Rethans J J, van Leeuwen Y, Drop R, van der Vleuten C, Sturmans F
Department of General Practice, University of Limburg, Maastricht, The Netherlands.
Fam Pract. 1990 Sep;7(3):168-74. doi: 10.1093/fampra/7.3.168.
In the debate about 'what is a competent general practitioner?' little attention has been paid ot the actual practice situation of general practitioners. This paper, based on the 18 most important studies in the literature about medical competence, tries to re-initiate this debate by proposing a clear distinction between 'competence', (what a physician is capable of doing) and 'performance' (what a physician does in his day-to-day practice). With this distinction we looked at whether studies defined both competence and performance, how they dealt with these concepts, what measurement instruments were used and what the conclusions of the studies were. Although it is the common reasoning that competence is a good predictor of performance this concept could not be affirmed. This survey shows that the majority of studies use wrong concepts and come to invalid conclusions. With the empirical distinction between competence and performance however, this paper proposes new directions for the quality assessment of general practitioners.
在关于“什么是称职的全科医生？”的辩论中，很少有人关注全科医生的实际执业情况。本文基于文献中18项关于医学能力的最重要研究，试图通过明确区分“能力”（医生能够做什么）和“表现”（医生在日常实践中做了什么）来重新引发这场辩论。基于这种区分，我们研究了各项研究是否对能力和表现都进行了定义，它们如何处理这些概念，使用了哪些测量工具以及研究得出了什么结论。尽管通常认为能力是表现的良好预测指标，但这一概念并未得到证实。本次调查表明，大多数研究使用了错误的概念并得出了无效的结论。然而，通过对能力和表现进行实证区分，本文为全科医生的质量评估提出了新的方向。
