5. A needs assessment for a CanMEDS-based curriculum in ambulatory care for internal medicine residents in Canada
Bibliographic record
Abstract
In Canada, graduates of internal medicine training programs should be proficient in ambulatory medicine and practice. Before determining how to improve education in ambulatory care, a list of desired learning outcomes must be identified and used as the foundation for the design, implementation and evaluation of instructional events. The Delphi technique is a qualitative-research method that uses a series of questionnaires sent to a group of experts with controlled feedback provided by the researchers after each round of questions. A modified Delphi technique was used to determine the competencies required for an ambulatory care curriculum based on the CanMEDS roles. Four groups deemed to be critical stakeholders in residency education were invited to take part in this study: 1. Medical educators and planners, 2. Members of the Canadian Society of Internal Medicine (CSIM), 3. Recent Royal College certificants in internal medicine, 4. Residents currently in core internal medicine residency programs. Panelists were sent questionnaires asking them to rate learning outcomes based on their importance to residency training in ambulatory care. Four hundred and nineteen participants completed the round 1 questionnaire that was comprised of 75 topics identified through a literature search. Using predefined criteria for degree of importance and consensus, 19 items were included in the compendium and 9 were excluded after one round. Forty-two items for which the panel that did not reach consensus, as well as 3 new items suggested by the panel were included in the questionnaire for round 2. Two hundred and forty participants completed the round 2 questionnaire; consensus was reached for each of the 45 items. After two rounds, 21 items were included in the final compendium as very high priority topics (“must be able to”). An additional 26 items were identified as high priority topics (“should be able to”). The overall ratings by each of the four groups were similar and there were no differences between groups that affected the selection of items for the final compendium. To our knowledge this is the first time a Delphi-process has been used to determine the content of an ambulatory care curriculum in internal medicine in Canada. The compendium could potentially be used as the basis to structure training programs in ambulatory care. Barker LR. Curriculum for Ambulatory Care Training in Medical residency: rationale, attitudes and generic proficiencies. J Gen Intern Med 1990; 5(supp.):S3-S14. Levinsky NG. A survey of changes in the proportions of ambulatory training in internal medicine clerkships and residencies from 1986-87 to 1996-97. Acad Med 1998; 73:1114-1115. Linn LS, Brook RH, Clarke VA, Fink A, Kosecoff J. Evaluation of ambulatory care training by graduates of internal medicine residencies. J Med Educ 1986; 61:293-302.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".