2013-2014 - Glenn Regehr

Many organizations across the country are responsible for ensuring that physicians’ practices align with professional standards and that physicians themselves engage in ongoing practice improvement. This commonly involves assessment processes such as practice review by a trained peer physician and/or surveys completed by the physicians’ colleagues and patients (i.e., Multi-Source Feedback). Despite considerable resources being spent on these activities, and substantial amounts of data being fed back to physicians, the degree of improvement demonstrated after these performance reviews varies greatly. As the effectiveness of the Canadian healthcare system rests extensively on the performance of its practitioners it is crucial that we better understand why this is so and how to intervene effectively to help physicians improve their practice.

The objective of this project, therefore, is to improve the functional value of data collected regarding the performance of physicians in practice by researching ways in which ‘assessment-for-learning’ data can be fed back to practitioners most effectively.

For the past decade our team has been conducting research aimed at better understanding the ability to judge one’s own strengths and weaknesses and take corrective action. We have demonstrated that self-assessment cannot be trusted, but that energy aimed at helping physicians recognize weaknesses in their practice is often wasted because the feedback is rejected. While the accumulation of experience yields confidence that will enable one to practice well, it also makes one more likely to ignore information that is readily available and could help one’s practice improve. Further, feedback that does convince people of their weaknesses can create situations in which people stop trying to improve, narrow their practice, or give up practice altogether. This project will take us the next step towards tailored feedback practices that will maximize the positive impact of physician quality improvement programs on the health and safety of Canadians.