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September 1, 1993

Competency Assessment of Primary Care Physicians as Part of a Peer Review Program

Author Affiliations

From the Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton (Drs Norman, Davis, and Lamb and Ms Hanna), the University of Toronto (Dr Caulford), and the College of Physicians and Surgeons of Ontario (Dr Kaigas), Toronto, Ontario, Canada.

JAMA. 1993;270(9):1046-1051. doi:10.1001/jama.1993.03510090030007

Objective.  —To design and test a program that assesses clinical competence as a second stage in a peer review process and to determine the program's reliability.

Design and Setting.  —A three-cohort study of Ontario primary care physicians.

Participants.  —Reference physicians (n=26) randomly drawn from the Hamilton, Ontario, area; volunteer, self-referred physicians (n=20); and physicians referred by the licensing body (n=37) as a result of a disciplinary hearing or peer review.

Main Outcome Measures.  —Standardized patients, structured oral examinations, chart-stimulated recall, objective structured clinical examination, and multiplechoice examination.

Results.  —Test reliability was high, ranging from 0.73 to 0.91, and all tests discriminated among subgroups. Demographic variables relating to the final category were age, Canadian or foreign graduates, and whether or not participants were certified in family medicine.

Conclusions.  —The study demonstrated the feasibility, reliability, and validity of a multicomponent examination in the peer review process.(JAMA. 1993;270:1046-1051)