Developing physicians as managers of care: a systematic review of assessment methods. Author: Stammen, L.A., Busari J.O., Gennissen L.M., Moonen R.M. Date: 27-09-2013
Background Higher demands health care Costs Quality Efficiency accountability 2
Competence based learning 3
Management competence (i) Recent studies All competences are important (Stutsky et al. 2012) Definition of competences (Halpern et al. 2001) Little attention for management (Patel et al. 2009) Need for management training (Busari et al. 2010/2011 ) 4
Management competence (ii) Medical leadership and management - Individual - Team member - Health care worker Local Regional National International 5
Aim 1. Which assessment methods are currently being used to assess the competence of manager? 2. Which methods use valid or reliable assessment instruments? 6
Methods 7
Results (i) 25 articles 4 categories Assessment tools to evaluate the effect of implemented curricular interventions (N=10) based on recommendations or views from consensus surveys or conventions (N=1) intended for assessing general competencies (N=12) focused exclusively on systems-based practice or management competencies (N=2) 8
Results (ii) Category 1 Assessment tools to evaluate the effect of implemented curricular interventions (N=10) No evidence of reliability or validity of the assessment-tool. Category 2 Assessment tools based on recommendations or views from consensus surveys or conventions (N=1) Recommendations Combination of assessment tools gave an accurate reflection of the resident competence Create own assessment systems Novel methods such as computerized simulations of practice situations 9
Results (iii) Category 3 Assessment tools intended for assessing general competencies (N=12) No coherent conclusion. Impossible to measure the competencies independently? Category 4 Assessment tools that focused exclusively on systems-based practice or management competencies (N=2) Direct observation Global rating form 360 evaluations Portfolio Knowledge testing: both oral and written 10
Conclusion In conclusion, the findings of our review suggest that there is no single valid, feasible and/or reliable assessment tool available that can solely evaluate the management competency of residents in clinical practice. 11
Recommendations 1. A combination of different assessment instruments 2. Development of new assessment instruments is necessary 3. More research - Which categories that are important for such instruments 12
Literature 1. Porter, M.E. and E.O. Thijsburg, Redefining health care: Creating value based competition on results. Boston: Harvard Business School Press, 2006: p. 71-95. 2. Bohmer, R.M.J. and C.I. Knoop, The challenge facing the U.S. healthcare delivery system. Boston: Harvard Business School, 2007: p. 606-609. 3. Busari, J.O., L. Berkenbosch, and J.W. Brouns, Physicians as managers of health care delivery and the implications for postgraduate medical training: a literature review. Teach Learn Med, 2011. 23(2): p. 186-96. 4. Stephenson, J., Doctors in management. British Medical Journal, 2009. 339: p. 45-95 13
Questions Management Corresponding author: j.busari@atriummc.nl 14
I do not have an affiliation (financial or otherwise) with a pharmaceutical, medical device or communications organization. Je n ai aucune affiliation (financière ou autre) avec une entreprise pharmaceutique, un fabricant d appareils médicaux ou un cabinet de communication. Author: Stammen L.A., Busari J.O., Gennissen L.M., Moonen R.M. Date: 27-09-2013
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