Search PubMed⌕ Search

Biomedical subjects

Paul E Mazmanian

Publications and source records attributed to Paul E Mazmanian.

7 recordsLinked to original sources
PubMed2006

Accuracy of physician self-assessment compared with observed measures of competence: a systematic review.

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.

Clinical Competence↗
PubMed2005

Physician migration, education, and health care.

Physician migration is a complex and multifaceted phenomenon that is intimately intertwined with medical education. Imbalances in the production of physicians lead to workforce shortages and surpluses that compromise the ability to deliver adequate and equitable health care to large parts of the world's population. In this overview, we address a special section of the journal and briefly describe the current state of affairs in physician migration and its effects on donor and recipient countries. Global forms of practice and education, based on initiatives such as telemedicine and the International Virtual Medical School, hold promise of redressing some of these imbalances without requiring physicians to leave their countries. Other initiatives, such as those to raise the standards of medical education across the continuum, will improve the quality of care locally and permit the movement of physicians, resulting in better distribution of the workforce. All of these actions require a uniquely global perspective that places a premium on the long-term benefits to humankind while respecting the rights of patients and physicians.

Education, Medical↗
PubMed2005

The Self-Directed Learning Readiness Scale: a factor analysis study.

BACKGROUND: The practice of medicine demands that its physician practitioners are self-directed, life-long learners. The Self-Directed Learning Readiness Scale (SDLRS) intends to measure adults' readiness to engage in self-directed learning. PURPOSE: The present study assesses the underlying factor structure of the SDLRS for a sample of entering medical students. METHODS: Over a period of 6 years, 972 first year medical students at the Virginia Commonwealth University School of Medicine completed the SDLRS. To summarise the inter-relationships among variables, a principal axis factor analysis with oblique rotation was used on the 58 SDLRS items. A series of confirmatory factor analyses using LISREL 8.54 was performed to further examine the measurement model underlying the SDLRS. RESULTS: A 4-factor confirmatory model representing 4 correlated substantive factors and a reverse coding method factor fits these data well. CONCLUSIONS: Medical educators should hold limited expectations of the SDLRS to measure medical students' readiness to engage in self-directed learning. The definitions and theoretical assumptions that inform readiness for self-directed learning should be reconsidered. Alternative approaches to studying self-directed learning should be explored.

Education, Medical, Continuing↗
PubMed2004

Understanding primary care residency choices: a test of selected variables in the Bland-Meurer model.

PURPOSE: This study tested the predictive validity of variables related to student characteristics of the Bland-Meurer Model of Career Decision-Making. METHOD: A study was conducted using Association of American Medical Colleges' Graduate Student Questionnaire and career data from one medical school. Logistic regression analyses generated predictive models of primary care residency choice, including family medicine, general internal medicine, and pediatrics for 555 medical school graduates over five years. RESULTS: Variables predictive of primary care residency choice were gender; student ratings of psychiatry, surgery, and internal medicine clerkships; not having participated in a research project in medical school; attitudes toward "the changing health care system on physicians" and "access to medical care"; and planned practice in a medically underserved area. Results differed for each field within each residency choice. CONCLUSIONS: The Bland-Meurer Model may be used for variable selection in multivariate predictive models of family medicine, internal medicine and pediatrics residency choice. The authors' results may help guide admissions decisions, while providing medical educators and health care policymakers with a clearer picture of residency choice and a better understanding of how to meet the demands of selected patient populations.

Adult↗