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Herta Fidler

Publications and source records attributed to Herta Fidler.

10 recordsLinked to original sources
PubMed2006

The assessment of emergency physicians by a regulatory authority.

OBJECTIVES: To determine whether it is possible to develop a feasible, valid, and reliable multisource feedback program (360 degree evaluation) for emergency physicians. METHODS: Surveys with 16, 20, 30, and 31 items were developed to assess emergency physicians by 25 patients, eight coworkers, eight medical colleagues, and self, respectively, using five-point scales along with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, and self-management. RESULTS: Data from 187 physicians who identified themselves as emergency physicians were available. The mean number of respondents per physician was 21.6 (SD +/- 3.87) (93%) for patients, 7.6 (SD +/- 0.89) (96%) for coworkers, and 7.7 (SD +/- 0.61) (95%) for medical colleagues, suggesting it was a feasible tool. Only the patient survey had four items with "unable to assess" percentages > or = 15%. The factor analysis indicated there were two factors on the patient questionnaire (communication/professionalism and patient education), two on the coworker survey (communication/collegiality and professionalism), and four on the medical colleague questionnaire (clinical performance, professionalism, self-management, and record management) that accounted for 80.0%, 62.5%, and 71.9% of the variance on the surveys, respectively. The factors were consistent with the intent of the instruments, providing empirical evidence of validity for the instruments. Reliability was established for the instruments (Cronbach's alpha > 0.94) and for each physician (generalizability coefficients were 0.68 for patients, 0.85 for coworkers, and 0.84 for medical colleagues). CONCLUSIONS: The psychometric examination of the data suggests that the instruments developed to assess emergency physicians were feasible and provide evidence for validity and reliability.

Clinical Competence↗
PubMed2006

The development and testing of a performance checklist to assess neonatal resuscitation megacode skill.

PURPOSE: The purpose of this work was to develop and assess the feasibility, reliability, and validity of a brief performance checklist to evaluate skills during a simulated neonatal resuscitation ("megacode") for the Neonatal Resuscitation Program of the American Academy of Pediatrics. METHODS: A performance checklist of items was created, validated, and modified in sequential phases involving: an expert committee, review, and feedback by Neonatal Resuscitation Program instructors for feasibility and criticality and use of the performance checklist by Neonatal Resuscitation Program instructors reviewing videotaped megacodes. The final 20-item performance checklist used a 3-point scale and was assessed by student and instructor volunteers. Megacode scores, the NRP multiple-choice examination scores, student assessments of their ability and performance, and sociodemographic descriptors for both students and instructors were collected. Data were analyzed descriptively. In addition, we assessed the megacode score internal consistency reliability, the correlations between megacode and multiple-choice examination scores, and the variance in scores based on instructor and student characteristics. RESULTS: A total of 468 students and 148 instructors volunteered for the study. The instrument was reliable and internally consistent. Student's scores were high on most items. There was a significant but low correlation between the megacode score and the written knowledge examination. Instructor and student characteristics had little effect on the variance in scores. CONCLUSIONS: This performance checklist provides a feasible assessment tool. There is evidence for its reliability and validity.

Clinical Competence↗
PubMed2006

A multi source feedback program for anesthesiologists.

PURPOSE: To assess the feasibility, validity, and reliability of a multi source feedback program for anesthesiologists. METHODS: Surveys with 11, 19, 29 and 29 items were developed for patients, coworkers, medical colleagues and self, respectively, using five-point scales with an 'unable to assess' category. The items addressed communication skills, professionalism, collegiality, continuing professional development and collaboration. Each anesthesiologist was assessed by eight medical colleagues, eight coworkers, and 30 patients. Feasibility was assessed by response rates for each instrument. Validity was assessed by rating profiles, the percentage of participants unable to assess the physician for each item, and exploratory factor analyses to determine which items grouped together into scales. Cronbach's alpha and generalizability coefficient analyses assessed reliability. RESULTS: One hundred and eighty-six physicians participated. The mean number and percentage return rate of respondents per physician was 17.7 (56.2%) for patients, 7.8 (95.1%) for coworkers, and 7.8 (94.6%) for medical colleagues. The mean ratings ranged from four to five for each item on each scale. There were relatively few items with high percentages of 'unable to assess'. The factor analyses revealed a two-factor solution for the patient, a two-factor solution for the coworker and a three-factor solution for the medical colleague survey, accounting for at least 70% of the variance. All instruments had a high internal consistency reliability (Cronbach's alpha > 0.95). The generalizability coefficients were 0.65 for patients, 0.56 for coworkers and 0.69 for peers. CONCLUSION: It is feasible to develop multi source feedback instruments for anesthesiologists that are valid and reliable.

