Intern preparedness for the CanMEDS roles and the Dunning-Kruger effect: a survey

Abstract

BackgroundThe purpose of this study was to determine whether the first cohort of graduates from a new undergraduate medical programme in Botswana were adequately prepared for internship.MethodsThe authors surveyed 27 interns and 13 intern supervisors on site, who rated intern preparedness for 44 tasks using a previously validated instrument. Tasks were grouped according to the seven roles of the physician in the CanMEDS framework and Cronbach α values confirmed internal consistency. To determine the direction of differences between intern and supervisor ratings for tasks Likert scale ratings were treated as interval data and mean scores calculated. Rating frequencies for each role were compared using the χ2 statistic. Reasons for differences between intern and supervisor ratings were explored by determining correlations between scores using the Spearman ρ statistic, and analysing qualitative data generated by the questionnaire.ResultsPreparedness for all seven roles and the majority of tasks was found to be between ‘Fairly well prepared’ and ‘Well prepared’. The ratings for four roles (Medical expert, Communicator, Collaborator, Professional) differed statistically, but not for the three others (Leader, Health advocate, Scholar). Interns rated their proficiency higher than their supervisors for the tasks in six roles; for the ‘Professional’ role intern ratings were mostly lower. Correlations between intern and supervisors scores were only significant for three roles (Medical expert, Communicator, Collaborator). Qualitative data provided further insights into the reasons for these associations.ConclusionsIntern preparedness for tasks and roles varied but was generally satisfactory. Based on the analysis of the data seeming discrepancies in between interns and supervisor ratings were investigated and explanations are offered. For three roles the data indicate that their component tasks are understood in the same way by interns and supervisors, but not for the other roles. The Dunning-Kruger effect offers a plausible explanation for higher intern scores for tasks in six of the roles. For the ‘Professional’ role differences between interns’ internal, individual understanding and supervisors’ external, group understanding may explain lower intern scores. The fact that respondents may understand the tasks they rate differently has implications for all research of this nature.

The development of an advanced diploma program for palliative care leaders in Chile

“…This may be evidence of the Dunning-Kruger effect, in which people overestimate their abilities within a context where they have not yet engaged with the full complexity of a multifaceted task, such as communication skills or psychosocial suffering. 16 – 19 Lastly, the target audience respondents also noted the need for non-traditional teaching methods such as asynchronous virtual learning, as well as virtual case review and discussion sessions. This highlights the importance of designing educational programs that are as accessible as possible to reach the largest potential audience.…”

Do South African anaesthesiology graduates consider themselves fit for purpose? A longitudinal study

“…22 Both over-and underestimation may result from the Dunning-Kruger effect; 48 incompetent individuals may be unable to recognise their own shortcomings. [48][49][50] The ability to self-assess and self-regulate is an important part of professional practice, 51 ensuring practitioner accountability to the profession, the public and themselves, 24 and allowing professional progression. 52 However, not all graduates possess these abilities 53 at the time of graduation, with deficits only evident with the passage of time, specialist experience 33 or learner maturity.…”

“You Never Get a Second Chance”: First Impressions of Physicians Depend on Their Body Posture and Gender

“…The CanMeds framework has been developed for medical education and details six roles, which a physician needs to master to become a medical expert: the Professional, the Communicator, the Scholar, the Health Advocate, the Leader, and the Collaborator ( Frank et al, 2015 ). Albeit developed for medical education, the CanMEDS roles are operationalized and discussed in health care research as well ( Ringsted et al, 2006 ; Dwyer et al, 2014 ; Prozesky et al, 2019 ). Based on research, educational principles, and stakeholder consensus, each role has been conceptualized with respect to observable key competencies, which provide an ideal basis for empirical study ( Frank and Danoff, 2007 ).…”