title: Are some of the challenging aspects of the CanMEDS roles valid outside Canada?
abstract: BACKGROUND
  Many countries have adopted the CanMEDS roles. However, there is limited information on how these apply in an international context and in different specialties.
  
  
  OBJECTIVE
  To survey trainee and specialist ratings of the importance of the CanMEDS roles and perceived ability to perform tasks within the roles.
  
  
  METHODS
  We surveyed 8749 doctors within a defined region (eastern Denmark) via a single-issue, mailed questionnaire. Each of the 7 roles was represented by 3 questionnaire items to be rated for perceived importance and confidence in ability to perform the role.
  
  
  RESULTS
  Responses were received from 3476 doctors (42.8%), including 190 interns, 201 doctors in the introductory year of specialist training, 529 residents and 2152 specialists. The overall mean rating of importance (on a scale of 1-5) of the aspects of competence described in the CanMEDS roles was 4.2 (standard deviation 0.6) and did not differ between trainee groups and specialists. Mean ratings of confidence were lower than ratings of importance and increased across the groups from interns to specialists. Differences between specialty groups were evident in both importance and confidence for many of the roles. For laboratory, technical and, to a lesser extent, cognitive specialties, the role of Health Advocate scored the lowest in importance. For general medicine specialties, the roles of Medical Expert, Collaborator, Manager and Scholar all scored lower for importance and confidence.
  
  
  CONCLUSIONS
  This study provides a sketch of the content and construct validity of the CanMEDS roles in a non-Canadian setting. More research is needed in how these aspects of competence can be best taught and applied across specialties in different jurisdictions.
authors.affiliation: Centre of Clinical Education, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. charlotte.ringsted@rh.hosp.dk
authors.forename: Charlotte
authors.initials: C
authors.lastname: Ringsted
authors.forename: Torben Lindskov
authors.initials: TL
authors.lastname: Hansen
authors.forename: Deborah
authors.initials: D
authors.lastname: Davis
authors.forename: Albert
authors.initials: A
authors.lastname: Scherpbier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003162:Competency-Based Education; D003718:Denmark; D004504:Education, Medical, Undergraduate / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013038:Specialization / Q000592:standards*; D011795:Surveys and Questionnaires