Aligning family medicine residency learning outcomes with societal needs: a nominal group study

Current evidence suggests that family physicians, who have traditionally provided a wide range of services across various settings, are choosing to reduce their scope of practice. This can have negative effects on communities that rely on family physicians to meet their diverse primary care needs. The College of Family Physicians of Canada (CFPC) spearheaded a curriculum review and renewal of postgraduate residency training to support broad-scope family medicine and specifically address six areas of evolving societal need: (i) home and long-term care; (ii) addiction and mental health; (iii) Indigenous health; (iv) health equity and anti-racism; (v) virtual care and health informatics; and (vi) leadership, advocacy, and scholarship. This study answered the following research question: Which learning outcomes for the six areas of societal need identified by the CFPC should be prioritized in family medicine postgraduate education, according to local stakeholders? As part of a broad investigation, we conducted a descriptive study using the nominal group technique. Participants—researchers, clinical educators, and residents affiliated with a Canadian university—first generated ideas for learning outcomes and rated each idea’s importance on a five-point Likert scale. Then, they selected the five ideas per area of societal need that they believed to be of highest priority. Fifty-nine participants took part in six sessions in the fall of 2023. They generated and prioritized 227 learning outcomes, emphasizing topics related to patient-centred care and to personal and professional skills in care delivery. They also highlighted the need for both culturally safe care and a better understanding of the history of inequity in health care for marginalized populations. This study generated and prioritized many learning outcomes relevant to the six areas identified by the CFPC. Combined with national-level work and international consultations, this work provides actionable learning outcomes for family medicine residency training programs.