ERIC Number: EJ759249
Record Type: Journal
Publication Date: 2006
Reference Count: N/A
The Prevalence and Special Educational Requirements of Dyscompetent Physicians
Williams, Betsy W.
Journal of Continuing Education in the Health Professions, v26 n3 p173-191 Sum 2006
Underperformance among physicians is not well studied or defined; yet, the identification and remediation of physicians who are not performing up to acceptable standards is central to quality care and patient safety. Methods for estimating the prevalence of dyscompetence include evaluating available data on medical errors, malpractice claims, disciplinary actions, quality control studies, medical record review studies, and in-stream assessments of physician performance. These data provide a range of estimates from 0.6% to 50%, depending on the method. A reasonable estimate of dyscompetence appears to be 6% to 12%. Age-related cognitive decline, impairment due to substance use disorders, and other psychiatric illness can contribute to underperformance, diminishing physicians' insight into their level of performance as well as their ability to benefit from an educational experience. Currently, dyscompetent physicians in the United States are identified through either the legal system or peer review. The primary method of resolving issues of underperformance in physicians is through continuing medical education (CME). Although a number of specialized assessment and education programs exist in the United States, these programs are largely underutilized. Similar programs exist in Canada and have provided evidence of the efficacy of a more specialized and individualized educational approach for underperforming physicians. Current specialty programs focused on this population employ individual assessments of knowledge and performance, individually designed educational programs, long-term plans for maintenance of educational activity, and repeated assessment of performance level. Noting that few CME programs offer these requirements, a number of changes to current medical quality assurance programs that might foster such educational requirements for underperforming physicians are provided.
Descriptors: Program Effectiveness, Foreign Countries, Physicians, Incidence, Quality Control, Medical Education, Underachievement, Performance Based Assessment, Medical Care Evaluation, Convergent Thinking, Evaluation Problems, Comparative Education, Portfolios (Background Materials), Professional Continuing Education
John Wiley & Sons, Inc. Subscription Department, 111 River Street, Hoboken, NJ 07030-5774. Tel: 800-825-7550; Tel: 201-748-6645; Fax: 201-748-6021; e-mail: email@example.com; Web site: http://www3.interscience.wiley.com/browse/?type=JOURNAL
Publication Type: Journal Articles; Reports - Descriptive
Education Level: Postsecondary Education
Authoring Institution: N/A
Identifiers - Location: Canada; United States