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Related Experiment Videos

Competence and cognitive difficulty in physicians: a follow-up study.

John Turnbull1, John Cunnington, Ayse Unsal

  • 1McMaster University, Hamilton, Ontario, Canada. turnbull@mcmaster.ca

Academic Medicine : Journal of the Association of American Medical Colleges
|September 21, 2006
PubMed
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Cognitive impairment significantly impacts physician competence and remediation success. Many incompetent physicians show neuropsychological deficits that hinder improvement with continuing medical education (CME).

Area of Science:

  • Neuropsychology
  • Medical Education
  • Physician Competency

Background:

  • Remediation of incompetent physicians is challenging.
  • Understanding underlying causes of physician incompetence is crucial.

Purpose of the Study:

  • To determine if neuropsychological impairment explains physician incompetence.
  • To assess if impairment affects improvement after remedial continuing medical education (CME).

Main Methods:

  • Neuropsychological screening of 45 physicians in a competency assessment program (1997-2001).
  • Correlation of reassessment findings with neuropsychological scores after remediation.

Main Results:

  • Physicians performing poorly often had significant neuropsychological deficits.

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  • Cognitive impairment was more pronounced in older physicians.
  • No physician with moderate/severe impairment succeeded in competency reassessment.
  • Conclusions:

    • A substantial minority of underperforming physicians have cognitive impairment explaining their incompetence.
    • Neuropsychological deficits impede successful remediation through CME.