《CanMEDS 医师能力框架中的新兴概念》。
Emerging concepts in the CanMEDS physician competency framework.
机构信息
University of Saskatchewan, Saskatchewan, Canada.
Royal College of Physicians and Surgeons of Canada, Ontario, Canada.
出版信息
Can Med Educ J. 2023 Mar 21;14(1):4-12. doi: 10.36834/cmej.75591. eCollection 2023 Mar.
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.
背景
CanMEDS 医师能力框架将于 2025 年进行更新。此次修订正值 COVID-19 大流行以及人们越来越认识到殖民主义、系统性歧视、气候变化和新兴技术对医疗保健和培训的影响，导致社会、医疗保健和医学教育发生颠覆和转型之际。为了为此次修订提供信息，我们试图确定文献中与医师能力相关的新兴概念。
方法
新兴概念被定义为与医师角色和能力相关的文献中讨论的观点，这些观点在 2015 年 CanMEDS 框架中缺失或代表性不足。我们进行了文献扫描、标题和摘要审查以及主题分析，以确定新兴概念。从 2018 年 10 月 1 日至 2021 年 10 月 1 日期间，在五本医学教育期刊上发表的所有文章的元数据都被提取出来。15 名作者对标题和摘要进行了审查，以确定和标记代表性不足的概念。两名作者对结果进行了主题分析，以确定新兴概念。进行了成员检查。
结果
在纳入的 4973 篇文章中有 1017 篇（20.5%）讨论了一个新兴概念。主题分析确定了十个主题：公平、多样性、包容和社会正义；反种族主义；医师人文主义；数据驱动医学；复杂适应系统；临床学习环境；虚拟护理；临床推理；适应专长；和行星健康。所有主题都得到了作者团队的认可，被认为是新兴概念。
结论
本次文献扫描确定了十个新兴概念，为 2025 年 CanMEDS 医师能力框架的修订提供了信息。这项工作的公开出版将提高修订过程的透明度，并支持对医师能力的持续对话。已经招募了写作小组来详细阐述每个新兴概念，以及如何将其进一步纳入 CanMEDS 2025。
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