Anesthesiology↗
PubMed2006

A study of a multi-source feedback system for international medical graduates holding defined licences.

OBJECTIVE: To develop and assess the feasibility and psychometric properties of multi-source feedback questionnaires to monitor international medical graduates practising in Canada under 'defined' licences. METHOD: Four questionnaires (patient, co-worker, colleague and self) were developed and administered in 2 phases through paper-based and telephone or Internet formats. Reliability was assessed with Cronbach's alpha and generalisability coefficient analyses. Validity was established through mean ratings, 'unable to respond' rates and factor analyses. RESULTS: A total of 37 doctors participated in the 2 phases. Overall response rates were 70% for patients, 86% for co-workers, 72% for medical colleagues and 92% for self, with response rates higher for the paper-based format than the Internet and phone formats. The instruments had high internal consistency reliability, with Cronbach's alphas of 0.83 for self-assessment and > 0.90 for the other instruments. The generalisability coefficients were Ep(2) = 0.71 for 25 patients on a 13-item survey, Ep(2) = 0.59 for 8 co-workers on a 13-item survey, and Ep(2) = 0.67 for 8 colleagues on a 21-item questionnaire. The range of mean scores was narrow (between 4 and 5) for all items and all surveys. The factor analyses identified that 2 factors accounted for 70% or more of the variance for the patient and colleague surveys and 60% of the variance for the co-worker survey. CONCLUSION: These data suggest that the instruments have reasonable psychometric properties. Traditional survey methods (i.e. paper-based) yielded better results than Internet or phone methods for this group of doctors.

Accreditation↗
PubMed2006

Assessment of pediatricians by a regulatory authority.

OBJECTIVE: To determine whether it is possible to develop feasible, valid, and reliable multisource feedback data for pediatricians. METHODS: Surveys with 40, 22, 38, and 37 items were developed for assessment of pediatricians by patients, co-workers, medical colleagues, and themselves, respectively, using 5-point scales with an "unable to assess" category. Items addressed key competencies related to communication skills, professionalism, collegiality, continuing professional development, and collaboration. Each pediatrician was assessed by 25 patients, 8 medical colleagues, and 8 co-workers. Feasibility was assessed with response rates for each instrument. Validity was assessed with rating profiles, the percentage of participants unable to assess the physician for each item, and exploratory factor analyses to determine which items grouped together into scales. Cronbach's alpha and generalizability coefficient analyses assessed reliability. RESULTS: One hundred pediatricians participated. The mean number of respondents per physician was 23.4 (93.6%) for patients, 7.6 (94.8%) for co-workers, and 7.6 (95.5%) for medical colleagues. The mean ratings ranged from 4 to 5 for each item on each scale. Few items had high percentages of "unable to assess" responses. The factor analyses revealed a 4-factor solution for the patient survey, a 3-factor solution for the co-worker survey, and a 4-factor solution for the medical colleague survey, accounting for at least 64% of the variance. All instruments had high internal consistency. The generalizability coefficients were .85 for patients, .87 for co-workers, and .78 for medical colleagues. CONCLUSION: Surveys can be developed to provide feedback data on key competencies.

Canada↗
PubMed2005

Assessing outcomes through congruence of course objectives and reflective work.

