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Turner, SR, White JS, Poth C & Rogers WT (2012) Learning the CanMEDS roles in a near-peer shadowing program: A mixed methods randomized control trial, Medical Teacher, 34:888-892.
Reviewed by Janice Hanson, University of Colorado School of Medicine

What was the study question?
What is the impact of a near-peer shadowing program on first-year medical students' knowledge and attitudes related to CanMEDS roles?

How was the study done?
Eighty-three of 185 first-year students were randomly selected from 173 volunteers and paired with 83 first-year residents in a near-peer shadowing program at the University of Alberta. The 90 additional first-year student volunteers formed a control group. Pre- and post-encounter questionnaires assessed knowledge of CanMEDS roles (Medical Expert, Communicator, Collaborator, Health Advocate, Manager, Professional and Scholar) and attitudes about these roles. Semi-structured small group interviews explored experiences of participants. (Details about the program appear in another article, Turner SR et al. Preparing students for clerkship: A resident shadowing program. Academic Medicine 2012;87(9):1288-1291.)

What were the results?
Students who shadowed residents gained knowledge of the CanMeds roles (i.e., correctly named a greater number of the roles) while students in the control group did not. About 60% of intervention students thought their knowledge and support of CanMEDS roles increased; most thought their competence in most of the roles also increased. Participating residents also thought their knowledge of the CanMEDS framework increased, although they were not asked to name the roles after the program. Qualitative data from 27 students and 3 residents supported these findings, although comments reported tend to be general statements about the CanMEDS roles rather than specific examples of knowledge and competence gained.

What are the implications of these findings?
Early immersion in the clinical environment with observation and participation that have been focused by explicit discussion of the CanMEDS roles seems to help build a foundation for professional identity early in a medical school career. This is a low-cost, feasible way to address an elusive aspect of medical education.

Editor's note: The seven CanMEDS roles are analogous to the six ACGME competencies. It will be interesting to see if this immersive experience has long-lasting effects - hopefully, the authors will follow and study these students when they are clinical clerks (SLB).

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