Attempting to Ensure Physician Competence FREE

David A. Davis, MD; Geoffrey R. Norman, PhD; Arnaud Painvin, MD; Elizabeth Lindsay, PhD; Mohan S. Ragbeer; Darlyne Rath, BScN

[+] Author Affiliations

Reprint requests to McMaster University, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Dr Davis).

JAMA. 1990;263(15):2041-2042. doi:10.1001/jama.1990.03440150039012

Text Size: A A A

Published online

Article

References

ABSTRACT

ABSTRACT | REFERENCES

Ensuring the competence of the 17 000 practicing physicians in the Canadian province of Ontario has occupied more than a decade of activity on the part of the provincial licensing authority, the College of Physicians and Surgeons of Ontario (CPSO).¹ While still in a developmental stage, the provincial peer review system places importance on (and thus provides an opportunity to test models of) physician assessment, learning, and change.

The peer review system was initially developed in the mid1970s. At that time, peer review policymakers viewed continuing medical education (CME) activities in a narrow, but appropriately critical, light and rejected compliance with mandatory CME requirements as a measurement of physician competence. This action reflected the belief that most CME programs failed to change physician performance. Studies conducted since that time concluded that formal CME courses do produce knowledge transfer^2-6; but without reinforcement, feedback, or other behavior modification techniques, CME

REFERENCES

ABSTRACT | REFERENCES

McAuley RG. Results of the Peer Assessment Program of the College of Physicians and Surgeons of Ontario . Can Med Assoc J. 1984;;131:557-560.

Bertram DA, Brooks-Bertram PA. The evaluation of continuing medical education: literature review . Health Educ Monogr. 1977;;5:330-363.

Lloyd JS, Abrahamson S. Effectiveness of continuing medical education: a review of the evidence . Evaluation Health Professions. 1979;;2:251-280.

Davis D, Haynes RB, Chambers L, Neufeld VR, McKibbon A, Tugwell P. The impact of CME . Evaluation Health Professions. 1984;;7:251-283.

Haynes RB, Davis DA, McKibbon KA, Tugwell P. A critical appraisal of the efficacy of continuing medical education . JAMA. 1984;;251:61-64.

Fox RD, Mazmanian P, Putnam RW. Change and Learning in the Lives of Physicians . New York, NY: Praeger Publishers; 1989;.

Donabedian A. A Guide to Medical Care Administration . New York, NY: American Public Health Association; 1969;;2:123-135.

Sibley JC, Spitzer WO, Rudnick KV, Bell JD, Bethune RD, Sackett DL. A randomized trial of continuing medical education . N Engl J Med. 1982;;306:511-515.

Coleman JS, Katz E, Menzel H. Medical Innovation: A Diffusion Study . Indianapolis, Ind: Bobbs-Merrill Press; 1966;.

Neufeld VR, Norman G. Assessing Clinical Competence . New York, NY: Springer Publishers; 1985;.

Norman G, Painvin A, Davis D, Lindsay E, Ragbeer M, Rath D. A comprehensive assessment of clinical competence of family/general physicians using multiple measures . Presented at the 28th Conference on Research in Medical Education; November 1,1989; Washington, DC .

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal