Document Detail


Factors that influence general internists' and surgeons' performance on maintenance of certification exams.
MedLine Citation:
PMID:  21099396     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: Good clinical judgment is important to providing high-quality patient care. Keeping current in one's field is challenged by rapid advances in health care and demanding practices. Understanding the collective factors that influence a practicing physician's clinical judgment could help medical educators design improvement programs that target specific audiences.
METHOD: Data from two medical specialty boards, the American Board of Internal Medicine and American Board of Surgery, were used. Multiple regression analyses were conducted relating first-attempt performance on the maintenance of certification (MOC) exam with physician age, amount of continuing medical education (CME) undertaken, number of physicians in the practice, medical school type, and prior exam performance. Data were based on demographics and exam scores of 18,447 general internists and 4,961 general surgeons who took the MOC exam for the first time between 2003 and 2007.
RESULTS: Similar findings were obtained for general internists and surgeons. Younger physicians, those with higher scores on initial certification, physicians in group not solo practice, and U.S. medical graduates were significantly more likely to pass the MOC exam (P<.001). Effect sizes were small except for performance on the initial certification exam. General internists with higher internal medicine program directors' ratings and more CME activities were also significantly more likely to pass (P<.001).
CONCLUSIONS: Medical educators may target improvement programs for those who practice in isolation, are older, are international medical graduates, and performed poorly on their initial certification exam. Practicing without sustaining requisite clinical judgment has serious implications for patient care.
Authors:
Rebecca Lipner; Hao Song; Thomas Biester; Robert Rhodes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  86     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  53-8     Citation Subset:  AIM; IM    
Affiliation:
American Board of Internal Medicine, Philadelphia, Pennsylvania 19106, USA. rlipner@abim.org
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Comment In:
Acad Med. 2011 Jan;86(1):6-7   [PMID:  21191200 ]

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