Predicting doctor performance outcomes of curriculum interventions: problem-based learning and continuing competence.

Area of Science:

• Medical Education
• Continuing Medical Education
• Physician Performance

Background:

• Problem-based learning (PBL) is an educational strategy aimed at improving self-assessment, self-directed learning, and lifelong learning skills.
• This study investigates whether the impact of PBL on continuing medical competence is measurable through a peer review program.

Purpose of the Study:

• To determine if graduates from McMaster University, which utilizes PBL, were less likely to have competence issues identified by peer review compared to graduates from other Ontario medical schools.
• To assess the long-term impact of PBL on physician competence in practice.

Main Methods:

• A cohort of 1166 doctors who graduated after 1972 and completed a mandated peer review program were analyzed.
• Graduation from McMaster University (n=108) was compared against graduation from other Canadian medical schools (n=857) using cross-tabulation and multiple regression analysis.

Main Results:

• No significant difference was found in the rates of "cause for concern" or "serious concern" between McMaster graduates (4%) and other graduates (5%).
• Excellent ratings were similar between groups (24% McMaster vs. 28% other).
• Predictors of practice outcomes included specialty certification, female gender, and younger age, but not the school of graduation.

Conclusions:

• The study found no evidence that Problem-based learning graduates maintain competence better than graduates from conventional medical schools.
• Linking undergraduate educational interventions directly to physician performance outcomes presents potential challenges.