title: An objective structured clinical exam to measure intrinsic CanMEDS roles.
abstract: BACKGROUND
  The CanMEDS roles provide a comprehensive framework to organize competency-based curricula; however, there is a challenge in finding feasible, valid, and reliable assessment methods to measure intrinsic roles such as Communicator and Collaborator. The objective structured clinical exam (OSCE) is more commonly used in postgraduate medical education for the assessment of clinical skills beyond medical expertise.
  
  
  METHODS
  We developed the CanMEDS In-Training Exam (CITE), a six-station OSCE designed to assess two different CanMEDS roles (one primary and one secondary) and general communication skills at each station. Correlation coefficients were computed for CanMEDS roles within and between stations, and for general communication, global rating, and total scores. One-way analysis of variance (ANOVA) was used to investigate differences between year of residency, sex, and the type of residency program.
  
  
  RESULTS
  In total, 63 residents participated in the CITE; 40 residents (63%) were from internal medicine programs, whereas the remaining 23 (37%) were pursuing other specialties. There was satisfactory internal consistency for all stations, and the total scores of the stations were strongly correlated with the global scores r=0.86, p<0.05. Noninternal medicine residents scored higher in terms of the Professional competency overall, whereas internal medicine residents scored significantly higher in the Collaborator competency overall.
  
  
  CONCLUSIONS
  The OSCE checklists developed for the assessment of intrinsic CanMEDS roles were functional, but the specific items within stations required more uniformity to be used between stations. More generic types of checklists may also improve correlations across stations.
  
  
  CONCLUSIONS
  An OSCE measuring intrinsic competence is feasible; however, further development of our cases and checklists is needed. We provide a model of how to develop an OSCE to measure intrinsic CanMEDS roles that educators may adopt as residency programs move into competency-based medical education.
authors.affiliation: Office of Postgraduate Medical Education, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; kassama@ucalgary.ca.
authors.forename: Aliya
authors.initials: A
authors.lastname: Kassam
authors.affiliation: Office of Postgraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Michèle
authors.initials: M
authors.lastname: Cowan
authors.affiliation: Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.|Testing & Measurement, Canada's Testing Company, Assessment Strategies Inc., Ottawa, ON, Canada.
authors.forename: Tyrone
authors.initials: T
authors.lastname: Donnon
mesh_terms: D057189:Checklist; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D003162:Competency-Based Education / Q000379:methods; D003299:Cooperative Behavior; D004503:Education, Medical, Graduate / Q000379:methods* / Q000592:standards*; D004521:Educational Measurement / Q000379:methods* / Q000592:standards*; D006801:Humans; D010817:Physician-Patient Relations; D058996:Quality Improvement; D015203:Reproducibility of Results
keywords: competency-based medical education; intrinsic roles; objective structured clinical exam; postgraduate medical education