Educating the medical specialists : The CanMed Model Rethy K. Chhem - - PowerPoint PPT Presentation

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Educating the medical specialists : The CanMed Model

Rethy K. Chhem

Division of Human Health

Department of Nuclear Sciences and Applications

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What is CanMEDS?

• “Canadian Medical Education

Directions for Specialists.”

• Framework that seeks to answer a

fundamental question:

• “How can we best prepare physicians to

be effective in this environment and truly meet the needs of their patients?”

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History of CanMEDS

• When? Early 90s
• Why? A need to reform medical education

due to:

• the explosion of medical knowledge,
• access to medical information on the Internet,
• an increase in disruptive technologies, etc.

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CanMEDS competencies

The Royal College of Physicians and Surgeons of Canada selected:

7 general competencies for specialists

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Competencies?

• “Complex set of behaviors built on the

components of knowledge, skills, attitudes, and competence as personal ability.”

• Shift from “structure- and process-based”

curriculum to competency-based education and outcomes evaluation.

Caraccio et al, 2002

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Competencies

• focuses on performance of the end-product or

goal-state of instruction

• reflects expectations that are external to the

immediate instructional programme

• expressible in terms of measurable behaviour
• uses a standard for judging competence that is

not dependent upon the performance of other learners

• informs learners about what is expected of

them

Albanese et al, 2008

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Outcome-based education

• Development of clearly defined and published

learning outcomes that must be achieved before the end of the course;

• Design of a curriculum and learning strategies to

ensure the achievement of the learning outcome;

• Assessment process that matched to the learning
• utcomes;
• Provision of remediation and enrichment for

students as appropriate.

Harden, 2002

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What is CanMEDS?

• Framework structure: 7

thematic groups of competencies

• “Medical expert” is the

central integrative role

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• 1. Medical Expert

The physician should be able to:

• Function effectively as consultants, integrating all of the

CanMEDS Roles to provide optimal, ethical and patient- centered medical care;

• Establish and maintain clinical knowledge, skills and

attitudes appropriate to his/her practice;

• Perform a complete and appropriate assessment of a

patient;

• Use preventive and therapeutic interventions effectively;
• Demonstrate proficient and appropriate use, both diagnostic

and therapeutic skills;

• Seek appropriate consultation from other health

professionals, recognizing the limits of his/her expertise.

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• 2. Communicator

The physician should be able to:

(In relationships with patients and families, colleagues and

• ther health professionals)
• Develop rapport, trust and ethical therapeutic;
• Accurately elicit and synthesize relevant information;
• Accurately convey relevant information and explanations;
• Develop a common understanding on issues, problems and

plans.

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• 3. Collaborator

The physician should be able to:

• Participate effectively and appropriately on

an interprofessional healthcare team;

• Effectively work with other health

professionals to prevent, negotiate, and resolve interprofessional conflict.

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• 4. Manager

The physician should be able to:

• Contribute to the effectiveness of

healthcare organizations. Allocate finite healthcare resources appropriately;

• Manage his/her practice and career

effectively;

• Serve in administration and leadership

roles, as appropriate.

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• 5. Health Advocate

The physician should be able to:

• Respond to individual patient and

communities health needs;

• Identify the determinants of health of the

populations;

• Promote the health of individual patients,

communities and populations.

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• 6. Scholar

The physician should be able to:

• Contribute to the creation, dissemination,

application, and translation of new medical knowledge;

• Practice evidence-based medicine;
• Facilitate the learning of patients, families,

students, residents, other health professionals, the public.

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• 7. Professional

The physician should be able to:

• Demonstrate a commitment to her patients,

profession, and society through ethical practice; participation in profession-led regulation;

• Demonstrate a commitment to physician health

and sustainable practice.

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How to evaluate competences?

• Relevant and optimal tools for a valid and accurate

assessment

• Reliability: “a way to deliver consistent results in the

same situation time after time”

• Validity: “assessing intended knowledge, attitudes,

skills or behaviors, that are accepted as legitimate by teachers and learners”

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How to evaluate competences?

• Process should be placed in “a concrete,
• bservable learner behaviours or well-

defined components of a learner’s knowledge base”

• Role and use of portfolio learning for

personal and professional development

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Key tools for assessing the CanMEDS competencies

(Bandiera et al. 2006) Medical Expert Communi

• cator

Collabo- rator Health advocate Manager Scholar Profes- sional

• 1. Written

tests (MCQ, SAQ) +++ + ++ ++ + ++ +

• 2. Essays

++ + + +++ + + +

• 3. Oral exam

+++ + + + * * +

• 4. Direct
• bservation

and ITER +++ +++ +++ +++ +++ +++ +++

• 5. OSCE/SP

+++ +++ +++ ++ * * +

• 6. Multi-source

feedback ++ +++ +++ +++ +++ ++ +++

• 7. Portfolio

++ ++ + +++ ++ +++ +++

• 8. Simulations

+++ + +++ * ++ * ++

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Challenges for Implementation

Successful implementation of CanMEDS requires a strategy involving 4 main domains:

• 1. Standards for curriculum teaching and

assessment;

• 2. Faculty Development for CanMEDS;
• 3. Research and Development Resources;
• 4. Outreach and Communication.

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Challenges for Implementation

Inter-professional cooperation

Need to establish connections with related health professionals: technicians, nurses, chiropractors, physicians’ assistants, pharmacists.

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Challenges for Implementation

Globalization

Partnerships and collaboration across the globe by openly sharing CanMEDS intellectual property worldwide

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Thank you