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Exploring Integration in Action: Competencies as Building Blocks of Expertise.
Acad Med
December 2017
M. Mylopoulos is assistant professor and scientist, Wilson Centre and Department of Paediatrics, University of Toronto, Toronto, Ontario, Canada. D.(T.) Borschel is associate professor, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. T. O'Brien is assistant professor, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. S. Martimianakis is research assistant, Wilson Centre, University of Toronto, Toronto, Ontario, Canada. N.N. Woods is assistant professor and scientist, Wilson Centre and Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Purpose: Competency frameworks such as the CanMEDS roles and the ACGME core competencies may lead to the implicit assumption that physicians can learn and practice individual competencies in isolation. In contrast, models of adaptive expertise suggest that the integration of competencies reflects the capabilities of an expert physician. Thus, educational programming aimed at teaching discrete roles or competencies might overlook expert physician capabilities that are central to patient care.
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