PMID- 23969366
OWN - NLM
STAT- MEDLINE
DCOM- 20131203
LR  - 20151119
IS  - 1938-808X (Electronic)
IS  - 1040-2446 (Linking)
VI  - 88
IP  - 10
DP  - 2013 Oct
TI  - Practice indicators of suboptimal care and avoidable adverse events: a content 
      analysis of a national qualifying examination.
PG  - 1493-8
LID - 10.1097/ACM.0b013e3182a356af [doi]
AB  - PURPOSE: To (1) compile an initial list of physician-related practice indicators 
      (PRINDs) that contribute to causing or preventing suboptimal care (SOCR) and 
      adverse events (AEs) and (2) determine the extent to which one national exam 
      assessed these PRINDs. METHOD: In 2009-2010, the authors searched the literature 
      and surveyed 17 physician experts to compile a list of PRINDs of SOCR and 
      avoidable AEs. They then conducted a content analysis of the 2008 and 2009 
      Medical Council of Canada (MCC) Qualifying Examinations (QEs). RESULTS: The 
      authors identified 92 unique PRINDs, of which 59 were behaviors or decisions 
      expected of all physicians and suitable for assessment on a general medical 
      examination. Of these, 36 (61%) were tested on the 2008 and 2009 MCC QEs. The 
      mean number of PRINDs tested per exam was highest for Part I Knowledge (32.2), 
      followed by Part I clinical decision making (CDM) (18.4) and Part II clinical 
      performance (objective structured clinical examination [OSCE]) (9.8). The 
      percentage of questions or cases per exam testing a PRIND (e.g., 14/36 [39%] for 
      CDM and 5.26/12 [44%] for OSCE) differed from the percentage of the total test 
      score attributed to PRINDs (e.g., 10.8/36 [30%] for CDM and 68.5/1,522.3 [5%] for 
      OSCE). CONCLUSIONS: PRINDs represent candidates' abilities to avoid SOCR and AEs 
      and constitute an important aspect of medical practice to be assessed on 
      licensing or certifying examinations to best protect the public. The different 
      scoring methods used to measure such knowledge and skills warrant further 
      consideration.
FAU - Bordage, Georges
AU  - Bordage G
AD  - Dr. Bordage is professor, Department of Medical Education, University of Illinois 
      at Chicago College of Medicine, Chicago, Illinois. Dr. Meguerditchian is 
      assistant professor, Department of Oncology and Department of Surgery, McGill 
      University Faculty of Medicine, Montreal, Quebec, Canada. Dr. Tamblyn is 
      professor, Department of Medicine and Department of Epidemiology and 
      Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada.
FAU - Meguerditchian, Ari-Nareg
AU  - Meguerditchian AN
FAU - Tamblyn, Robyn
AU  - Tamblyn R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Acad Med
JT  - Academic medicine : journal of the Association of American Medical Colleges
JID - 8904605
SB  - IM
MH  - Canada
MH  - *Clinical Competence
MH  - Decision Making
MH  - *Education, Medical
MH  - Educational Measurement/*methods
MH  - Humans
MH  - Medical Errors/*prevention & control
MH  - *Patient Safety
MH  - Practice Patterns, Physicians'/*statistics & numerical data
MH  - Predictive Value of Tests
MH  - *Quality Assurance, Health Care
MH  - Risk Factors
EDAT- 2013/08/24 06:00
MHDA- 2013/12/16 06:00
CRDT- 2013/08/24 06:00
PHST- 2013/08/24 06:00 [entrez]
PHST- 2013/08/24 06:00 [pubmed]
PHST- 2013/12/16 06:00 [medline]
AID - 10.1097/ACM.0b013e3182a356af [doi]
PST - ppublish
SO  - Acad Med. 2013 Oct;88(10):1493-8. doi: 10.1097/ACM.0b013e3182a356af.