What competencies should community

What competencies should community-based rotations
address? A Delphi study in Endocrinology and
Metabolism
Adam Millar, MD, MScCH
Supervisor: Rene Wong, MD, MMEd
University of Toronto
October 19, 2012
I had an affiliation (financial
or otherwise) with a
pharmaceutical, medical
device or communications
organization. I have acted
as a consultant to Paladin
Labs.
J’ai (ou j’ai eu) une affiliation
(financière ou autre) avec une
entreprise pharmaceutique, un
fabricant d’appareils médicaux
ou un cabinet de
communication.
Adam Millar, MD, MScCH
Supervisor: Rene Wong, MD, MMEd
University of Toronto
October 19, 2012
What competencies should community-based rotations address? | Adam Millar
Take-home point
• Community-based rotations may have
better opportunities in which to learn
CanMEDS Manager Roles
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What competencies should community-based rotations address? | Adam Millar
Background
• Royal College – “Community Experience”
• No consensus on what this entails
• Heterogeneity of community experience
• Delphi Method – Consensus-gathering tool
• Both qualitative and quantitative portions
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What competencies should community-based rotations address? | Adam Millar
Our Representation
• Endo. Program Director: 6
• Community
endocrinologist: 3
• Recent endo. Grad.: 3
3 1
• Endo. resident: 6
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3
5
What competencies should community-based rotations address? | Adam Millar
Qualitative Round
“Please list the competencies/skills for which you
think community endocrine rotations would
provide the best learning opportunities over that
of an academic centre”
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What competencies should community-based rotations address? | Adam Millar
Quantitative Rounds
•
“Rate the extent to which a community endocrine
rotation would provide better learning opportunities over
that of an academic centre”
Not learned in a community rotation (best learned
in academic centre) ( score = 1/5)
…
Best learned in a community rotation (score = 5/5)
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What competencies should community-based rotations address? | Adam Millar
Results – After 5 Survey Rounds
• Of original 44 competencies, 34 deemed essential
by panel
• Highest rated items – “Manager” role
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What competencies should community-based rotations address? | Adam Millar
Results – Highest Rated Competencies
• Describe what to look for in a potential office
space for an outpatient endocrinology practice
• Discuss principles of how to negotiate a lease for
office space
• Describe strategies to advertise your practice to
referring physicians when starting a practice
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What competencies should community-based rotations address? | Adam Millar
An opportunity exists
• Literature - teaching of “Manager” roles deficient
across Canadian training programs:
» Internal medicine (Card, Snell & O'Brien 2006)
» Pediatrics (Lieberman, Hilliard 2006)
• American training programs - only 3% of medicine
subspecialties respondents believed preparation to
“manage business aspects of practice” was
good/excellent (Cantor, Baker & Hughes 1993)
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What competencies should community-based rotations address? | Adam Millar
Conclusions
1. Manager Roles often not learned effectively
2. Many “Manager” competencies may better be
learned in community setting
3. Results can be extrapolated towards
development of community rotations in other
subspecialties
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What competencies should community-based rotations address? | Adam Millar
Take-home point
• Community-based rotations may have
better opportunities in which to learn
CanMEDS Manager Roles
The International Conference on Residency Education
|
La conférence internationale sur la formation des résidents
12
What competencies should community-based rotations address? | Adam Millar
Next Steps
• Has been shared with Canadian Endocrine PDs –
use this info for curriculum mapping
• Use this information about Manager Role
towards faculty development:
» Teaching
» Assess performance
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What competencies should community-based rotations address? | Adam Millar
Thank you!
• [email protected]
• Full list of 34 competencies
http://www.royalcollege.ca/portal/page/portal/rc/canmeds
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