Predictors of Physician Performance on Competence Assessment

Grace, Elizabeth S.; Wenghofer, Elizabeth; Korinek, Elizabeth J.

doi:10.1097/acm.0000000000000248

Cited by 36 publications

(8 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Like the emerging framework of PM [3,29,30], PE posits that the offer of educational services should reflect the specific content, timing, conciseness, ergonomics, and use channel needs at the point of use rather than the one-size-fits-all approach adopted so far [13,31,32]. In other words, PE involves identification of specific context-by-user information needs, optimization of educational activities, and design of user-centered learning [33,34]. In this context, medical information departments have the possibility to provide reliable medical content in a timely manner answering specific inquiries from specialists.…”

Section: Principal Findingsmentioning

confidence: 99%

Information Needs and Information-Seeking Behavior of Italian Neurologists: Exploratory Mixed Methods Study

Demergazzi¹,

Pastore²,

Bassani³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

Background Current medical professions involve an extensive knowledge of the latest validated scientific data to implement disease diagnosis, therapeutic strategies, and patient care. Although clinicians can refer to a growing number and type of information sources to keep current with new scientific achievements, there are still various concerns about medical information validity, quality, and applicability into clinical practice. Novel strategies are required to identify physicians’ real-life needs with the final aim to improve modern medical information delivery. Objective Our research used an innovative tool to collect real-time physician queries in order to investigate information needs and seeking behavior of Italian neurologists treating patients with multiple sclerosis (MS) and migraine. Methods The study was designed as an exploratory mixed methods (ie, qualitative and quantitative) study involving 15 consecutive days of observation. A total of 50 neurologists (n=25 MS and n=25 migraine specialists) were recruited. Data were collected using an instant messaging mobile app designed for this research. At each information-seeking event, moderators triggered a computer-assisted personal interview including both semistructured interview and close-ended questions. Interactions and physician queries collected using the mobile app were coded into emerging themes by content analysis. Results Neurologist queries were relevant to the following major themes: therapy management (36/50, 71%) and drug-related information (34/50, 67%), followed by diagnostic strategies and procedures (21/50, 42%). Quantitative analysis indicated online resources were preferentially used by clinicians (48/50, 96%) compared with offline sources (24/50, 47%). A multichannel approach, in which both online and offline sources were consulted to meet the same need, was adopted in 33% (65/198) of information-seeking events. Neurologists more likely retrieved information from online relative to offline channels (F=1.7; P=.01). MS specialists were 53% more likely to engage in one information-seeking event compared with migraine neurologists (risk ratio 1.54; 95% CI 1.16-2.05). MS specialists tended to be more interested in patient-related content than migraine clinicians (28% [7/25] vs 10% [2/25], P=.06), who conversely more likely sought information concerning therapy management (85% [21/25] vs 60% [15/25], P=.05). Compared with MS clinicians, migraine specialists had a harder time finding the required information, either looking at online or offline channels (F=12.5; P=.01) and less frequently used offline channels (30% [8/25] vs 60% [15/25] of information-seeking events, P=.02). When multiple sources needed to be consulted to retrieve an information item, a reduced satisfaction rate was observed both among migraine and MS specialists (single source vs multiple sources P=.003). Conclusions This study provides a detailed description of real-life seeking behavior, educational needs, and information sources adopted by Italian MS and migraine neurologists. Neurologist information needs and seeking behavior reflect the specific characteristics of the specialty area in which they operate. These findings suggest identification of time- and context-specific needs of clinicians is required to design an effective medical information strategy.

show abstract

Section: Principal Findingsmentioning

confidence: 99%

Information Needs and Information-Seeking Behavior of Italian Neurologists: Exploratory Mixed Methods Study

Demergazzi¹,

Pastore²,

Bassani³

et al. 2020

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…An evidence synthesis in 20151 examined 17 primary studies looking at risk and support factors for quality clinical practices across three performance outcomes: complaints, disciplinary action and prescribing and testing errors. This synthesis, along with other published work, highlights several risk factors that are consistent predictors of poor performance across a variety of outcomes: gender,2–4 age4–6 and performance on medical examinations have consistently been shown to be risk factors of poor performance; workload,7 8 practising in a solo environment,9 and practice specialty3 10 have been studied less frequently but seem to pose some risk to poor performance; and being an internationally-trained medical graduate is inconsistently related to performance 10 11. A recent (2017) scoping review of literature regarding risk and support factors of competence for healthcare professionals12 revealed that the top four risk factors discussed in medicine were transitions in practice, being an international medical graduate, lack of clinical exposure and age.…”

