title: Dispatches from the front: emergency medicine teachers' perceptions of competency-based education.
abstract: OBJECTIVE
  Controversy exists regarding the applicability of competency-based education during clinical rotations in emergency medicine (EM). Little has been written about the perceptions of front-line teachers regarding one such competency-based education paradigm, the CanMEDS framework. We undertook to determine 1) what perceptions exist among front-line teachers at two academic health science emergency departments (EDs) regarding the use of the CanMEDS roles to frame what residents should learn on ED rotations and 2) how those same teachers envision practically incorporating the CanMEDS roles into feedback provided to residents.
  
  
  METHODS
  Teachers at two sites volunteered for a semistructured focus group study. Focus groups were moderated by an experienced qualitative researcher, and verbatim transcriptions were coded by two independent reviewers. The codes were merged into final themes. The final focus group was used to further explore issues raised and test assumptions made in the preceding groups.
  
  
  RESULTS
  In five focus groups involving 21 participants, the Medical Expert and Professional roles were seen as most relevant to an EM rotation, whereas the Health Advocate, Manager, Scholar, and Collaborator roles were least relevant. On further exploration, however, faculty identified highly relevant components of each role that they could envision teaching in an ED. Participants also felt that the framework helped highlight the breadth of physician competencies and provided structure for teaching and feedback.
  
  
  CONCLUSIONS
  EM faculty find the CanMEDS framework helpful for structuring teaching and learning and that many elements of the roles, when defined, are feasible to integrate into a clinical rotation.
authors.affiliation: Division of Emergency Medicine, Department of Medicine, St.Michael’s Hospital, University of Toronto, Toronto, ON. bandierag@smh.toronto.on.ca
authors.forename: Glen
authors.initials: G
authors.lastname: Bandiera
authors.forename: David
authors.initials: D
authors.lastname: Lendrum
mesh_terms: D002983:Clinical Competence; D003162:Competency-Based Education; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency