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PubMed · 14987181

Assessing practice-based learning and improvement.

Deirdre C Lynch·Susan R Swing·Sheldon D Horowitz·Kathleen Holt·Joseph V Messer
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Abstract

BACKGROUND: Practice-based learning and improvement (PBLI) is 1 of 6 general competencies expected of physicians who graduate from an accredited residency education program in the United States and is an anticipated requirement for those who wish to maintain certification by the member boards of the American Board of Medical Specialties. This article describes methods used to assess PBLI. SUMMARY: Six electronic databases were searched using several search terms pertaining to PBLI. The review indicated that 4 assessment methods have been used to assess some or all steps of PBLI: portfolios, projects, patient record and chart review, and performance ratings. Each method is described, examples of application are provided, and validity, reliability, and feasibility characteristics are discussed. CONCLUSION: Portfolios may be the most useful approach to assess residents' PBLI abilities. Active participation in peer-driven performance improvement initiatives may be a valuable approach to confirm practicing physician involvement in PBLI.

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Clinical CompetenceEducational MeasurementHumansLearningMedical AuditPhysiciansProblem-Based LearningProgram EvaluationUnited StatesJournal ArticleResearch Support, Non-U.S. Gov't

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Deirdre C Lynch, Susan R Swing, Sheldon D Horowitz, Kathleen Holt, Joseph V Messer. 2004. Assessing practice-based learning and improvement.. https://doi.org/10.1207/s15328015tlm1601_17

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Discussing randomised clinical trials of cancer therapy: evaluation of a Cancer Research UK training programme.

OBJECTIVE: To evaluate a training intervention aimed at improving healthcare professionals' communication with cancer patients about randomised clinical trials. DESIGN: Before and after evaluation of training programme. SETTING: Members of the National Cancer Research Network, Scottish Trials Network, and the Welsh Cancer Trials Network. PARTICIPANTS: 101 healthcare professionals (33 clinicians and 68 research nurses). INTERVENTION: Four modules delivered by a trained facilitator using videotapes and interactive exercises to cover general issues about discussing randomised clinical trials with patients, problems specific to adjuvant trials, trials with palliation as the goal, and trials where patients had a strong preference for one treatment arm. MAIN OUTCOME MEASURES: Before and after the intervention, participants were videotaped discussing a trial with an actor portraying a patient. These consultations were assessed for presence of information required by good clinical practice guidelines. The actor patients gave an assessment after each interview. Participants reported their self confidence about key aspects of trial discussion. RESULTS: Analysis of the videotaped consultations showed that, after intervention, significantly more participants displayed key communication behaviours such as explaining randomisation (69 v 81, odds ratio 2.33, P = 0.033), checking patients' understanding (11 v 31, odds ratio 3.22, P = 0.002), and discussing standard treatment (73 v 88, odds ratio 4.75, P = 0.005) and side effects (69 v 85, odds ratio 3.29, P = 0.006). Participants' self confidence increased significantly (P < 0.001) across all areas. Actor patients' ratings of participants' communication showed significant improvements for 12/15 key items. CONCLUSION: This intensive 8 hour intervention significantly improved participants' confidence and competence when communicating about randomised clinical trials.

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