Section: Introductionmentioning

confidence: 84%

Experiential knowledge of risk and support factors for physician performance in Canada: a qualitative study

et al. 2019

View full text Add to dashboard Cite

ObjectiveTo identify, understand and explain potential risk and protective factors that may influence individual and physician group performance, by accessing the experiential knowledge of physician-assessors at three medical regulatory authorities (MRAs) in Canada.DesignQualitative analysis of physician-assessors’ interview transcripts. Telephone or in-person interviews were audio-recorded on consent, and transcribed verbatim. Interview questions related to four topics: Definition/discussion of what makes a ‘high-quality physician;’ factors for individual physician performance; factors for group physician performance; and recommendations on how to support high-quality medical practice. A grounded-theory approach was used to analyse the data.SettingThree provinces (Alberta, Manitoba, Ontario) in Canada.ParticipantsTwenty-three (11 female, 12 male) physician-assessors from three MRAs in Canada (the College of Physicians & Surgeons of Alberta, the College of Physicians and Surgeons of Manitoba and the College of Physicians and Surgeons of Ontario).ResultsParticipants outlined various protective factors for individual physician performance, including: being engaged in continuous quality improvement; having a support network of colleagues; working in a defined scope of practice; maintaining engagement in medicine; receiving regular feedback; and maintaining work-life balance. Individual risk factors included being money-oriented; having a high-volume practice; and practising in isolation. Group protective factors incorporated having regular communication among the group; effective collaboration; a shared philosophy of care; a diversity of physician perspectives; and appropriate practice management procedures. Group risk factors included: a lack of or ineffective communication/collaboration among the group; a group that doesn’t empower change; or having one disruptive or ‘risky’ physician in the group.ConclusionsThis is the first qualitative inquiry to explore the experiential knowledge of physician-assessors related to physician performance. By understanding the risk and support factors for both individual physicians and groups, MRAs will be better-equipped to tailor physician assessments and limited resources to support competence and enhance physician performance.

show abstract

“…14 Beyond clinical skills, physician performance is based on a combination of individual differences including specialty area, gender, and age. 15,16 Evidence suggests that biases against international medical graduates may lead to more complaints against physicians and disciplinary outcomes, 17 but ndings on biased physician performance evaluations are mixed. 18 Given the inconclusive evidence, having two examiners appears to mitigate potential sex or ethnic biases against physicians who are being evaluated based on their clinical performance.…”

Section: Multisource Feedbackmentioning

confidence: 99%

Assessing Physician Performance Using Multisource Surveys: Do Biases Exist Due to Gender, Country of Training, Native Language, and Age?

Lanz

Gregory²,

Harmon³

2020

Preprint

View full text Add to dashboard Cite

Background: With a growing number of foreign-trained physicians joining the United States workforce, there is a need to assess their job performance fairly. The purpose of this study was to explore the fairness of a multisource competency assessment on U.S.- and non-U.S.-trained physicians. Methods: We conducted a non-experimental retrospective analysis on physicians working in the United States (n=258) who participated in a physician assessment and education program. Results: There were no significant differences in performance outcomes at the scale level of teamwork, motivating or discouraging behaviors, technical practice, and patient interactions, nor the item level based on demographic differences. Conclusions: The PULSE 360 is a powerful tool that can be used to evaluate physician performance without bias due demographic differences including: gender, country of physician medical training, physician native language, or age.

show abstract

Predictors of Physician Performance on Competence Assessment

Cited by 36 publications

References 30 publications

Information Needs and Information-Seeking Behavior of Italian Neurologists: Exploratory Mixed Methods Study

Information Needs and Information-Seeking Behavior of Italian Neurologists: Exploratory Mixed Methods Study

Experiential knowledge of risk and support factors for physician performance in Canada: a qualitative study

Assessing Physician Performance Using Multisource Surveys: Do Biases Exist Due to Gender, Country of Training, Native Language, and Age?

Contact Info

Product

Resources

About