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Table 3 The definitive competence inventory as confirmed by the experts in the last Delphi round

From: A Delphi study to construct a CanMEDS competence based inventory applicable for workplace assessment

CanMEDS role Key competence
Medical Expert * has insight in required medical knowledge with regard to a clinical problem, i.e.:
the student applies the acquired knowledge
  applies medical decision making
  * efficiently applies acquired medical skills with regard to a clinical problem
  * accomplishes a health care plan:
  performs a relevant and adequate intake and anamnesis
  performs an efficient physical or other examination
  generates a differential diagnosis
  efficiently gathers, analysis, and interprets data (from anamnesis, physical examination, and technical investigations)
  generates an accurate diagnosis
  presents efficient treatment plans
  * generates an accurate, multidisciplinary health care plan with specific attention for patient’s self care and follow up care
  * defines symptoms of the most common and critical diseases and recognises alarm symptoms (also for differential diagnosis)
  * integrates the different CanMEDS roles
Communicator * clearly and understandable reports a relevant, complete, systematic and accurate intake and anamnesis
the student * writes reports concerning patients encounters in the medical record and in referral letters to other health care providers
  * can manage a patient record, and clearly and structurally provides (all) the information to other health care providers.
  * verbally reports on patients encounters to other doctors and health care providers
  * communicates scientific research in a clear, complete and structural way
  * communicates during a patient’s encounter according to the rules of good practice
  * establishes (and maintains) an empathic, trustful and ethical doctor-patient relationship and doctor-family relationship
  * reflects on own communication skills and their progression
Collaborator * knows and involves the profile and competences of other health care providers
  * actively takes part in team work
the student * effectively contributes to the interdisciplinary teamwork concerning patient care, education and research
  * integrates following aspects with regard to team work:
  taking and giving responsibility
  delegating and organising
  giving and taking suggestions to/of other health care providers
  supporting the “chain-of-care” (increasing effective team work)
  coping with conflicts between professionals
  * reflects on teamwork and on respecting the opinions of other team members
Manager * reflects on self-care and the balance between work and personal development (work/private time management)
the student * ranks information in order of importance and urgency; responsibly prioritises, and motivates priorities (professional time management)
  * correctly and punctually deals with administrative and organisational tasks
  * registers, classifies, and transfers patient related data in an effective (and trustful) way
  * uses information technology to:
  optimise patient care and practice organisation – (patient related databases)
  stimulate “life long learning” – (medical databases)
  * can work within the health care system and other care systems (welfare, justice) in Belgium
  * has insights in costs of medical care and their implication for society, patients and medical doctors
  * has insights in procedures for solicitations and contractual negotiations
Health advocate * reflects on: psychological, social, economical, biological, ethical, cultural, and religious aspects influencing patients’ health
the student * attends to the individual patient and the population regarding health-related aspects (primary prevention)
  * deals with prevention and health promotion for the individual patient and the population (secondary prevention)
  * has attention for patient safety
  * efficiently accompanies patients through the health care system and reasons in support of a decision making
  * prioritises the patient’s benefits
  * involves and facilitates the accessibility of health care during daily practice, especially for vulnerable groups of patients
  * reflects on critical incidents in doctor’s practice
Scholar * poses relevant, practical and scientific questions with regard to patient care
the student * performs searches in medical scientific databases/sources in an efficient, purposeful and rapid way
  * questions the quality of consulted medical scientific databases/sources
  * adequately applies scientific information in decision making in doctor’s practice
  * development and follow up of a personal learning plan
  can critically reflect on daily performance in the doctor’s practice
  describes and analyses own personal learning needs
  applies an adequate learning method
  self evaluates or evaluates with peers his learning results and remediates
  * assists in creating, spreading, and applying new medical knowledge and practice
  * stimulates training of patients, family, students, trainees, other health care workers, population
  * adapts his functioning to societal evolutions in health care
  * is open-minded towards “life long learning”
Professional * utilises the highest quality of care for his patient in an integral, upright and ethical way
the student * understands the meaning of and applies:
  professional codes
  ethical codes and dilemmas (= uses an ethical frame)
  legal codes
  * reflects on
  own behaviour
  own professional attitude: shows willingness to offer medical care in an optimal, ethical, and patient centred way
  attitude and behaviour of others and evaluates this for himself
  legal implications of patient care (patient rights, professional secrecy or professional confidentiality, DNR-codes, end-of-life coaching)
  professional, ethical and legal codes
  * has an appropriate professional attitude and behaviour, demonstrating
  understanding, empathy
  and remediates (himself) when needed
  * recognises his own limits, weaknesses or lacunas and can cope with these