title: Internists' attitudes about assessing and maintaining clinical competence.
abstract: BACKGROUND
  Important changes are occurring in how the medical profession approaches assessing and maintaining competence. Physician support for such changes will be essential for their success.
  
  
  OBJECTIVE
  To describe physician attitudes towards assessing and maintaining competence.
  
  
  METHODS
  Cross-sectional internet survey.
  
  
  METHODS
  Random sample of 1,000 American College of Physicians members who were eligible to participate in the American Board of Internal Medicine Maintenance of Certification program.
  
  
  METHODS
  Questions assessed physicians' attitudes and experiences regarding: 1) self-regulation, 2) feedback on knowledge and clinical care, 3) demonstrating knowledge and clinical competence, 4) frequency of use and effectiveness of methods to assess or improve clinical care, and 5) transparency.
  
  
  RESULTS
  Surveys were completed by 446 of 943 eligible respondents (47%). Eighty percent reported it was important (somewhat/very) to receive feedback on their knowledge, and 94% considered it important (somewhat/very) to get feedback on their quality of care. However, only 24% reported that they receive useful feedback on their knowledge most/all of the time, and 27% reported receiving useful feedback on their clinical care most/all of the time. Seventy-five percent agreed that participating in programs to assess their knowledge is important to staying up-to-date, yet only 52% reported participating in such programs within the last 3 years. The majority (58%) believed physicians should be required to demonstrate their knowledge via a secure examination every 9-10 years. Support was low for Specialty Certification Boards making information about physician competence publically available, with respondents expressing concern about patients misinterpreting information about their Board Certification activities.
  
  
  CONCLUSIONS
  A gap exists between physicians' interest in feedback on their competence and existing programs' ability to provide such feedback. Educating physicians about the importance of regularly assessing their knowledge and quality of care, coupled with enhanced systems to provide such feedback, is needed to close this gap.
authors.affiliation: Department of Medicine, University of Washington, 4311-11th Ave NE, Suite 230, Seattle, WA, 98015-6367, USA, thomasg@uw.edu.
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Gallagher
authors.forename: Carolyn D
authors.initials: CD
authors.lastname: Prouty
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Brock
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Liao
authors.forename: Arlene
authors.initials: A
authors.lastname: Weissman
authors.forename: Eric S
authors.initials: ES
authors.lastname: Holmboe
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000592:standards*; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology / Q000592:standards*