INTRODUCTION: Course outcomes have been assessed by examining the congruence between statements of commitment to change (CTCs) and course objectives. Other forms of postcourse reflective exercises (for example, impact and unmet-needs statements) have not been examined for congruence with course objectives or their utility in assessing course outcomes. This study assessed the congruence of course objectives and statements of commitment to change, effects on practice, unmet-needs, and the utility of supplementing CTCs with other forms of reflective work in course evaluations. METHODS: A 3-module course on Alzheimer's disease and other dementias provided end-of-course CTC statements, follow-up data, and statements of effects on practice and unmet needs. Statements were aligned to module objectives and analyzed descriptively. RESULTS: Of the 932 physicians who registered for 1 of the 3 modules, 404 provided CTCs, 302 provided impact statements, and 265 provided unmet-needs statements. Sixty percent of the CTCs could be assigned to an objective for their module, and between 14% and 25% of CTCs were assigned to objectives for another module. Three-quarters of CTCs were fully or partially implemented. Physicians did not have an opportunity to implement the new content in 70% of nonimplemented CTCs. Fewer impact and unmet-needs statements were congruent with course objectives than CTCs. CONCLUSIONS: Commitment-to-change statements had more congruence with objectives than did impact or unmet-needs statements. These latter statements, particularly those that could not be assigned to an objective, may reinforce and supplement the information provided by CTC analyses.

Alzheimer Disease↗
PubMed2003

Likelihood of change: a study assessing surgeon use of multisource feedback data.

BACKGROUND: Multisource feedback, using questionnaire-based data from patients, coworkers, and medical colleagues, is designed to provide broad-based information about clinical performance to facilitate change. PURPOSE: To determine and explain the likelihood that surgeons would implement change following receipt of performance data. METHODS: Surgeons were surveyed to determine the likelihood they would make changes based on specific feedback about their clinical practices. RESULTS: One hundred fifty-three surgeons (76.5%) responded to the follow-up survey. There was little correlation between performance ratings provided by self or medical colleagues and the likelihood of change. A linear regression analysis indicated that 19.2% of the variance in likelihood to change could be explained by age, time spent reviewing feedback, the gap between self- and other ratings, and surgical specialty. CONCLUSION: Surgeons made few changes in practice in response to feedback data. Attention needs to be paid to methods that might increase surgeon use of performance data

Alberta↗
PubMed2002

Permanent small groups: group dynamics, learning, and change.

INTRODUCTION: The concept of "communities of practice," a special facet of social constructivist learning theory, provides a new template against which we can examine the learning that goes on within permanent small groups of physicians. We interviewed participants and facilitators about the dynamics of these groups, their learning in conjunction with these groups, and the role the facilitator played to see the extent to which they captured the essence of communities of practice. METHODS: Semistructured interviews were conducted with physicians known to be participants or facilitators of small groups that met regularly. A constant comparative method was used for data gathering and analysis leading to coded themes, categories, and subcategories. The coding schemas were tested, the analyses were reviewed, and data were recoded as necessary. To ensure accuracy, interviewees were provided with a preliminary copy of the manuscript to ensure that the interpretation of the data was appropriately handled. RESULTS: Interviews were conducted with 10 facilitators and 22 group members representing 24 different groups of physicians. The groups appeared to function as communities of practice in which the members were supportive of each other's learning and respectful of one another, reporting little conflict. Members preferred to agree to disagree rather than pursue a "right" answer or consensus. Most of the discussion focused on scientific information and the way in which their colleagues approached common problems. Practice refinement rather than new directions in patient care appeared to be the goal. The facilitators in these groups played a key role in providing administrative support for the group and often the energy needed to sustain them. DISCUSSION: Small groups that meet regularly provide a supportive network to share knowledge and validate clinical experience. There is some evidence that the groups have the potential to become communities of practice but do not actually achieve that level of sharing. Research needs to be done to determine how these groups could become more powerful as communities of practice and vehicles for more substantive learning and change.

Attitude of Health Personnel↗