Long-term follow-up in the Peer Assessment Program for nonspecialist physicians in Ontario, Canada

Impact of college-administered quality practice assessments: a longitudinal evaluation of repeat peer assessments of continuing competence in physiotherapists

PURPOSE

The College of Physiotherapists of Ontario (CPO) developed its peer practice assessment (PA) process under statutory requirements for quality assurance. Each year, a small percentage of physiotherapists, most selected at random, undergo PA. To shed light on continuing competence, we report outcomes from physiotherapists who have had two PAs.

METHODS

Records were extracted for physiotherapists with two unrelated PAs. Demographic features, peer assessors' scores, and consequent outcome decisions were examined. Outcomes were examined cross-sectionally (vs. other PAs in the same time period) and longitudinally (within cohort).

RESULTS

Between 2004 and 2012, 117 Ontario physiotherapists underwent two unrelated PAs, typically 5-7 years apart. This cohort was representative of Ontario physiotherapists in terms of sex ratios, education, and years in practice. At the first PA (PA1), this cohort's outcomes were similar to those of other physiotherapists; at the second PA (PA2), they were better than others undergoing PA1 in the same period (p=0.02). The cohort's outcomes were better at PA2 than at PA1 (p<0.001).

CONCLUSIONS

Physiotherapists are likely to meet professional standards in a repeat PA 5-7 years after an initial one. Additional research is required to identify risk factors for not meeting standards. The findings provide empirical evidence to guide ongoing development of the CPO's quality management program.

[The Canadian experience with methods of systematic assessment of performance and revalidation in medicine. Chances for Germany]

Recertification and systematic assessment of performance are components of well-developed medical quality culture. Canada has accumulated a wealth of experience in the development and application of methods of assessment. Germany can learn from the Canadian experience. In this article the Canadian three-step approach to assessment is introduced as well as the experience of its implementation in the provinces of Ontario and Alberta.

Linking assessment to learning: a new route to quality assurance in medical practice

BACKGROUND

If continuing professional development is to work and be sensible, an understanding of clinical practice is needed, based on the daily experiences of doctors within the multiple factors that determine the nature and quality of practice. Moreover, there must be a way to link performance and assessment to ensure that ongoing learning and continuing competence are, in reality, connected. Current understanding of learning no longer holds that a doctor enters practice thoroughly trained with a lifetime's storehouse of knowledge. Rather a doctor's ongoing learning is a 'journey' across a practice lifetime, which involves the doctor as a person, interacting with their patients, other health professionals and the larger societal and community issues.

OBJECTIVES

In this paper, we describe a model of learning and practice that proposes how change occurs, and how assessment links practice performance and learning. We describe how doctors define desired performance, compare actual with desired performance, define educational need and initiate educational action.

METHOD

To illustrate the model, we describe how doctor performance varies over time for any one condition, and across conditions. We discuss how doctors perceive and respond to these variations in their performance. The model is also used to illustrate different formative and summative approaches to assessment, and to highlight the aspects of performance these can assess.

CONCLUSIONS

We conclude by exploring the implications of this model for integrated medical services, highlighting the actions and directions that would be required of doctors, medical and professional organisations, universities and other continuing education providers, credentialling bodies and governments.