How Continuing Medical Education Impacts Physician Self-Assessment

The importance of lifelong learning in continuing medical education was explored in a systematic review published in the Journal of the American Medical Association (JAMA). Required for all healthcare professionals, continuing medical education (CME) serves the purpose of creating a culture of lifelong learning, assessing clinical competence, and fulfilling mandatory training for licensure. This JAMA article by Davis et. al suggested that despite physician professional development, there may be limitations in the self-assessing standards that physicians have for themselves. In other words, physicians’ self-assessment of their own capabilities does not often match with externally measured competence. The article offers five measures to improve this disparity by way of bettering medical education. 

In this review, Davis et al.’s looked at physicians’ accuracy in self-assessing competence. They offered five concluding measures of improvement that are aimed towards creating more effective CME for physicians. Having engaging learning mechanisms would not only increase self-assessment skills but could also potentially increase the quality of care and patient safety.  The first measure suggested was the development of a more holistic professional development process, such as increasing practice-based learning activities that align with the competencies that the Accreditation Council for Graduate Medical Education puts forth. The inclusion of holistic medical education would serve the purpose of widening the scope of learning. The second measure concerns comparative feedback and the internalization of performance benchmarks. Having the space to receive feedback on clinical and educational performance could possibly decrease the gap between self-assessment and external assessment. 

Thirdly, the implementation of a relatively new concept in this field called multisource feedback evaluations or 360°’s (learn more here) could increase communication, interpersonal, and professional skills. Within multisource feedback, the evaluations of the physician themselves are combined with their subordinates, colleagues, and supervisors. These could increase the quality of communications while simultaneously ensuring that self-assessment does not differ widely from other’s external assessments. The fourth suggested measure is having objective measures of competence. In the realm of patient safety, medical licensure, recertification, and quality of care, ensuring that objective measures of education are met is essential. An example of this would be to engage in appraisal, where the process of self-assessment is guided by an external figure to prevent subjective ideals. Lastly, increasing the impact that specialty societies have in the role of physician competence in order to make sure that thoroughly-researched and evidence-based practices are known would further create another external marker of competence. 

The medical field as a whole has to update its continuing education to be more focused on external assessment in order for physicians to do the safest, most accurate, and effective work. This responsibility lies with those overseeing continuing education to ensure that large system-level changes that provide holistic, researched, and relevant learning are initiated. By the nature of their profession, physicians and other healthcare clinicians are lifelong learners. The education provided to them must be high-quality to make certain that their own view of their competence aligns with their actual competence. 

Sources:

Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006 Sep 6;296(9):1094-102. doi: 10.1001/jama.296.9.1094. PMID: 16954489.

Tariq, M., Govaerts, M., Afzal, A. et al. Ratings of performance in multisource feedback: comparing performance theories of residents and nurses. BMC Med Educ 20, 355 (2020). https://doi.org/10.1186/s12909-020-02276-1

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