Practice May Not Make Perfect

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. …