title: Competencies in Swedish emergency departments - The practitioners' and managers' perspective.
abstract: The task of emergency departments (EDs) is to provide safe emergency healthcare while adopting a caring, cost-effective approach. Patients attending EDs have different medical and caring needs and it is assumed that practitioners have the requisite competencies to meet those needs. The aim of the present study is to explore what kind of competencies practitioners and managers describe as necessary for the practitioners to perform their everyday work in EDs.
  
  
  METHODS
  This study used a qualitative, exploratory design. Interviews were conducted in two EDs. Data were analysed using inductive content analysis.
  
  
  RESULTS
  The competence focus in everyday work in EDs is on emergency and life-saving actions. There is a polarisation between medical and caring competencies. There is also tension between professional groups in EDs as well as hierarchical boundaries that influence the ability to develop competencies in everyday work. Medical competencies are valued more and caring competencies are subsequently downgraded. A medical approach to competencies consolidates the view of necessary competencies in everyday work in EDs.
  
  
  CONCLUSIONS
  The study shows that the competencies that are valued consolidate the prevailing medical paradigm. There is a traditional, one-sided approach to competencies, a hierarchical distinction between professional groups and unclear occupational functions.
authors.affiliation: University of Gothenburg, Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden; University of Borås, School of Health Sciences, SE-501 90 Borås, Sweden. Electronic address: henrik.andersson@hb.se.
authors.forename: Henrik
authors.initials: H
authors.lastname: Andersson
authors.affiliation: University of Borås, School of Health Sciences, SE-501 90 Borås, Sweden.
authors.forename: Birgitta Wireklint
authors.initials: BW
authors.lastname: Sundström
authors.affiliation: University of Gothenburg, Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Nilsson
authors.affiliation: University of Gothenburg, Sahlgrenska Academy, Institute of Health and Care Sciences, Göteborg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Jakobsson Ung
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D013548:Sweden
keywords: Competencies; Emergency healthcare; Everyday work; Qualitative content analysis