title: Defining competency-based evaluation objectives in family medicine: dimensions of competence and priority topics for assessment.
abstract: OBJECTIVE
  To develop a definition of competence in family medicine sufficient to guide a review of Certification examinations by the Board of Examiners of the College of Family Physicians of Canada.
  
  
  METHODS
  Delphi analysis of responses to a 4-question postal survey.
  
  
  METHODS
  Canadian family practice.
  
  
  METHODS
  A total of 302 family physicians who have served as examiners for the College of Family Physicians of Canada's Certification examination.
  
  
  METHODS
  A survey comprising 4 short-answer questions was mailed to the 302 participating family physicians asking them to list elements that define competence in family medicine among newly certified family physicians beginning independent practice. Two expert groups used a modified Delphi consensus process to analyze responses and generate 2 basic components of this definition of competence: first, the problems that a newly practising family physician should be competent to handle; second, the qualities, behaviour, and skills that characterize competence at the start of independent practice.
  
  
  RESULTS
  Response rate was 54%; total number of elements among all responses was 5077, for an average 31 per respondent. Of the elements, 2676 were topics or clinical situations to be dealt with; the other 2401 were skills, behaviour patterns, or qualities, without reference to a specific clinical problem. The expert groups identified 6 essential skills, the phases of the clinical encounter, and 99 priority topics as the descriptors used by the respondents. More than 20% of respondents cited 30 of the topics.
  
  
  CONCLUSIONS
  Family physicians define the domain of competence in family medicine in terms of 6 essential skills, the phases of the clinical encounter, and priority topics. This survey represents the first level of definition of evaluation objectives in family medicine. Definition of the interactions among these elements will permit these objectives to become detailed enough to effectively guide assessment.
authors.affiliation: Department of Family and Emergency Medicine at Laval University in Quebec, Canada. tim.allen@arul.ulaval.ca
authors.forename: Tim
authors.initials: T
authors.lastname: Allen
authors.forename: Carlos
authors.initials: C
authors.lastname: Brailovsky
authors.forename: Paul
authors.initials: P
authors.lastname: Rainsberry
authors.forename: Katherine
authors.initials: K
authors.lastname: Lawrence
authors.forename: Tom
authors.initials: T
authors.lastname: Crichton
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Carpentier
authors.forename: Shaun
authors.initials: S
authors.lastname: Visser
mesh_terms: D002170:Canada; D002568:Certification / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D003697:Delphi Technique; D004521:Educational Measurement; D005194:Family Practice / Q000592:standards*; D006801:Humans; D009048:Motor Skills; D018802:Patient-Centered Care / Q000592:standards; D010817:Physician-Patient Relations; D012955:Societies, Medical / Q000592:standards