How do Lebanese patients perceive the ideal doctor based on the CanMEDS competency framework?

Abstract

BackgroundDuring their training, Lebanese medical students develop a high medical expertise but are not focusing on other competencies such as communication, collaboration, erudition, professionalism, leadership and health promotion. There is also insufficient data about patients’ preference for these skills. This study describes the different weights patients attribute to these physician’s competencies.MethodsThis is a cross-sectional study based on a questionnaire distributed to 133 Lebanese patients. It included 15 questions assessing how patients prioritize the physician’s competencies, with open-ended questions asking them to define “the good doctor”. Krippendorff’s alpha coefficient was used to analyze the reliability of the competencies’ classification.ResultsOne hundred twenty five patients completed the questionnaire in this cross-sectional study. Their mean age was 48 ± 16.76 years. When classifying competencies, 73.6% opted for medical expertise as first choice and 48% put communication as second. Based on the Krippendorff’s coefficient, we identified a moderate agreement for the seven choices (alpha = 0.44). In open-ended questions, patients defined the good doctor in 325 answers: 64.3% mentioned medical expertise, 34.1% high ethics and 26.2% communication.ConclusionsThis patient-centered study concurs well with the worldwide practice that puts medical expertise at the center of medical education. However Lebanese patients don’t perceive equally other competencies and favor professionalism and communication that should be integrated in priority in students’ curricula.

Competency frameworks, nursing perspectives, and interdisciplinary collaborations for good patient care: Delineating boundaries

“…Further, there is a danger that competencies become reductionistic (Reeves et al, 2009) and distract nurses from critiquing the status quo of environmental and other obstacles to the exercise of the newly gained competencies. Such less than optimal outcomes have been observed in medical education (Aoun et al, 2019;Busche et al, 2016;Giuliani et al, 2020). EPAs are new to nursing and would need to be adapted.…”

“…Besides the issue of professional formation, although each of these framework account to a certain degree for addressing ethical issues in practice, translation into actual practice settings remains challenging. Indeed, there are indications that the frameworks do not provide sufficient guidance and that clinicians struggle when confronted with ethically demanding situations in practice (Aoun et al, 2019 ; Bellini et al, 2019 ; Busche et al, 2016 ; Englander et al, 2013 ; Englander & Carraccio, 2018 ; Giuliani et al, 2020 ; Naidu et al, 2020 ).…”

The Role of EPAs in Creating a National System of Time-Variable Competency-Based Medical Education

“…[1][2][3] CanMEDS is now used in about 50 jurisdictions around the world. [4][5][6][7][8][9][10][11][12][13][14] However, despite the efforts and resources expended in supporting implementation of CanMEDS, there are challenges at the teacher-learner interface, as there would be with the use of any framework made of many competencies. 15 Trainees and teachers, while expressing support for the general ideas of the CanMEDS competencies, describe difficulty remembering all the required competencies and adapting them to specific problems and specialty practice at the bedside.…”