Value of General Medical Knowledge Examinations in Performance Assessment of Practicing Physicians With Potential Competence and Performance Deficiencies.
Problems with a physician's performance may arise at any point during their career. As such, there is a need for effective, valid tools and processes to accurately assess and identify deficiencies in competence or performance. Although scores on multiple-choice questions have been shown to be predictive of some aspects of physician performance in practicing physicians, their relationship to overall clinical competence is somewhat uncertain particularly after the first 10 years of practice. As such, the purpose of this study was to examine how a general medical knowledge multiple-choice question examination is associated with a comprehensive assessment of competence and performance in experienced practicing physicians with potential competence and performance deficiencies.



The study included 233 physicians, of varying specialties, assessed by the University of California, San Diego Physician Assessment and Clinical Education Program (PACE), between 2008 and 2012, who completed the Post-Licensure Assessment System Mechanisms of Disease (MoD) examination. Logistic regression determined if the examination score significantly predicted passing assessment outcome after correcting for gender, international medical graduate status, certification status, and age.



Most physicians (89.7%) received an overall passing assessment outcome on the PACE assessment. The mean MoD score was 66.9% correct, with a median of 68.0%. Logistic regression (P = .038) was significant in indicating that physicians with higher MoD examination scores had an increased likelihood of achieving a passing assessment outcome (odds ratio = 1.057).



Physician MoD scores are significant predictors of overall physician competence and performance as evaluated by PACE assessment.
Dr. Wenghofer: Associate Professor, School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada, and Research Director, Physician Assessment and Clinical Education (PACE) Program, University of California San Diego, San Diego, CA. Dr. Henzel: Research Analyst, Policy & Product Development, National Board of Medical Examiners, Philadelphia, PA. Dr. Miller: Voluntary Clinical Professor of Family and Preventive Medicine and Surgery, University of California San Diego, San Diego, CA. Dr. Norcross: Clinical Professor and Director Physician Assessment and Clinical Education (PACE) Program, University of California San Diego, San Diego, CA. Mr. Boal: Associate Director, Physician Assessment and Clinical Education (PACE) Program, University of California San Diego, San Diego, CA.
Elizabeth F
EF
Wenghofer
Thomas R
TR
Henzel
Stephen H
SH
Miller
William
W
Norcross
Peter
P
Boal
D000328:Adult; D000368:Aged; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D019359:Knowledge; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000592:standards*; D000066477:Work Performance / Q000592:standards* / Q000706:statistics & numerical data