The 'missing person' in roles-based competency models: a historical, cross-national, contrastive case study

Area of Science:

• Medical Education
• Health Professions Education
• Competency Frameworks

Background:

• Role-based frameworks, like CanMEDS, are popular in health professions education.
• The inclusion and exclusion of the 'physician as person' role in these frameworks are historically and culturally influenced.
• Analyzing role nomenclature provides insight into the construction of professional roles.

Purpose of the Study:

• To examine the implications of including or excluding the 'physician as person' role in competency frameworks.
• To analyze how cultural and historical contexts shape the conceptualization of physicians' roles.
• To understand the impact of language choices in professional role development.

Main Methods:

• Contrastive analysis of competency framework development in Canada and the Netherlands.
• Application of critical social science theories, focusing on the power of language.
• Examination of historical and cultural factors influencing role definitions.

Main Results:

• The 'physician as person' role was added late and then excluded from the Canadian CanMEDS framework.
• Dutch medical programs adopted CanMEDS and added a 'reflector' role to emphasize the trainee's personhood.
• This highlights differing approaches to integrating the physician's personal dimension into training.

Conclusions:

• Choices in role naming reflect cultural and historical contexts in medical education.
• The variable inclusion of the 'person' role suggests a need to reconsider how trainees' personhood is integrated into curricula and assessments.
• Medical educators should consciously address the visibility of the physician as a person in training.