Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada.
Med Educ. 2009 Aug;43(8):741-8. doi: 10.1111/j.1365-2923.2009.03404.x.
Despite the fact that Canadian residency programmes are required to assess trainees' performance within the context of the CanMEDS Roles Framework, there has been no inquiry into the potential relationship between residents' perceptions of the framework and their in-training assessments (ITA). Using data collected during the study of ITA, we explored residents' perceptions of these competencies.
From May 2006-07, a purposive sample of 20 resident doctors from internal medicine, paediatrics, and surgery were interviewed about their ITA experiences. Data collection and analysis proceeded in an iterative fashion consistent with grounded theory. In April 2008, a summary of recurrent themes was presented during a focus group interview of another five residents to afford further elaboration and refinement of thematic findings.
The in-training assessment report (ITAR) was perceived as a primary source of residents' information on CanMEDS. Residents' familiarity with the set of competencies appeared to be quite limited and they possessed narrow definitions of the roles. Several trainees questioned the framework's relevance and some appeared confused about the overlapping nature of the roles. Although residents viewed the central Medical Expert role as the most relevant and important competency, they incorrectly perceived it as only involving the acquisition of medical and scientific knowledge. A visual rhetorical analysis of a typical ITAR suggests that the visual features found within this assessment tool may be misrepresenting the framework and the centrality of the Medical Expert role.
Resident doctors' knowledge of CanMEDS was found to be limited. The visual structure of the ITAR appears to be a factor in residents' apparent distortion of the CanMEDS construct from its original holistic philosophy.
尽管加拿大住院医师培训计划要求根据 CanMEDS 角色框架评估学员的表现，但尚未研究学员对该框架的看法与他们的培训评估（ITA）之间是否存在潜在关系。本研究利用 ITA 研究期间收集的数据，探讨了住院医师对这些能力的看法。
2006-07 年 5 月，从内科、儿科和外科随机抽取 20 名住院医师进行 ITA 经验访谈。数据收集和分析采用与扎根理论一致的迭代方式进行。2008 年 4 月，在对另外 5 名住院医师进行的焦点小组访谈中，介绍了反复出现的主题的摘要，以进一步阐述和完善主题发现。
培训评估报告（ITAR）被视为住院医师了解 CanMEDS 的主要信息来源。住院医师对能力组的熟悉程度似乎非常有限，他们对角色的定义也很狭窄。一些学员质疑该框架的相关性，有些人似乎对角色的重叠性质感到困惑。尽管住院医师认为核心的医学专家角色是最相关和最重要的能力，但他们错误地认为它只涉及医学和科学知识的获取。对典型 ITAR 的视觉修辞分析表明，该评估工具中的视觉特征可能会歪曲框架和医学专家角色的核心地位。
住院医师对 CanMEDS 的了解有限。ITAR 的视觉结构似乎是住院医师对 CanMEDS 结构从其原始整体哲学中明显扭曲的一个因素。
