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. 2023 Mar 21;14(1):4-12.
doi: 10.36834/cmej.75591. eCollection 2023 Mar.

Emerging concepts in the CanMEDS physician competency framework

Brent Thoma  1   2 , Anna Karwowska  3   4 , Louise Samson  5   6 , Nicole Labine  1 , Heather Waters  7 , Meredith Giuliani  8 , Teresa M Chan  7 , Adelle Atkinson  2   8 , Evelyn Constantin  9 , Andrew K Hall  2   3 , Carlos Gomez-Garibello  10 , Nancy Fowler  7   10 , Leon Tourian  9 , Jason Frank  3 , Rob Anderson  2   11 , Linda Snell  2   9 , Elaine Van Melle  2   12
Affiliations

Emerging concepts in the CanMEDS physician competency framework

Brent Thoma et al. Can Med Educ J. .

Abstract
in English, French

Background: The CanMEDS physician competency framework will be updated in 2025. The revision occurs during a time of disruption and transformation to society, healthcare, and medical education caused by the COVID-19 pandemic and growing acknowledgement of the impacts of colonialism, systemic discrimination, climate change, and emerging technologies on healthcare and training. To inform this revision, we sought to identify emerging concepts in the literature related to physician competencies.

Methods: Emerging concepts were defined as ideas discussed in the literature related to the roles and competencies of physicians that are absent or underrepresented in the 2015 CanMEDS framework. We conducted a literature scan, title and abstract review, and thematic analysis to identify emerging concepts. Metadata for all articles published in five medical education journals between October 1, 2018 and October 1, 2021 were extracted. Fifteen authors performed a title and abstract review to identify and label underrepresented concepts. Two authors thematically analyzed the results to identify emerging concepts. A member check was conducted.

Results: 1017 of 4973 (20.5%) of the included articles discussed an emerging concept. The thematic analysis identified ten themes: Equity, Diversity, Inclusion, and Social Justice; Anti-racism; Physician Humanism; Data-Informed Medicine; Complex Adaptive Systems; Clinical Learning Environment; Virtual Care; Clinical Reasoning; Adaptive Expertise; and Planetary Health. All themes were endorsed by the authorship team as emerging concepts.

Conclusion: This literature scan identified ten emerging concepts to inform the 2025 revision of the CanMEDS physician competency framework. Open publication of this work will promote greater transparency in the revision process and support an ongoing dialogue on physician competence. Writing groups have been recruited to elaborate on each of the emerging concepts and how they could be further incorporated into CanMEDS 2025.

Contexte: Le référentiel de compétences CanMEDS pour les médecins sera mis à jour en 2025. Cette révision arrive à un moment où la société, les soins de santé et l’enseignement médical sont bouleversés et en pleine mutation à cause de la pandémie de la COVID-19. On est aussi à l’heure où l’on reconnaît de plus en plus les effets du colonialisme, de la discrimination systémique, des changements climatiques et des nouvelles technologies sur les soins de santé et la formation des médecins. Pour effectuer cette révision, nous avons avons extrait de la littérature scientifique les concepts émergents se rapportant aux compétences des médecins.

Méthodes: Les concepts émergents ont été définis comme des idées ayant trait aux rôles et aux compétences des médecins qui sont débattues dans la littérature, mais qui sont absentes ou sous-représentées dans le cadre CanMEDS 2015. Nous avons réalisé une recherche documentaire, un examen des titres et des résumés, et une analyse thématique pour repérer les concepts émergents. Les métadonnées de tous les articles publiés dans cinq revues d’éducation médicale entre le 1er octobre 2018 et le 1er octobre 2021 ont été extraites. Quinze auteurs ont effectué un examen des titres et des résumés pour relever et étiqueter les concepts sous-représentés. Deux auteurs ont procédé à une analyse thématique des résultats pour dégager les concepts émergents. Une vérification a été faite par les membres de l’équipe.

Résultats: Parmi les 4973 articles dépouillés, 1017 (20,5 %) abordaient un concept émergent. Les dix thèmes suivants sont ressortis de l’analyse thématique: l’équité, la diversité, l’inclusion et la justice sociale; l’antiracisme; l’humanité du médecin; la médecine fondée sur les données; les systèmes adaptatifs complexes; l’environnement de l’apprentissage clinique; les soins virtuels; le raisonnement clinique; l’expertise adaptative; et la santé planétaire. L’ensemble de ces thèmes ont été approuvés comme concepts émergents par l’équipe de rédaction.

Conclusion: Cet examen de la littérature a permis de relever dix concepts émergents qui peuvent servir à éclairer la révision du référentiel de compétences CanMEDS pour les médecins qui aura lieu en 2025. La publication en libre accès de ce travail favorisera la transparence du processus de révision et le dialogue continu sur les compétences des médecins. Des groupes de rédaction ont été recrutés pour développer chacun des concepts émergents et pour examiner la façon dont ils pourraient être intégrés dans la version du référentiel CanMEDS de 2025.

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Conflict of interest statement

Thoma, Atkinson, Hall, Frank, Snell, Anderson, and Van Melle have received stipends from the Royal College of Physicians and Surgeons of Canada. Thoma also reports payments for teaching, research, and administrative work from the University of Saskatchewan College of Medicine and teaching honoraria from various institutions within the past 3 years (Harvard Medical School, the New England Journal of Medicine, the University of Cincinnati Children's Hospital, and NYC Health + Hospitals). Samson receives stipends from the Collège des médecins du Québec and the Université de Montréal. Giuliani has an unrelated conflict-of-interest with AstraZeneca and Bristol Myers Squibb. Chan reports honoraria from McMaster University for her education research work with the McMaster Education Research, Innovation, and Theory (MERIT) group and administrative stipend for her role of Associate Dean via the McMaster Faculty of Health Sciences Office of Continuing Professional Development. Chan also reports teaching honoraria from various institutions within the past three years (UBC, UNBC, Baylor College of Medicine, Harvard University, NOSM, Catholic University of Korea, Taiwan Veteran’s General Hospital, Prince of Songkla University). Waters reports honoraria and salary support for academic contributions from McMaster University. Chan and Waters have received educational research grant funding from the Royal College of Physicians and Surgeons of Canada. Fowler is a paid employee of the College of Family Physicians of Canada. Tourian receives a salary from McGill University for his administrative work as the Assistant Dean of Postgraduate Medical Education. Constantin received a stipend from the Collège des médecins du Québec as an expert advisor; she also receives a salary from McGill University for her administrative and education work within Postgraduate Medical Education as well as within the Office of International Affairs. Karwowska receives a stipend from the Association of Faculties of medicine of Canada.

Figures

Figure 1
Figure 1
Figure 1. Flow diagram outlining the articles considered within the literature scan and the title/abstract review.
See this image and copyright information in PMC

References

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