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Renting N, Dornan T, Gans RO, et al. What supervisors say in their feedback: construction of CanMEDS roles in workplace settings. Adv Health Sci Educ Theory Pract. 2015;21(2):375-87doi: 10.1007/s10459-015-9634-9.
Renting, N., Dornan, T., Gans, R. O., Borleffs, J. C., Cohen-Schotanus, J., & Jaarsma, A. D. (2016). What supervisors say in their feedback: construction of CanMEDS roles in workplace settings. Advances in health sciences education : theory and practice, 21(2), 375-87. https://doi.org/10.1007/s10459-015-9634-9
Renting, Nienke, et al. "What supervisors say in their feedback: construction of CanMEDS roles in workplace settings." Advances in health sciences education : theory and practice vol. 21,2 (2016): 375-87. doi: https://doi.org/10.1007/s10459-015-9634-9
Renting N, Dornan T, Gans RO, Borleffs JC, Cohen-Schotanus J, Jaarsma AD. What supervisors say in their feedback: construction of CanMEDS roles in workplace settings. Adv Health Sci Educ Theory Pract. 2016 May;21(2):375-87. doi: 10.1007/s10459-015-9634-9. Epub 2015 Sep 05. PMID: 26342599; PMCID: PMC4801985.
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Adv Health Sci Educ Theory Pract. 2016 May;21(2):375-87. doi: 10.1007/s10459-015-9634-9. Epub 2015 Sep 05.

What supervisors say in their feedback: construction of CanMEDS roles in workplace settings.

Advances in health sciences education : theory and practice

Nienke Renting, Tim Dornan, Rijk O B Gans, Jan C C Borleffs, Janke Cohen-Schotanus, A Debbie C Jaarsma

Affiliations

  1. Center for Educational Development and Research in Health Professions, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands. [email protected].
  2. Centre for Medical Education, Queen's University Belfast, Belfast, UK.
  3. Department of Education Development and Research, Maastricht University, Maastricht, The Netherlands.
  4. Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
  5. Center for Educational Development and Research in Health Professions, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.

PMID: 26342599 PMCID: PMC4801985 DOI: 10.1007/s10459-015-9634-9

Abstract

The CanMEDS framework has been widely adopted in residency education and feedback processes are guided by it. It is, however, only one of many influences on what is actually discussed in feedback. The sociohistorical culture of medicine and individual supervisors' contexts, experiences and beliefs are also influential. Our aim was to find how CanMEDS roles are constructed in feedback in a postgraduate curriculum-in-action. We applied a set of discourse analytic tools to written feedback from 591 feedback forms from 7 hospitals, including 3150 feedback comments in which 126 supervisors provided feedback to 120 residents after observing their performance in authentic settings. The role of Collaborator was constructed in two different ways: a cooperative discourse of equality with other workers and patients; and a discourse, which gave residents positions of power-delegating, asserting and 'taking a firm stance'. Efficiency-being fast and to the point emerged as an important attribute of physicians. Patients were seldom part of the discourses and, when they were, they were constructed as objects of communication and collaboration rather than partners. Although some of the discourses are in line with what might be expected, others were in striking contrast to the spirit of CanMEDS. This study's findings suggest that it takes more than a competency framework, evaluation instruments, and supervisor training to change the culture of workplaces. The impact on residents of training in such demanding, efficiency-focused clinical environments is an important topic for future research.

Keywords: CanMEDS; Competency-based medical education; Discourse analysis; Feedback; Patient-centred care; Postgraduate training; Residency; Workplace learning

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