Tieder Joel S, Prall Sean P, Beck Jimmy, Alberda Erin, Jensen Debra, Nair Deepthi, Carline Jan D
Seattle Children's Hospital, Seattle, Washington; and
Division of Hospital Medicine, Department of Pediatrics and.
Hosp Pediatr. 2017 Nov;7(11):642-648. doi: 10.1542/hpeds.2017-0117.
Evaluative assessment is needed to inform improvement of Part 4 Maintenance of Certification (MOC), a large-scale program that aims to improve physician knowledge, engagement, and skills in quality improvement (QI). We sought to determine if Part 4 MOC participation improves perceived educational and clinical outcomes by piloting a new physician survey.
We administered a new online survey (MOC Practice, Engagement, Attitude, and Knowledge Survey) to physicians at the beginning and end of a Part 4 MOC project sponsored by a pediatric hospital's American Board of Medical Specialties' portfolio program during 2015. Participants worked in academic and community settings and in various accredited specialties. The main outcome was change in survey response on a 5-point Likert scale (1 = best) for 3 learning domains (QI engagement and attitude; QI method application, and improved patient care).
Of 123 complete responses and a 97% response rate, mean baseline responses were positive or neutral (2.2, 2.3, 1.9, respectively). Responses improved in QI engagement and attitude (-0.15, score = -2.78, = .005), QI method application (-0.39, score = -7.364, < .005), and improved patient care (-0.11, score = -1.728, = .084).
A Part 4 MOC physician survey provides valuable data to evaluate and improve the learning activity. In this children's hospital program, physicians view Part 4 favorably. Participation was associated with modest improvements in perceptions of QI engagement and attitude, application of QI methods, and patient care. Systematic evaluation of all Part 4 MOC projects and programs has the potential to improve the program nationally.
需要进行评估性评估,以为第4部分认证维持计划(MOC)的改进提供依据,该计划是一个大规模项目,旨在提高医生在质量改进(QI)方面的知识、参与度和技能。我们试图通过开展一项新的医生调查,来确定参与第4部分MOC是否能改善感知到的教育和临床结果。
在一家儿童医院的美国医学专业委员会组合项目所赞助的第4部分MOC项目开始时和结束时,我们向医生发放了一份新的在线调查问卷(MOC实践、参与度、态度和知识调查)。参与者在学术和社区环境中工作,涉及各种认可的专业领域。主要结果是在一个5分制李克特量表(1 = 最佳)上,3个学习领域(QI参与度和态度;QI方法应用;改善患者护理)的调查回复变化。
在123份完整回复中,回复率为97%,平均基线回复为积极或中性(分别为2.2、2.3、1.9)。QI参与度和态度方面的回复有所改善(-0.15,得分=-2.78,P = 0.005),QI方法应用方面(-0.39,得分=-7.364,P < 0.005),以及改善患者护理方面(-0.11,得分=-1.728,P = 0.084)。
第4部分MOC医生调查为评估和改进学习活动提供了有价值的数据。在这个儿童医院项目中,医生对第4部分评价良好。参与与QI参与度和态度、QI方法应用以及患者护理的感知有适度改善相关。对所有第4部分MOC项目和计划进行系统评估有可能在全国范围内改进该计划。