Background:
The new Swiss postgraduate medical training largely inspires from the "CanMEDS framework". Since controversy exists regarding transferability of general competencies in different social and political settings, we undertook to determine, in the Swiss internal medicine (IM) hospital setting, 1) how front-line clinicians define competencies expected of residents at the end of their postgraduate training , 2) how they weight the importance of roles defined in the CanMEDS.
Summary of Work:
Mixed qualitative-quantitative study, among a purposive sample of faculty/attendings, chief residents, and residents at two large urban IM departments in Switzerland. 33 physicians participated in six semi-structured focus groups and completed a questionnaire. Transcriptions of tape-recorded discussion were coded by two independent researchers. We used for the analysis a partial "Grounded theory" approach.
Summary of Results:
Participants: 9 attending, 13 senior residents or chief residents and 11 junior residents. Participants' definition of competence included statements amenable to all seven CanMEDS roles. No new role was found. Nevertheless when exposed to the Canadian definitions physicians weighted the "Medical Expert", "Communicator", "Collaborator", "Professional" and "Scholar" roles as most relevant to an in-patient internal medicine rotation. Conversely items which define the "Manager" and "Health Advocate" roles were judged as least relevant. Qualitative and quantitative analyses support both those findings, independently from the physician status.
Conclusions:
Implementation in the Swiss internal medicine context of a curriculum inspired from the Canadian framework CanMEDs is feasible. Nevertheless, adjustments are needed in the description of some roles and competencies in order to make them acceptable and understandable for both the trainees and the clinical supervisors.
Take home message:
The CanMEDS framework is transferable in contexts other than the Canadian.