Informal Peer Interaction and Practice Type as Predictors of Physician Performance on Maintenance of Certification Examinations

By 16 april 2014 april 18th, 2019 Teameffectiviteit

Informal Peer Interaction and Practice Type as Predictors of Physician Performance on Maintenance of Certification Examinations

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Importance

Physicians can demonstrate mastery of the knowledge that supports continued clinical competence by passing a maintenance of certification examination (MOCEX). Performance depends on professional learning and development, which may be enhanced by informal routine interactions with colleagues. Some physicians, such as those in solo practice, may have less opportunity for peer interaction, thus negatively influencing their examination performance.

Objective

To determine the relationship among level of peer interaction, group and solo practice, and MOCEX performance.

Design, setting, and participants

Longitudinal cohort study of 568 surgeons taking the 2008 MOCEX. Survey responses reporting the level of physicians’ peer interactions and their practice type were related to MOCEX scores, controlling for initial qualifying examination scores, practice type, and personal characteristics.

Exposures

Solo practice and amount of peer interaction.

Main outcomes and measures

Scores on the MOCEX and pass-fail status.

Results

Of the 568 surgeons in the study sample, 557 (98.1%) passed the examination. Higher levels of peer interaction were associated with a higher score (β = 0.91 [95% CI, 0.31-1.52]) and higher likelihood of passing the examination (odds ratio, 2.58 [1.08-6.16]). Physicians in solo (vs group) practice had fewer peer interactions (β = -0.49 [95% CI, -0.64 to -0.33), received lower scores (β = -1.82 [-2.94 to -0.82]), and were less likely to pass the examination (odds ratio, 0.22 [0.06-0.77]). Level of peer interaction moderated the relationship between solo practice and MOCEX score; solo practitioners with high levels of peer interaction achieved an MOCEX performance on a par with that of group practitioners.

Conclusions and relevance

Physicians in solo practice had poorer MOCEX performance. However, solo practitioners who reported high levels of peer interaction performed as well as those in group practice. Peer interaction is important for professional learning and quality of care.

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