TY - JOUR
T1 - Setting performance standards for medical practice
T2 - A theoretical framework
AU - Southgate, L.
AU - Hays, R. B.
AU - Norcini, J.
AU - Mulholland, H.
AU - Ayers, B.
AU - Woolliscroft, J.
AU - Cusimano, M.
AU - McAvoy, P.
AU - Ainsworth, M.
AU - Haist, S.
AU - Campbell, M.
PY - 2001
Y1 - 2001
N2 - Background: The assessment of performance in the real world of medical practice is now widely accepted as the goal of assessment at the postgraduate level. This is largely a validity issue, as it is recognised that tests of knowledge and in clinical simulations cannot on their own really measure how medical practitioners function in the broader health care system. However, the development of standards for performance-based assessment is not as well understood as in competency assessment, where simulations can more readily reflect narrower issues of knowledge and skills. This paper proposes a theoretical framework for the development of standards that reflect the more complex world in which experienced medical practitioners work. Methods: The paper reflects the combined experiences of a group of education researchers and the results of literature searches that included identifying current health system data sources that might contribute information to the measurement of standards. Conclusion: Standards that reflect the complexity of medical practice may best be developed through an 'expert systems' analysis of clinical conditions for which desired health care outcomes reflect the contribution of several health professionals within a complex, three-dimensional, contextual model. Examples of the model are provided, but further work is needed to test validity and measurability.
AB - Background: The assessment of performance in the real world of medical practice is now widely accepted as the goal of assessment at the postgraduate level. This is largely a validity issue, as it is recognised that tests of knowledge and in clinical simulations cannot on their own really measure how medical practitioners function in the broader health care system. However, the development of standards for performance-based assessment is not as well understood as in competency assessment, where simulations can more readily reflect narrower issues of knowledge and skills. This paper proposes a theoretical framework for the development of standards that reflect the more complex world in which experienced medical practitioners work. Methods: The paper reflects the combined experiences of a group of education researchers and the results of literature searches that included identifying current health system data sources that might contribute information to the measurement of standards. Conclusion: Standards that reflect the complexity of medical practice may best be developed through an 'expert systems' analysis of clinical conditions for which desired health care outcomes reflect the contribution of several health professionals within a complex, three-dimensional, contextual model. Examples of the model are provided, but further work is needed to test validity and measurability.
KW - Clinical competence, standards
KW - Models, theoretical
KW - Organization, standards
KW - Quality of health care
KW - Research design
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U2 - 10.1046/j.1365-2923.2001.00897.x
DO - 10.1046/j.1365-2923.2001.00897.x
M3 - Article
C2 - 11328518
AN - SCOPUS:0035021523
SN - 0308-0110
VL - 35
SP - 474
EP - 481
JO - Medical Education
JF - Medical Education
IS - 5
ER -