Quality of care associated with number of cases seen and self-reports of clinical competence for Japanese physicians-in-training in internal medicine

dc.creator	Kikawa Kazuhiko
dc.creator	Hirao Yoshihiko
dc.creator	Mutoh Yoshitomo
dc.creator	Peabody John W
dc.creator	Bertenthal Dan
dc.creator	Minami Taro
dc.creator	Noguchi Yoshinori
dc.creator	Matsui Kunihiko
dc.creator	Fukuhara Shunich
dc.creator	Hayashino Yasuaki
dc.creator	Fukumoto Yohei
dc.creator	Hayano Junichiro
dc.creator	Ino Teruo
dc.creator	Sawada Umihiko
dc.creator	Seino Jin
dc.creator	Higuma Norio
dc.creator	Ishimaru Hiroyasu
dc.date	2006-06-01T00:00:00Z
dc.date.accessioned	2015-07-20T22:13:42Z
dc.date.available	2015-07-20T22:13:42Z
dc.identifier	10.1186/1472-6920-6-33
dc.identifier	1472-6920
dc.identifier	https://doaj.org/article/d49a47a40fcd44bba17216ceca5c2918
dc.identifier.uri	http://evidence.thinkportal.org/handle/123456789/16256
dc.description	<p>Abstract</p> <p>Background</p> <p>The extent of clinical exposure needed to ensure quality care has not been well determined during internal medicine training. We aimed to determine the association between clinical exposure (number of cases seen), self- reports of clinical competence, and type of institution (predictor variables) and quality of care (outcome variable) as measured by clinical vignettes.</p> <p>Methods</p> <p>Cross-sectional study using univariate and multivariate linear analyses in 11 teaching hospitals in Japan. Participants were physicians-in-training in internal medicine departments. Main outcome measure was standardized t-scores (quality of care) derived from responses to five clinical vignettes.</p> <p>Results</p> <p>Of the 375 eligible participants, 263 (70.1%) completed the vignettes. Most were in their first (57.8%) and second year (28.5%) of training; on average, the participants were 1.8 years (range = 1–8) after graduation. Two thirds of the participants (68.8%) worked in university-affiliated teaching hospitals. The median number of cases seen was 210 (range = 10–11400). Greater exposure to cases (p = 0.0005), higher self-reports of clinical competence (p = 0.0095), and type of institution (p < 0.0001) were significantly associated with higher quality of care, using a multivariate linear model and adjusting for the remaining factors. Quality of care rapidly increased for the first 100 to 200 cases seen and tapered thereafter.</p> <p>Conclusion</p> <p>The amount of clinical exposure and levels of self-reports of clinical competence, not years after graduation, were positively associated with quality of care, adjusting for the remaining factors. The learning curve tapered after about 200 cases.</p>
dc.language	English
dc.publisher	BioMed Central
dc.relation	http://www.biomedcentral.com/1472-6920/6/33
dc.relation	https://doaj.org/toc/1472-6920
dc.rights	CC BY
dc.source	BMC Medical Education, Vol 6, Iss 1, p 33 (2006)
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	DOAJ:Medicine (General)
dc.subject	DOAJ:Health Sciences
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	DOAJ:Education
dc.subject	DOAJ:Social Sciences
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	DOAJ:Medicine (General)
dc.subject	DOAJ:Health Sciences
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	DOAJ:Education
dc.subject	DOAJ:Social Sciences
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.subject	Medicine (General)
dc.subject	R5-920
dc.subject	Medicine
dc.subject	R
dc.subject	Special aspects of education
dc.subject	LC8-6691
dc.subject	Education
dc.subject	L
dc.title	Quality of care associated with number of cases seen and self-reports of clinical competence for Japanese physicians-in-training in internal medicine
dc.type	article