Employability as sustainable balance of stakeholder expectations - towards a model for the health professions

The conceptual complexity of employability remains a barrier for its integration into discipline-based curricula. In the health professions, a particular challenge lies in integrating employability with the dominant paradigms of competency and professionalism. In this study, we explore these contextual challenges, and present the rationale and conceptual basis for a potential re-framing of employability within the context of this discipline group. We propose a novel definition and a conceptual model of employability better aligned to the needs of health professions. While employability has proven difficult to define broadly, it is framed around the expectations of both the employer and employee, thus may be viewed as a mutual transaction of expectations, which is most sustainable when all are optimally satisfied. Given that most work contexts involve multiple stakeholders, employability is defined here from an individual's perspective as their capacity to sustainably satisfy the optimal balance of all stakeholder demands and expectations in a work context, including their own. We draw upon a scan of the literature and evidence from one health profession, veterinary science (including re-analysis of comments from a stakeholder survey), to inform a conceptual model of employability for these contexts. We propose employability is only partly comprised of skills and knowledge (human capital), and more of psychological capital spanning approaches to work, approaches to self, and approaches to others. The expectations underpinning employability are partly oriented to the work itself, and partly to the human interactions supporting it; partly to efficacy and partly to sustainability. These principles establish a matrix of five domains: effective practice, productive relationships, professional commitment, and psychological resources, plus a central element of reflective identity representing the fundamental growth process of self-awareness and identity formation. By this conception, employability is complementary to, but readily integrated with, outcomes frameworks such as competency and professionalism.