In the progression through a physician’s career, competencies acquired at a given stage are sustained and developed further through subsequent stages. Where a specific milestone for the acquisition of an enabling competency is not specified for a given stage, it should be assumed that earlier milestones for that competency still apply.
Throughout the CanMEDS 2015 Framework and Milestones Guide, reference to the patient’s family are intended to include all those who are personally significant to the patient and are concerned with his or her care, including, according to the patient’s circumstances, family members, partners, caregivers, legal guardians, and substitute decision-makers.
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Collaborator
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| Collaborator |
| 1 Work effectively with physicians and other colleagues in the health care professions |
| 1.1 Establish and maintain positive relationships with physicians and other colleagues in the health care professions to support relationship-centred collaborative care | Describe relationship-centred care Identify the stages of group development in health care settings Introduce themselves and their role to physicians and other health care professionals Identify opportunities for collaboration among health care professionals along the continuum of care | Compare and contrast enablers of and barriers to collaboration in health care | Respect established rules of their team Receive and appropriately respond to input from other health care professionals Differentiate between task and relationship issues among health care professionals | Anticipate, identify, and respond to patient safety issues related to the function of a team | Establish and maintain healthy relationships with physicians and other colleagues in the health care professions to support relationship-centred collaborative care | Analyze interactions among health care professionals to provide feedback to optimize the performance of a team for the benefit of patients Advocate for organizational structures that support relationship-centred collaborative care Contribute to policy discussions related to collaborative care Teach, assess, or develop the relationship-centred model of collaborative care |
| 1.2 Negotiate overlapping and shared responsibilities with physicians and other colleagues in the health care professions in episodic and ongoing care | Describe the importance of professional role diversity and integration in high-quality and safe patient care | Discuss the role and responsibilities of a specialist in their discipline | Describe the roles and scopes of practice of other health care professionals related to their discipline | Consult as needed with other health care professionals, including other physicians | Negotiate overlapping and shared care responsibilities with physicians and other colleagues in the health care professions in episodic and ongoing care | Teach and assess the negotiation of role overlap and shared responsibilities with other health care professionals |
| 1.3 Engage in respectful shared decision-making with physicians and other colleagues in the health care professions | Describe strategies to promote the engagement of physicians and other colleagues in the health care professions in shared decision-making | Discuss with the patient and family any plan for involving other health care professionals, including other physicians, in the patient’s care | Integrate the patient’s perspective and context into the collaborative care plan | Communicate effectively with physicians and other colleagues in the health care professions Provide timely and necessary written information to colleagues to enable effective relationship-centred care | Engage in respectful shared decision-making with physicians and other colleagues in the health care professions Use referral and consultation as opportunities to improve quality of care and patient safety by sharing expertise | Integrate feedback into shared decision-making processes as part of a quality improvement initiative Analyze, for the purposes of teaching others, shared decision-making processes in a given patient’s care Use technology to enhance collaboration in health care |
| 2 Work with physicians and other colleagues in the health care professions to promote understanding, manage differences, and resolve conflicts |
| 2.1 Show respect toward collaborators | Respect the diversity of perspectives and expertise among health care professionals | Convey information thoughtfully Respond to requests and feedback in a respectful and timely manner | Actively listen to and engage in interactions with collaborators | Delegate tasks and responsibilities in an appropriate and respectful manner | Show respect toward collaborators | |
| 2.2 Implement strategies to promote understanding, manage differences, and resolve conflicts in a manner that supports a collaborative culture | List factors that contribute to misunderstandings, differences, and conflicts in the health care setting Describe different approaches to promote understanding and manage differences | | Identify communication barriers between health care professionals Communicate clearly and directly to promote understanding, manage differences, and resolve conflicts Listen to understand and find common ground with collaborators | Gather the information and resources needed to manage differences and resolve conflicts among collaborators Analyze team dynamics Gain consensus among colleagues in resolving conflicts | Implement strategies to promote understanding, manage differences, and resolve conflicts in a manner that supports a collaborative culture | Act as a consultant to physicians and other health care professionals in the promotion of a culture of collaboration Teach conflict resolution in health care |
| 3 Hand over the care of a patient to another health care professional to facilitate continuity of safe patient care |
| 3.1 Determine when care should be transferred to another physician or health care professional | Describe how scope of practice can trigger transfer of care Describe common transitions in health care and the process of safe transfer of care | | Identify patients requiring handover to other physicians or health care professionals | | Determine when care should be transferred to another physician or health care professional | |
| 3.2 Demonstrate safe handover of care, using both verbal and written communication, during a patient transition to a different health care professional, setting, or stage of care | Describe a structured framework for transfer of care that ensures the patient, physicians, and other health care professionals understand and agree with all aspects of the care | Describe specific information required for safe handover during transitions in care | Communicate with the receiving physicians or health care professionals during transitions in care, clarifying issues after transfer as needed Communicate with the patient’s primary health care professional about the patient’s care Summarize the patient’s issues in the transfer summary, including plans to deal with the ongoing issues | Organize the handover of care to the most appropriate physician or health care professional Analyze gaps in communication between health care professionals during transitions in care Recognize and act on patient safety issues in the transfer of care | Demonstrate safe handover of care, both verbal and written, during patient transitions to a different health care professional, setting, or stage of care | Teach effective handover, including structured frameworks for safe and effective transfer of care Analyze local handover practices and contribute to process improvements to enhance the safety and effectiveness of transfer of care |
