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Yahoo! Health News are reporting: Doctors Often Overestimate Their Expertise
Quote:
Doctors often have a falsely exaggerated view of their own capabilities, a new study suggests.
In fact, physicians who were judged by outsiders to be the worst performers in a given area often gave themselves especially high marks, researchers report.
"There is a subset of clinicians who appear, either by training or personality, unable to judge themselves," said study lead researcher Dr. David Davis, a professor of health policy management and evaluation at the University of Toronto, in Canada.
The findings suggest that outside evaluators might be better equipped to review a physician's performance, then direct him or her to areas that need improvement with continuing medical education.
Right now, those decisions are left up to the individual doctor. But, "we need to have systems that inform physicians about what they know and don't know," Davis said.
His team published its findings in the Sept. 6 issue of the Journal of the American Medical Association.
More than almost any other profession, doctors are engaged in ongoing, lifelong training in the form of continuing medical education, or CME. In fact, medical boards require that doctors engage in regular CME for their re-certification. This training refreshes a doctor's skills while keeping them up-to-date on the latest innovations in medicine.
But, in most cases, doctors decide what their particular areas of weakness might be.
In their review, Davis and his colleagues in Canada and the United States decided to see what the accumulated data had to say about the accuracy of physician self-assessments. To do so, they focused on 17 studies comparing doctors' self-assessments against those of an objective, external reviewer.
"In two-thirds of those studies, it appears as though physicians, without any outside means of observing their behavior, misjudged their competence," Davis said.
In many cases, doctors thought they were very adept in certain tasks -- detecting signs of sexual abuse in patients, for example, or delivering joint injections -- but were typically deemed to be poor performers by outside experts.
Davis said the findings shouldn't come as a big surprise to anyone familiar with human nature.
"This isn't peculiar to physicians," he said. "It's peculiar to us all as human beings. It's just part of the human condition that we don't have full, objective opinions of ourselves." In fact, he added, studies have found similar trends among lawyers, engineers and other professionals.....
Accuracy of Physician Self-assessment Compared With Observed Measures of Competence: A Systematic Review
David A. Davis, MD; Paul E. Mazmanian, PhD; Michael Fordis, MD; R. Van Harrison, PhD; Kevin E. Thorpe, MMath; Laure Perrier, MEd, MLIS JAMA. 2006;296:1094-1102.
Quote:
Context Core physician activities of lifelong learning, continuing medical education credit, relicensure, specialty recertification, and clinical competence are linked to the abilities of physicians to assess their own learning needs and choose educational activities that meet these needs.
Objective To determine how accurately physicians self-assess compared with external observations of their competence.
Data Sources The electronic databases MEDLINE (1966-July 2006), EMBASE (1980-July 2006), CINAHL (1982-July 2006), PsycINFO (1967-July 2006), the Research and Development Resource Base in CME (1978-July 2006), and proprietary search engines were searched using terms related to self-directed learning, self-assessment, and self-reflection.
Study Selection Studies were included if they compared physicians' self-rated assessments with external observations, used quantifiable and replicable measures, included a study population of at least 50% practicing physicians, residents, or similar health professionals, and were conducted in the United Kingdom, Canada, United States, Australia, or New Zealand. Studies were excluded if they were comparisons of self-reports, studies of medical students, assessed physician beliefs about patient status, described the development of self-assessment measures, or were self-assessment programs of specialty societies. Studies conducted in the context of an educational or quality improvement intervention were included only if comparative data were obtained before the intervention.
Data Extraction Study population, content area and self-assessment domain of the study, methods used to measure the self-assessment of study participants and those used to measure their competence or performance, existence and use of statistical tests, study outcomes, and explanatory comparative data were extracted.
Data Synthesis The search yielded 725 articles, of which 17 met all inclusion criteria. The studies included a wide range of domains, comparisons, measures, and methodological rigor. Of the 20 comparisons between self- and external assessment, 13 demonstrated little, no, or an inverse relationship and 7 demonstrated positive associations. A number of studies found the worst accuracy in self-assessment among physicians who were the least skilled and those who were the most confident. These results are consistent with those found in other professions.
Conclusions While suboptimal in quality, the preponderance of evidence suggests that physicians have a limited ability to accurately self-assess. The processes currently used to undertake professional development and evaluate competence may need to focus more on external assessment.
But, in most cases, doctors decide what their particular areas of weakness might be.
Maybe thats a good thing because the evidence suggests that adults learn best when they have self-identified and acknowledged a deficit and set out to rectify that deficit.
__________________
Craig Payne
Department of Podiatry
La Trobe University
Melbourne, Australia http://www.latrobe.edu.au/podiatry
__________________________________________________ ___________________________________ God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.
The views expressed above are those of the author and not that of La Trobe University This is where I am, where are you?
How can a person who spends 6 yrs studying the entire human body, diseases and treatments be better equipped to diagnose and/or treat a disorder of a particular body part than another person who spends four years on that one area?
In other words: why should a doctor be better at foot problems than a podiatrist?
My experience is they dont have a clue. In fact, I have a friend that is a GP who studied medicine in melbourne and his class ran out of time and did not learn anything about feet at all. His class was told not to worry because it would not be on the exam and it is just like the hand anyway!!!! I kid you not.
Would you like this dr to perform your PNA? I dont think so!
How can a person who spends 6 yrs studying the entire human body, diseases and treatments be better equipped to diagnose and/or treat a disorder of a particular body part than another person who spends four years on that one area?!
If that disturbs you, then consider that the majority of medical schools in Australia have moved to a graduate program that is typically 4 years long. So someone with a basic degree unrelated to medicine, can then do 4 years and treat any foot condition with a greater scope of practice than podiatrist in this country can. We are the clever country!
Doctors Often Overestimate Their Expertise
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