A presentation at the AMEE 2010 conference

1. Do physicians’ professional
competencies change during the
career?
- A Finnish national survey
Topi Litmanen M.Ed Kristiina Patja MD PhD
The Association for Continuous Professional Medical Development in Finland
topi.litmanen@promedico.fi

2. Competency areas
CanMeds. Canada
The Accreditation Council for The European Federation of
Graduate Medical Education. Internal Medicine (EFIM). Europe
(ACGME) USA
Medical Expert
Medical Knowledge
Medical knowledge
Practice-based Learning and Academic activities — education
Scholar
Improvement
and research
Interpersonal and Communication
Communicator.
Communication skills
Skills
Collaborator
Professionalism. ethical. and legal
Professional
Professionalism
issues
Organizational planning and
Manager
Systems-based Practice
service management skills
Health advocate
Patient Care
Patient Care

3. Goals of the present study
1. What competence areas can be found in
Finnish physicians self-evaluations of skills
they need in their work?
2. How self-perceived competencies differ
between different specialities and age

4. Method
• An annual questionnaire was mailed by
the Finnish Medical Association to all
18.918 physicians who were licensed in
Finland in year 2009.
• Response rate 63 %; N=11 959

5. Questionnaire
How much do you need following areas in your work
assignments? (1=Not at all – 7=Very much)
CanMeds. Canada
Medical knowledge
Managing information
Medical Expert
Acquiring new knowledge
Scholar
Interpersonal skills
Communicator.
Collaboration
Professionalism (deleted)
Collaborator
Managing one’s own work
Professional
Managing work processes
Manager
Computer skills
Economical skills
Health advocate
Health advocacy

6. Factor analysis
Medical
Management skills
knowledge
Interpersonal skills
Communality
0.80
0.23
0.74
Managing work processes
0.59
0.29
0.30
0.52
Managing one’s own work
0.51
0.28
Economical skills
0.46
0.38
0.38
Computer skills
0.36
0.70
0.21
0.66
Managing information
0.21
0.67
0.52
Acquiring new knowledge
0.52
0.20
0.32
Medical knowledge
0.22
0.95
0.98
Interpersonal skills
0.32
0.30
0.68
0.65
Collaboration
0.30
0.26
0.36
0.29
Health advocacy
Eigenvalue
4.6
1.2
1
% of variance
42
11
10

7. Questionnaire
How much do you need following areas in your work
assignments? (1=Not at all – 7=Very much)
CanMeds. Canada
Medical knowledge
Medical
Managing information
Medical Expert
knowledge
Acquiring new knowledge
α=.71
Scholar
Interpersonal skills
Communicator.
Collaboration
Interpersonal
Professionalism (deleted)
skills
Collaborator
Managing one’s own work
α=.72
Professional
Managing work processes
Manager
Computer skills
Management
Economical skills
skills
Health advocate
Health advocacy
α=.73

8. Medical knowledge
99% cl. of mean
Z-score

9. Interpersonal skills
99% cl. of mean
Z-score

10. Management skills
99% cl. of mean
Z-score

11. Medical Skills
99% cl. of mean
Z-score

12. Interpersonal skills
99% cl. of mean
Interpersonal skills
Z-score

13. Management skills
99% cl. of mean
Z-score

14. Conclusions
Silber,
Verhulst et al. Arnold et al. Brasel et al. Medical
Acad.Med. J.Med.Educ. J.Med.Educ. Am.J.Surg. knowledge
2004/79
1986/61
1984/59
2004/188
α=.71
Medical Clinical skills
Clinical Medical
knowledge
knowledge
knowledge
Interpersonal
Patient data Patient care
skills
gathering
α=.72
Interpersonal interpersional Interpersonal
skill
skills
skills.
Management
Professional Professionalism
skills
behaviour
α=.73

15. Conclusions
• The perceived need for competencies
– vary between specialities
– change along with career
– reflect the physicians’ position and working
environment
• Number of competency areas
– Comprehensiveness vs. Practicality

16. Thank you for your attention!
• Research group:
– Topi Litmanen, Pro Medico
– Kristiina Patja, Pro Medico
– Hannu Halila, Finnish Medical Association
– Juho Ruskoaho, Finnish Medical Association
– Jukka Vänskä, Finnish Medical Association