[Implementing the seven roles of the specialist training reform].
BACKGROUND
On 1 January 2004, a new medical specialist reform was implemented. The Danish School of Education, University of Aarhus, conducted research from 2002-2006 in the form of two studies to study educational practice within medical specialist training programmes. This article, based on selected data from the second study, sheds light on the reception of the reform's seven competence roles. The roles represented a pedagogical paradigm shift which calls for a new interpretation of the spectrum of medical expertise. However, the reform's reception has not previously been subject to qualitative analysis.


METHODS
The qualitative data consists of two semi-structured focus group interviews comprising 13 doctors and six rounds of observation of three junior hospital doctors with individual follow-up interviews.


RESULTS
The study shows that, almost two years after the reform's introduction, the roles were not ascribed equal value by the doctors, even if this was intended by the reform. The description of competence objectives does not sufficiently reflect everyday practice where competences are often socially situated and constructed. Furthermore, the study indicates a need for training of supervisors in the evaluation of the competence objectives.


CONCLUSIONS
The doctors' perception of the roles indicate a discrepancy between their official formulation and everyday practice. This discrepancy can partly be attributed to the profession's focus on the role as medical expert, inexhaustive descriptions of objectives, and a surfeit of pedagogical qualifications among instructors.
Danmarks Paedagogiske Universitetsskole ved Aarhus Universitet, Tuborgvej 164, DK-2400 København NV. pede@dpu.dk
Pernille
P
Dehn
Carsten Hering
CH
Nielsen
Kristian
K
Larsen
Martin
M
Bayer
D002983:Clinical Competence / Q000592:standards; D003142:Communication; D003718:Denmark; D004503:Education, Medical, Graduate / Q000379:methods / Q000592:standards; D017144:Focus Groups; D005500:Follow-Up Studies; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D007400:Interprofessional Relations; D007857:Leadership; D008505:Medical Staff, Hospital / Q000193:education; D010819:Physician's Role; D011231:Preceptorship / Q000592:standards; D011795:Surveys and Questionnaires