeding professional to be proficient in this competency. For example, within the standard “Practices within the law” is a competency that states “Applies legal parameters to practice.” Within each competency, there are a series of indicators. These are more detailed aspects of what you would expect to see in a proficient birth-breastfeeding professional. For example, one of the indicators for “Applies legal parameters to practice” is “Comply with regional and national requirements for establishing a business.” In each section, you will find all the competencies laid out with examples of what indicators would identify competency. This section can be helpful to training organizations who would like to develop their curricula to be competency-based.
Standards and competencies will be different for each type of professional. For example, competencies related to knowledge on preconception will be relevant to an infertility counselor, while competencies on the postpartum period will be relevant to a postpartum doula or a lactation consultant.
Levels of Competency
Much of what we learn as professionals comes from experience – working with families and learning “on the job.” It would be unrealistic to expect a new doula, for example, to be competent in a broad range of skills after attending a two-day workshop and supporting two clients through labor and birth. The same applies to postpartum doulas, childbirth educators, and breastfeeding counselors. In order to address this, we identify the different levels of competency and outline examples of what would be expected.
Foundation
A new birth-breastfeeding professional is acquiring vast amounts of knowledge. They are beginning to contextualize this – in other words, to understand how this knowledge applies to their own communities and the clients they will work with. The focus is on learning and developing on the job experience. Those at this level are building their knowledge of terminology, concepts, and principles. Typically, a birth professional would be expected to have achieved foundation level competencies following a workshop and a minimal amount of client support.
Core
This level of competency comes after learning new knowledge, working with clients to develop their skills, and reflecting on their practice and experiences. A training program that certifies professionals should ensure that students gain enough knowledge and experience, have opportunities to practice reflection, and receive ongoing feedback from a trainer or mentor, in a way that enables them to achieve this level of competence by the time they are certified. The focus at this level is on enhancing knowledge and skills and applying them appropriately. While they may sometimes need guidance from someone more experienced, they can usually perform their job independently. Typically, a birth professional would achieve core competencies when they completed a workshop and are now well-established in their work, or when they have completed a comprehensive training program.
Advanced
A birth-breastfeeding professional with an advanced level of competence is the person that those with less experience or knowledge seek out for advice or guidance. They have moved beyond the basics of their work and are able to mentor. The focus is on broader issues and demonstrating strong leadership in their field within their own communities. They are beginning to advocate for improvements in the industry and developing an in-depth knowledge on specific topics that affect their clients. Typically, a birth-breastfeeding professional who has achieved advanced competency would be mentoring or training others in their area of expertise.
Expert
This is the highest level of competence. They are the “go-to” person when guidance is needed. The expert takes a more strategic approach to their work and is often at the forefront of driving change within their community. They are skilled in seeking out evidence-based information, analyzing it and communicating it to others. They take a broad perspective and are skilled in communicating across different professional groups, understanding and recognizing the perspective of a range of professionals. Typically, a birth-breastfeeding professional who has achieved expert competency is a leader in the industry and provides guidance to other organizations or institutions on best practice.
Training Programs and Competency Levels
A program that is training professionals should clearly state the level of competence that their program is designed to address. Such a program should identify how achievement of the competencies is measured and evaluated. Those studying through such a program should be able to track and monitor their achievement of the different competencies and be able to identify where they have gaps, and how these can be addressed.
Tracking and Monitoring Competency
IBBA provides tools for professionals to track and monitor their competency. Each professional can develop their own personal competency map, enabling them to identify areas that can be developed and different ways they can achieve the competency.
