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ARTICLE |

Competency Assessment of Primary Care Physicians as Part of a Peer Review Program FREE

Geoffrey R. Norman, PhD; David A. Davis, MD; Sheilah Lamb, MD; Eileen Hanna, BScN; Paul Caulford, MD; Tiina Kaigas, MD
[+] Author Affiliations

Reprint requests to Room 2C14, Health Sciences Centre, McMaster University, Hamilton, Ontario, Canada L8N 3Z5 (Dr Norman).


JAMA. 1993;270(9):1046-1051. doi:10.1001/jama.1993.03510090030007
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Objective.  —To design and test a program that assesses clinical competence as a second stage in a peer review process and to determine the program's reliability.

Design and Setting.  —A three-cohort study of Ontario primary care physicians.

Participants.  —Reference physicians (n=26) randomly drawn from the Hamilton, Ontario, area; volunteer, self-referred physicians (n=20); and physicians referred by the licensing body (n=37) as a result of a disciplinary hearing or peer review.

Main Outcome Measures.  —Standardized patients, structured oral examinations, chart-stimulated recall, objective structured clinical examination, and multiplechoice examination.

Results.  —Test reliability was high, ranging from 0.73 to 0.91, and all tests discriminated among subgroups. Demographic variables relating to the final category were age, Canadian or foreign graduates, and whether or not participants were certified in family medicine.

Conclusions.  —The study demonstrated the feasibility, reliability, and validity of a multicomponent examination in the peer review process.(JAMA. 1993;270:1046-1051)

REFERENCES

Last JM.  Maintenance of competence. Ann RCPSC . 1991;;24:7-8.
Farnsworth PB.  A Reevaluation of Physician Recredentialing. NY State J Med . 1990;;90:531-532.
McAuley RG, Henderson HW.  Results of the Peer Assessment Program of the College of Physicians & Surgeons of Ontario. Can Med Assoc J . 1984;;131:557-561.
Tugwell P, Dok C.  Medical record review.  In: Neufeld VR, Norman GR, eds. Assessing Clinical Competence . New York, NY: Springer Publishing Co Inc; 1985;.
Maatsch J. Toward a testable theory of clinical competence. Presented at the 17th Conference on Research in Medical Education; October 25-26,1978; New Orleans, La.
Barrows HS. Simulated Patients . Springfield, Ill: Thomas; 1971;.
Harden R McG, Gleeson FA.  Assessment of clinical competence using an objective structured clinical examination. Med Educ . 1979;;13:41-54.
Cronbach LJ, Glaser GC, Nanda H, Rajaratnam N. The Dependability of Behavioural Measurements: Theory of Generalizability for Scores and Profiles . New York, NY: John Wiley & Sons Inc; 1972;.
Stillman PSS, Swanson DB, Regan MB, et al.  Assessment of clinical skills of residents using standardized patients. Ann Intern Med . 1991;;114:393-401.
Cohen R, Reznick RK. Taylor BR, Provamn J, Rothman AI.  Reliability and validity of the objective structured clinical examination in assessing surgical residents. Am J Surg . 1990;;160:302-305.
Van der Vleuten CPM, Norman GR, De Graaff ED.  Pitfalls in the pursuit of objectivity—I: issues of reliability. Med Educ . 1991;;25:110-118.
Swanson DB, Van der Vleuten CPM, Swanson DB.  Assessment of clinical skills using standardized patients: the state of the art. Teach Lrn Med . 1990;;2:58-76.

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Last JM.  Maintenance of competence. Ann RCPSC . 1991;;24:7-8.
Farnsworth PB.  A Reevaluation of Physician Recredentialing. NY State J Med . 1990;;90:531-532.
McAuley RG, Henderson HW.  Results of the Peer Assessment Program of the College of Physicians & Surgeons of Ontario. Can Med Assoc J . 1984;;131:557-561.
Tugwell P, Dok C.  Medical record review.  In: Neufeld VR, Norman GR, eds. Assessing Clinical Competence . New York, NY: Springer Publishing Co Inc; 1985;.
Maatsch J. Toward a testable theory of clinical competence. Presented at the 17th Conference on Research in Medical Education; October 25-26,1978; New Orleans, La.
Barrows HS. Simulated Patients . Springfield, Ill: Thomas; 1971;.
Harden R McG, Gleeson FA.  Assessment of clinical competence using an objective structured clinical examination. Med Educ . 1979;;13:41-54.
Cronbach LJ, Glaser GC, Nanda H, Rajaratnam N. The Dependability of Behavioural Measurements: Theory of Generalizability for Scores and Profiles . New York, NY: John Wiley & Sons Inc; 1972;.
Stillman PSS, Swanson DB, Regan MB, et al.  Assessment of clinical skills of residents using standardized patients. Ann Intern Med . 1991;;114:393-401.
Cohen R, Reznick RK. Taylor BR, Provamn J, Rothman AI.  Reliability and validity of the objective structured clinical examination in assessing surgical residents. Am J Surg . 1990;;160:302-305.
Van der Vleuten CPM, Norman GR, De Graaff ED.  Pitfalls in the pursuit of objectivity—I: issues of reliability. Med Educ . 1991;;25:110-118.
Swanson DB, Van der Vleuten CPM, Swanson DB.  Assessment of clinical skills using standardized patients: the state of the art. Teach Lrn Med . 1990;;2:58-76.
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