title: The 'missing person' in roles-based competency models: a historical, cross-national, contrastive case study.
abstract: BACKGROUND
  The use of roles such as medical expert, advocate or communicator to define competencies is currently popular in health professions education. CanMEDS is one framework that has been subject to great uptake across multiple countries and professions. The examination of the historical and cultural choices of names for roles generates insight into the nature and construction of roles. One role that has appeared in and disappeared from roles-based frameworks is that of the 'person'.
  
  
  METHODS
  In order to examine the implications of explicitly including or excluding the role of the 'physician as person' in a competency framework, we conducted a contrastive analysis of the development of frameworks in Canada and the Netherlands. We drew upon critical social science theoretical understandings of the power of language in our analysis.
  
  
  RESULTS
  In Canada, the 'person' role was a late addition to the precursory work that informed CanMEDS, and was then excluded from the final set of CanMEDS role names. In the Netherlands, a 'reflector' role was added in some Dutch schools and programmes when CanMEDS was adopted. This was done in order to explicitly emphasise the importance of the 'person' of the trainee.
  
  
  CONCLUSIONS
  In analysing choices of names for roles, we have the opportunity to see how cultural and historical contexts affect conceptions of the roles of doctors. The taking up and discarding of the 'person' role in Canada and the Netherlands suggest that as medical educators we may need to further consider the ways in which we wish the trainee as a person to be made visible in the curriculum and in assessment tools.
authors.affiliation: Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Ambulatory Care Education, Women's College Hospital, Toronto, Ontario, Canada.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Whitehead
authors.forename: Veronica
authors.initials: V
authors.lastname: Selleger
authors.forename: José
authors.initials: J
authors.lastname: van de Kreeke
authors.forename: Brian
authors.initials: B
authors.lastname: Hodges
mesh_terms: D002170:Canada; D002983:Clinical Competence; D003142:Communication; D003479:Curriculum; D004501:Education, Medical / Q000458:organization & administration*; D004521:Educational Measurement; D005180:Faculty, Medical / Q000458:organization & administration*; D006801:Humans; D007858:Learning; D009426:Netherlands; D024382:Professional Role; D013663:Teaching