Knowing what we mean, meaning what we say: Clarifying Controversies in the Language of Medical Education - S. Taber, L. Gorman and K. Campbell ...
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Knowing what we mean, meaning what we say:
Clarifying Controversies in the Language of Medical Education
S. Taber, L. Gorman and K. Campbell
October 26, 2014
I do not have an affiliation (financial or otherwise)
with a pharmaceutical, medical device or
communications organization.
Je n’ai aucune affiliation (financière ou autre)
avec une entreprise pharmaceutique, un fabricant
d’appareils médicaux ou un cabinet de communication.
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Outline
• Why does terminology matter?
• Introduction to Terminology in Medical
Education Project
• Table work: defining terms
• Project Methods and Results
• Debate: controversies in terminology
3
Learning objectives
• Discuss controversies that may arise when
terminology is not commonly-accepted;
• Compare and contrast different usages of
terminology; and
• Provide input into the recommended
proposed terminology.
4
Terminology Confusion
Term Definition in United Definition in Britain
States
Public schools Schools where parents Schools where parents
do not pay fees pay fees
Social Security Pensions All state benefits (i.e.
what is known as
“welfare” in the US)
Federalist Someone who believes in Someone who believes
decentralizing the in centralizing the
powers of associated powers of associated
states states
Transportation A means of getting from A means of getting rid of
point A to point B convicts
5
Background
• Language of medical education = critical to
enterprise of the profession and training
• Commonly-used terms are ambiguously defined
and carry different meaning among stakeholders
– Adds complexity to multi-stakeholder collaborations
– Causes confusion within profession and among public
6
Project Goal
To create a national consensus lexicon of common
terms to enhance consistency and portability
among medical education stakeholders.
7Defining Medical Terms
8Defining Medical Terms
At your tables, define these terms in
the context of medical education or
health care delivery:
• Competence
• Interdisciplinary
• Assessment
9Competence
10Competence
The array of abilities across multiple
domains or aspects of physician
performance in a certain context.
Statements about competence require
descriptive qualifiers to define the
relevant abilities, context, and stage of
training or practice. Competence is multi-
dimensional and dynamic. It changes with
time, experience, and setting (Frank et al.
2010).
11Interdisciplinary
12Interdisciplinary
Individuals from two or more disciplines
(i.e. Emergency Medicine and Critical Care
Medicine) from within the same profession
(i.e., medicine) working collaboratively
with shared objectives, decision-making,
responsibility and power, to develop care
plans and make decisions about patient
care (CanMEDS).
13Assessment
14Assessment
A process of gathering and analyzing
information on competencies in order to
measure a physician’s competence or
performance and compare it to defined
criteria.
15Terminology in Medical
Education Project
16Methods
1. Initial list of terms
2. Environmental scan
3. Snowball
4. National modified nominal group technique
17Environmental Scan and
Literature Review
• Determined preliminary list of 16 terms
• 30 stakeholder websites reviewed
– “glossary of terms” & “definition of terms”
– 10 new definitions recorded
• Website links
– 3 new definitions recorded
• PubMed, MEDLINE & Embase
– 18 new definitions recorded
18Stakeholder Survey
• Surveyed national & international
stakeholders
1. Term used
2. Accepted definition
3. Synonyms
• Survey sent to 95 stakeholder groups
– Survey response rate = 28%
– 150 definitions submitted
• French equivalents given for 7 terms
19Lexicon
• Think, pair and share
20Final Lexicon
• 50 agreed upon terms
– Competence, International Medical
Graduate, Generalism, Evaluation, Fellow,
Intraprofessional, Role model, Resident, etc.
• 11 terms suggested for removal
– House officer, Foreign Medical Graduate
• 6 terms with no consensus
– PGME, GME, R(n), Y (n), Dyscompetent and
Supracompetent
21Debates in Medical
Education Terminology
22Introducing our Debaters
• Dr. Eric Webber, Head, Division of
Pediatric Surgery – UBC
• Mr. Steve Slade, Vice President, Data and
Analysis, Director of CAPER - AFMC
23Terminology Debate
• Graduate Medical • Postgraduate
Education (GME) Medical Education
(PGME)
Potential definition:
A period of formal structured medical education
after successful completion of a medical degree
in preparation for certification and practice
(e.g. Residency education, Areas of Focused
Competence/Diploma programs).
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Next Steps
• Continued dissemination and feedback of
lexicon
• Lexicon intended to be an evergreen
document
– Continued work on terms with no consensus
– Addition of new terms
• French translation
30Questions
31Help us improve. Aidons-nous à nous améliorer.
Your input matters. Votre opinion compte.
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