Integrated and implicit: how residents learn CanMEDS roles by participating in practice

Area of Science:

• Medical Education Research
• Competency-Based Medical Education
• Residency Training

Background:

• Competency frameworks like CanMEDS aim to enhance residency training outcomes.
• However, their practical application in daily workplace learning and supervisor-resident interactions is not well understood.

Purpose of the Study:

• To explore how the CanMEDS framework influences residents' practice-based learning and their interactions with supervisors.

Main Methods:

• A constructivist grounded theory approach was employed.
• Data collection involved direct observations and formal/field interviews with residents and supervisors.
• Analysis utilized sensitizing insights from communities of practice theory for a social learning perspective.

Main Results:

• CanMEDS roles were integrated and often implicit, with its terminology not adopted in clinical practice.
• The framework had limited influence compared to other factors like patient records.
• Residents' peripheral positions hindered learning of Health Advocate and Leader roles.

Conclusions:

• The CanMEDS framework did not explicitly guide practice or interactions, lacking a common language for performance discussions.
• Its actual impact on resident learning trajectories and feedback conversations remains uncertain.
• Integrating competency frameworks into complex practice-based learning is challenging.