An innovative approach to identifying learning needs for intrinsic CanMEDS roles in continuing professional development

Figures & data

Table 1. Overall demographic description of study participants.

Responses		N (%)
Gender
	Male	231 (56)
	Female	162 (39)
	Prefer not to answer	18 (4)
Geographic location
	Geographically isolated	3 (1)
	Small town	42 (10)
	Suburban	41 (10)
	Urban	315 (77)
	Other	10 (2)
Specialty
	Medical	296 (72)
	Surgical	115 (28)
Years in practice
	First year in practice	28 (7)
	1–5 years	74 (18)
	6–10 years	59 (14)
	11–15 years	55 (13)
	16–20 years	44 (11)
	21–25 years	42 (10)
	>25 years	109 (27)
Total		411 respondents

Table 2. Summary of major themes for each intrinsic CanMEDS role that emerged from comments with illustrative quotes.

	Learning needs	Challenges in practice
Communicator	Theme: Difficult conversations ‘Difficult code-status discussions’ ‘Dilemma in clinical communication’ ‘Dealing with difficult patients’	Theme: Personality attributes of patients and/or families ‘Difficult patients, i.e., verbally abusive, threatening harm to others’ ‘Management of hostile patients’ ‘Complex family making it difficult to treat’ Theme: Unrealistic expectations or requests ‘Demands of patients/families for tests/treatments not available’ ‘Dealing with families unrealistic expectations for terminal illness’ Theme: Patient noncompliance ‘Non-compliant patient failing to attend appointments’ ‘DM pt [sic] refuses to take medication’ Theme: Balancing multiple perspectives ‘Balancing family wishes and patient wishes with a patient with Huntington’s’ ‘Disagreement in management between parents’
Professional	Theme: Physician well-being ‘Maintaining motivation and preventing burnout’ ‘Physician self-care’ ‘Managing stress, time and work-life balance’ Theme: Ethical and medicolegal aspects of practice ‘Ethics of physician assisted suicide’ ‘Ethics and end of life care’ ‘Occupational medicine and the law’	Theme: Ethical and medicolegal aspects of practice ‘Ethics of physician assisted suicide’ ‘Ethics of surrogacy’ ‘Medico-legal frameworks governing practices’ ‘Highly litigious patient making unreasonable requests’
Collaborator	Theme: Interprofessional health care ‘Interprofessional collaboration’ ‘Integrated health care’	Theme: Conflict resolution and management ‘Disagreeing with management of consultant’ ‘Colleague power struggles’ ‘Interprofessional conflicts’ Theme: Transitions of care ‘When and where to transfer an epilepsy patient to adult care’ ‘Elderly patient with cardiac disease and fractured hip – come to operating room with medical clearance but not full cardiac workup’ ‘Patients sent for admission who do not need admission’
Health Advocate	Theme: Promoting healthy behaviors ‘Healthy lifestyle and metabolic factors’ ‘Integration of socioeconomic improvements and health’ “ACL injury prevention Theme: International aspects of health care ‘Medicine in the developing world’ ‘Newborn care in developing areas of the world’ ‘International health and surgery’	Theme: Accessing resources ‘Patients cannot buy meds’ ‘pt [sic] with ALS and chooses invasive ventilation and struggle to get resources to support him’ ‘Lack of resources for palliative patients in the community’ Theme: Social determinants of health ‘Multisystem ill patient with complex social situation’ ‘Complicated psychosocial environment’ Theme: Promoting healthy behaviors ‘Promoting weight loss’ ‘Getting patients to ambulate’
Leader	Theme: Leadership skills ‘Leadership skills development’ ‘Medical leadership and administration’ Theme: Practice management ‘Business administration’ ‘Running an office’ Theme: Budgeting and financing ‘Health care insurance’ ‘Billing practices for surgeons’	No clear themes, example quotes: ‘Bringing about change’ ‘Resources in hospitals’ ‘Raising awareness of overuse in antimicrobials’
Scholar	Theme: Educational practices ‘Giving effective feedback/evaluation to learners’ ‘Teaching strategies within a busy clinical practice’ ‘Curriculum development for medical students’ Theme: Research and scholarship ‘Network meta-analysis’ ‘Advanced RCTs’ ‘Successful grant applications’ Theme: Evidence informed decision making ‘Implementation of clinical practice guidelines’ “Establishing guidelines of axillary lymph node management for breast cancer patients	Theme: Research and scholarship ‘Conducting multinational RCTs’ ‘Grants preparation’

Figure 1. Content analysis of intrinsic CanMEDs roles obtained from response to open-ended questions aimed at identifying perceived learning needs and challenges encountered in clinical practice.