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Biomedical subjects

Laure Perrier

Publications and source records attributed to Laure Perrier.

7 recordsLinked to original sources
PubMed2006

Accuracy of physician self-assessment compared with observed measures of competence: a systematic review.

CONTEXT: Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs. OBJECTIVE: To determine how accurately physicians self-assess compared with external observations of their competence. DATA SOURCES: The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection. STUDY SELECTION: Studies were included if they compared physicians' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention. DATA EXTRACTION: Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted. DATA SYNTHESIS: The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions. CONCLUSIONS: While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.

Clinical Competence↗
PubMed2006

Research to practice in The Journal of Continuing Education in the Health Professions: a thematic analysis of volumes 1 through 24.

INTRODUCTION: Authors have stressed the importance of the broader contextual influences on practice improvement and learning and have expressed concern about gaps between research and practice. This implies a potential expansion of the knowledge base for continuing education in the health professions (CEHP) and an increased emphasis on research evidence for that knowledge. How has the content of The Journal of Continuing Education in the Health Professions (JCEHP) reflected those changes? What are the implications for CEHP practitioners? METHODS: Based on all abstracts, tables of contents, and editorials, a thematic analysis was completed for volumes 1 through 24 of JCEHP. All texts were downloaded into qualitative analysis software and coded. Main code categories included demographics of articles, concepts relating to CEHP as a discipline, knowledge translation and outcomes-oriented continuing education, and theories and frameworks. Key themes were identified. RESULTS: Key themes include categories of topics included in JCEHP over the years, the increased prominence of research in JCEHP, a dual research evidence-to-practice gap, the professionalization of continuing education providers, and interdisciplinarity and the links with broader frameworks that have been proposed for CEHP. DISCUSSION: Two sets of research-to-practice gaps are portrayed in the journal: the gap between clinical research and practice and the gap between research and practice in CEHP. To close the first gap, authors have asserted that the second gap must be addressed, ensuring that CEHP practices themselves are evidence based, driven by theory-based research. This is a variation on prior debates regarding the need to define CEHP as a discipline, which uses the language of professionalization. The increased focus of continuing education on the contexts of health care providers' practices has multiplied the topics that are potentially relevant to CEHP practice.

Education, Medical, Continuing↗
PubMed2005

Effectiveness of pre-licensure interprofessional education and post-licensure collaborative interventions.

In this paper we scanned and summarized the empirical research evidence and found that the effects of pre-licensure interprofessional education on patient/client care are unknown. In contrast, for post-licensure collaboration interventions, there is a growing body of evidence suggesting positive effects on the delivery of care. The coverage of this latter evidence, however, is patchy, being especially weak in primary care. In interprofessional education, where policy level interventions have been value driven for the last half century, we have identified a base of evidence for the effectiveness of certain post-licensure collaboration interventions; this evidence is lacking for pre-licensure interprofessional education. If interventions and policies for both pre-licensure interprofessional education and post-licensure collaboration are implemented without accompanying rigorous evaluation research, we will remain mired in this same uncertainty into the future.

Canada↗
PubMed2004

Solving the information overload problem: a letter from Canada.

Doctors are inundated with medical information, some inadequately evidence-based, much of it captured in clinical practice guidelines (CPGs). The Ontario Guidelines Advisory Committee (GAC) selects topic areas, searches for all CPGs on the topic, and reviews them using the AGREE Instrument. Based in large part on the AGREE score, the GAC summarises one guideline in each topic area and mounts it on its website, with links to other information (eg, clinical algorithms) where possible. Two topic areas have been selected for implementation--the reduction of unnecessary preoperative testing and the rational management of acute low back pain. Implementation strategies include performance feedback, training of opinion leaders, development of algorithms and reminders, and communication through journals and continuing medical education activities.

Diagnostic Tests, Routine↗
PubMed2004

Technology-enabled knowledge translation: frameworks to promote research and practice.

Knowledge translation articulates how new scientific insights can be implemented efficiently into clinical practice to reap maximal health benefits. Modern information and communication technologies can be effective tools to help in the collection, processing, and targeted distribution of information from which clinicians, researchers, administrators, policy makers in health, and the public can benefit. Effective implementation of knowledge translation through the use of information and communication technologies, or technology-enabled knowledge translation (TEKT), would benefit both the individual health professional and the health system. Successful TEKT in health requires cultivation and acceptance in the following key domains: Perceiving types of knowledge and ways in which clinicians acquire and apply knowledge in practice. Understanding the conceptual and contextual frameworks of information and communication technologies applied to health systems, particularly the push, pull, and exchange communication models. Comprehending essential issues in implementation of information and communication technologies and strategies to take advantage of emerging opportunities and overcome existing barriers. Establishing a common and widely acceptable evaluation framework in order that researchers can compare various methodologies in their rightful contexts in TEKT research and adoption. Achieving harmony and common understanding in these areas will go a long way in fostering a fertile and innovative environment to encourage research and advance understanding in this exciting domain of TEKT.

Artificial Intelligence↗
PubMed2003

Searching for evidence-based medicine in wound care: an introduction.

During the last 10 years, wound care knowledge and treatment options, as well as the amount of information in the literature pertaining to wound and patient treatment options, have expanded rapidly. As a result, clinicians need to be able to review the existing literature with knowledge of the steps involved in evidence-based medicine. By identifying search strategies to improve information retrieval, time can be saved, new knowledge can be obtained, and with an understanding of clinical experience and patient-centered concerns, the best evidence for decision making can be utilized. The information retrieved can be categorized according to the level of evidence and clinical practice guidelines (documents in which an expert panel has reviewed the evidence and interpreted it for patient care) can be measured by the Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument. Learning how to find and interpret the literature not only enhances clinical decision making, but it also may inspire additional inquiries that will add to the existing evidence base.

Benchmarking↗