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 Vol. 13 No. 5, May 2005
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AAP Grand Rounds 13:52-53 (2005)
© 2005 American Academy of Pediatrics

COMBINED INTERNAL MEDICINE-PEDIATRICS

Practice May Not Make Perfect

Source: Choudhry NK, Fletcher RH, Soumerai SB. The relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142:260–273.[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.

One of the basic assumptions in medical education is that with clinical experience comes better clinical practice. The authors of this review from Harvard Medical School systematically searched the literature for reports of physician knowledge; adherence to standards of care for diagnosis, screening or prevention; adherence to standards of care for therapy; and patient health outcomes as they related to experience. Physician experience was variably defined in the studies as years in practice, time since graduation from residency or graduation from medical school, or age. For a study to be included, it was required to be an original report, measure 1 of the outcomes of interest, and include some variable of physician experience. The 59 articles they found reported on a total of 62 outcomes. However, the studies used multiple techniques for measurement, including some without a quantitative element, which precluded applying formal meta-analytic tools to combine the study results. Instead, the authors categorized the results for each of the 62 outcomes into . . . [Full Text of this Article]

Brett Robbins, MD, FAAP1
1 Internal Medicine – Pediatric Residency, University of Rochester, Rochester, NY

 
Joseph D. Dickerman, MD, FAAP2
2 Pediatric Hematology/Oncology, University of Vermont, Burlington, VT

 



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