Medical revalidation and education--directed self-learning.
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Accreditation↗
Biomedical subjects
R Lewkonia
Publications and source records attributed to R Lewkonia.
Educational implications of practice isolation.
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Clinical Competence↗
Assessment of physician performance in Alberta: the physician achievement review.
The College of Physicians and Surgeons of Alberta, in collaboration with the Universities of Calgary and Alberta, has developed a program to routinely assess the performance of physicians, intended primarily for quality improvement in medical practice. The Physician Achievement Review (PAR) provides a multidimensional view of performance through structured feedback to physicians. The program will also provide a new mechanism for identifying physicians for whom more detailed assessment of practice performance or medical competence may be needed. Questionnaires were created to assess an array of performance attributes, and then appropriate assessors were designated--the physician himself or herself (self-evaluation), patients, medical peers, consultants and referring physicians, and non-physician coworkers. A pilot study with 308 physician volunteers was used to evaluate the psychometric and statistical properties of the questionnaires and to develop operating policies. The pilot surveys showed good statistical validity and technical reliability of the PAR questionnaires. For only 28 (9.1%) of the physicians were the PAR results more than one standard deviation from the peer group means for 3 or more of the 5 major domains of assessment (self, patients, peers, consultants and coworkers). In post-survey feedback, two-thirds of the physicians indicated that they were considering or had implemented changes to their medical practice on the basis of their PAR data. The estimated operating cost of the PAR program is approximately $200 per physician. In February 1999, on the basis of the operating experience and the results of the pilot survey, the College of Physicians and Surgeons of Alberta implemented this innovative program, in which all Alberta physicians will be required to participate every 5 years.
Alberta↗
Hospital grand rounds in family medicine. Content and educational structure.
OBJECTIVE: To investigate hospital grand rounds in family medicine, to examine their content and organization, and to recommend improved educational structures for these ubiquitous continuing medical education events. DATA SELECTION: Retrospective analysis of titles and content of 358 family medicine grand rounds offered in the department of family medicine of a large urban hospital from mid-1983 to the end of 1994. FINDINGS: Only 10% of family medicine grand rounds were presented by family physicians. Most grand rounds were in the form of specialists exhibiting their own interests in a lecture format. Analysis of grand rounds titles showed no consistent pattern of topics but an emphasis on practical aspects of medical care. Patient-based presentations were uncommon, as were grand rounds with more than one speaker. CONCLUSIONS: The content and mix of topics appeared appropriate, but in the absence of a curricular structure, or evaluation of learning gain, it is difficult to assess the value of grand rounds.
Alberta↗
Systemic lupus erythematosus. A prospective analysis.
The spectrum of organ involvement in 50 patients with systemic lupus erythematosus has been assessed in a prospective study. All patients were admitted to hospital electively for 2 days and a complete clinical and laboratory assessment protocol completed. Subsequent hospital admissions depended on clinical status. The overall mean observation period was 29 months. Widespread multisystem involvement was found in every patient. Subclinical abnormalities of respiratory and cerebral function were common even in patients in clinical remission. A more conservative approach than has been generally recommended was used for the management of systemic lupus erythematosus and is supported by the estimated 5-year survival of 98%.
Adolescent↗