Jump to start of content

Breadcrumb trail:

Physician Knowledge and Competency

Doctors have special expertise that they use every day to treat patients and make advances in their field.

For the safety of their patients and to prevent diagnostic errors, evidence shows it is important for physicians to assess their weakest areas to determine where their knowledge has declined over time.

Need for Physician Assessment and Clinical Judgment

Fraundorf, S. H., Caddick, Z. A., Nokes-Malach, T. J., & Rottman; B. M. (2023). Cognitive perspectives on maintaining physicians’ medical expertise: III. Strengths and weaknesses of self-assessment. Cognitive Research: Principles & Implications, 8, 58.

Fraundorf, S. H., Caddick, Z., Rottman, B., Nokes-Malach, T., Swanson, D. B., Bazemore, A., O’Neill, T., & Lipner, R. S. (2021). Conceptual foundations for designing continuing certification assessments for physicians.

Vandergrift JL, Gray BM. Physician clinical knowledge, practice infrastructure, and quality of care. American Journal of Managed Care. 2019; 25(10):497-503.

Brusca SB, Barnett C, Barnhart BJ, Weng W, Morrow DA, Soble JS, Katz JN, Wiley BM, van Diepen S, Gomez AD, Solomon MA. Role of critical care medicine training in the cardiovascular intensive care Unit: Survey responses from dual certified critical care cardiologists. J Am Heart Assoc. 2019; 8(6):e011721.

Duhigg LM, Baranowski RA, Arnold GK. Does having open access to care improve patient experience? A case-control study. Am J Med Qual. 2018 Jul;33(4):365-371.

Vandergrift JL, Gray BM, Weng W. Do state continuing medical education requirements for physicians improve clinical knowledge? Health Serv Res. 2018 Jun;53(3):1682-1701.

Norcini JJ, Boulet JR, Opalek A, Dauphinee WD. Patients of doctors further from medical school graduation have poorer outcomes. Med Educ. 2017; 51(5): 480-9.

Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ. 2016; 353: i2139.

National Academies of Sciences, Engineering, and Medicine. Improving diagnosis in health care. Washington, DC: The National Academies Press, 2015.

Durning SJ, Costanzo ME, Beckman TJ, Artino AR Jr, Roy MJ, Van Der Vleuten C, Holmboe ES, Lipner RS, Schuwirth L. Functional neuroimaging correlates of thinking flexibility and knowledge structure in memory: exploring the relationships between clinical reasoning and diagnostic thinking. Med Teach. 2016; 38(6): 570-7.

Hess BJ, Lipner RS, Thompson V, Holmboe ES, Graber ML. Blink or think: can further reflection improve initial diagnostic impressions? Acad Med. 2015; 90(1): 112-8.

Norman G, Sherbino J, Dore K, Wood T, Young M, Gaissmaier W, Kreuger S, Monteiro S. The etiology of diagnostic errors: a controlled trial of system 1 versus system 2 reasoning. Acad Med. 2014; 89(2): 277-84.

Graber ML, Wachter RM, Cassel CK. Bringing diagnosis into the quality and safety equations. JAMA. 2012; 308(12): 1211-2.

Eva KW, Regehr G, Gruppen LD. Blinded by “insight”: self-assessment and its role in performance improvement. In: Hodges BD, Lingard L, editors. The question of competence: Reconsidering medical education in the twenty-first century. New York: Cornell University Press; 2012. p. 131-54.

Berner ES, Graber ML. Overconfidence as a cause of diagnostic error in medicine. Am J Med. 2008; 121(5 Suppl): S2-23.

Eva KW, Regehr G. “I'll never play professional football” and other fallacies of self-assessment. J Contin Educ Health Prof. 2008; 28(1): 14-9.

Bowen JL. Educational strategies to promote clinical diagnostic reasoning. N Engl J Med. 2006; 355(21): 2217-25.

Davis DA, Mazmanian PE, Fordis M, Van Harrison R, Thorpe KE, Perrier L. Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. JAMA. 2006; 296(9): 1094-102.

Graber ML, Franklin N, Gordon R. Diagnostic error in internal medicine. Arch Intern Med. 2005; 165(13): 1493-9.

Audet AM, Doty MM, Shamasdin J, Schoenbaum SC. Measure, learn, and improve: physicians' involvement in quality improvement. Health Aff (Millwood). 2005; 24(3): 843-53.

Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med. 2005; 142(4): 260-73.

Fisher ES. Medical care--is more always better? N Engl J Med. 2003; 349(17): 1665-7.

Gruppen LD, Frohna AZ. Clinical reasoning. In: Norman GR, van der Vleuten C, Newble D, editors. International handbook of research in medical education. Norwell, MA: Kluwer Academic Publishers; 2002; 205-30.

Bordage G. Why did I miss the diagnosis? Some cognitive explanations and educational implications. Acad Med. 1999; 74(10 Suppl): S138-43.