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Prognosis: the "missing link" within the CanMEDS competency framework.

Vincent Maida1, Paul M Cheon

  • 1University of Toronto, 101 Humber College Boulevard, 9th Floor, Toronto, Ontario M9V 1R8, Canada. vincent.maida@utoronto.ca.

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Physician competency frameworks like CanMEDS show a significant lack of content on prognosis. This study found minimal inclusion of prognosis, highlighting a need to integrate this essential skill into medical education and physician training.

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Area of Science:

  • Medical Education
  • Physician Competency Frameworks

Background:

  • Prognosis, a historically vital medical skill, has diminished in modern practice due to advances in diagnostics and therapeutics.
  • Medical curricula and physician competency frameworks currently lack sufficient focus on prognosis.
  • This deficiency impacts the development of essential physician skills.

Purpose of the Study:

  • To quantitatively assess the extent of prognosis-related content within the CanMEDS (Canadian Medical Education Directives for Specialists) physician competency framework.
  • To identify specific deficiencies in the inclusion of prognosis across various medical specialties and physician roles.

Main Methods:

  • A quantitative content analysis was performed on the CanMEDS 2005 framework documents for 29 specialties and 37 subspecialties.
  • Keyword scanning software (Foxit Reader 5.1) was used to search for terms: prognosis, prognostic, prognosticate, and prognostication.
  • Analysis covered all seven physician roles: Medical Expert, Communicator, Collaborator, Manager, Health Advocate, Scholar, and Professional.

Main Results:

  • Only 20.7% of specialties and 43.2% of subspecialties contained "prognosis" citations.
  • The terms "prognosticate" and "prognostication" were entirely absent from all documents.
  • Prognosis-related keywords were predominantly associated with the Medical Expert (80.3%) and Scholar (11.5%) roles.

Conclusions:

  • The CanMEDS framework demonstrates significant deficiencies in addressing prognosis, a fundamental aspect of medical practice.
  • Physicians need enhanced training in the formulation and communication of prognosis.
  • Recommendations are made to address these shortcomings in future iterations of competency frameworks, such as the updated CanMEDS version.