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Toward a family medicine capability framework for Canada: From competence to capability
Monica Aggarwal1, Geoff Scott2, Ross E G Upshur3
1Assistant Professor in the Dalla Lana School of Public Health and the Department of Family and Community Medicine (DFCM) at the University of Toronto in Ontario.
Objective:
To inform the development of a Family Medicine (FM) Professional Capability Framework by examining the competencies and capabilities of high-performing family physicians (FPs).
Design:
A mixed-methods explanatory sequential study using a survey and focus groups.
Setting:
Ontario.
Participants:
Overall, 54 high-performing early-career FPs participated in the survey; and 21 FPs, educators, or leaders participated in the focus groups.
Main Outcome Measures:
To identify the 25 top-ranking competencies and capabilities of high-performing FPs.
Results:
The 25 top-ranking attributes of high-performing FPs were predominantly a set of personal, interpersonal, and cognitive capabilities. There was overwhelming consensus among focus group experts on the key capabilities and competencies for successful practice, thus validating the FM Professional Capability Framework. FPs reported not being equipped with specific competencies such as business management and leadership, personal capabilities (tolerating uncertainty and ambiguity, remaining calm under pressure, willingness to persevere when things go awry, and ability to make hard decisions), interpersonal capabilities (understanding how different groups operate in organization and influence situations, ability to communicate effectively and resolve conflicts, how to work in diverse teams), and intellectual capabilities (diagnostic, critical, and creative thinking, and self-reflection).
Conclusion:
FPs report that the FM residency training is not sufficiently developing key competencies and capabilities for successful practice. The FM Professional Capability Framework can be used to augment existing physician competency frameworks to drive enhancements in curriculum design, teaching, learning, assessment, and certification. This approach has the potential to foster the development of a robust FP workforce that can effectively respond to, adapt to, and successfully navigate unfamiliar and complex situations, settings, and populations, thereby enhancing physician resilience and the delivery of comprehensive, patient-centred care in an age of uncertainty and accelerating change.
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