Ramsey P G, Carline J D, Inui T S, Larson E B, LoGerfo J P, Norcini J J, Wenrich M D
Department of Medicine, University of Washington School of Medicine, Seattle.
JAMA. 1991 Aug 28;266(8):1103-7.
To determine factors affecting the knowledge base of practicing internists.
An 82-item multiple-choice examination with questions from the 1988 American Board of Internal Medicine (ABIM) certifying examination was used to assess the knowledge base of 289 internists.
Participants were selected from among practicing internists in New York, New Jersey, and Pennsylvania who had received ABIM certification 5 to 15 years previously.
significant inverse correlation (r = -.30) was found between examination scores and the number of years elapsed since certification. Knowledge declined sharply within 15 years of certification. In addition, procedure-oriented subspecialists (cardiologists and gastroenterologists) had lower scores than other internists in this examination of general medical knowledge. Multivariate analyses showed that independent variables that predicted test performance were initial ABIM certifying examination score, time elapsed since certification, subspecialty classification, medical school type, and residency type.
These results support the recent decision for time-limited certification of internists and raise questions related to content and standard setting for recertification examinations.
确定影响执业内科医生知识储备的因素。
采用一项包含82道选择题的考试，题目来自1988年美国内科医学委员会（ABIM）的认证考试，用于评估289名内科医生的知识储备。
参与者选自纽约、新泽西和宾夕法尼亚州的执业内科医生，他们在5至15年前获得了ABIM认证。
考试成绩与认证后过去的年数之间存在显著的负相关（r = -0.30）。在认证后的15年内，知识水平急剧下降。此外，在这次一般医学知识考试中，以程序为导向的亚专科医生（心脏病学家和胃肠病学家）的得分低于其他内科医生。多变量分析表明，预测考试成绩的独立变量是最初的ABIM认证考试成绩、认证后过去的时间、亚专科分类、医学院类型和住院医师培训类型。
这些结果支持了最近关于内科医生限时认证的决定，并引发了与再认证考试的内容和标准设定相关的问题。
