Back to the Future: Clinical Vignettes and the Measurement of Physician Performance
Authors: John Norcini
Journal: Annals of Internal Medicine (2004)

Editorials16 November 2004Back to the Future: Clinical Vignettes and the Measurement of Physician PerformanceJohn Norcini, PhDJohn Norcini, PhDFrom Foundation for Advancement of International Medical Education and Research, Philadelphia, PA 19104.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-10-200411160-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The past 2 decades have seen many efforts to improve the quality of health care. These efforts have relied on a series of methods devised by workers in the field of quality management science and, in some cases, used successfully in industry for more than 50 years (1, 2).Measuring performance is central to the quality management sciences. The principal measures in health care are patient outcomes and the process of care that physicians provide in practice. These measures identify areas that need improvement, signal the accomplishment of goals, and respond to the need for accountability (3). Unfortunately, methods of ...References1. Berwick DM, Godfrey AB, Roessner J. Curing Health Care: New Strategies for Quality Improvement. San Francisco: Jossey–Bass; 1990. Google Scholar2. Laffel G, Blumenthal D. The case for using industrial quality management science in health care organizations. JAMA. 1989;262:2869-73. [PMID: 2810623] CrossrefMedlineGoogle Scholar3. Plsek PE. Quality improvement methods in clinical medicine. Pediatrics. 1999;103:203-14. [PMID: 9917464] MedlineGoogle Scholar4. Norcini JJ. Work based assessment. BMJ. 2003;326:753-5. [PMID: 12676847] CrossrefMedlineGoogle Scholar5. Peabody JW, Luck J, Glassman P, Jain S, Hansen J, Spell M, et al. Measuring the quality of physician practice by using clinical vignettes: a prospective validation study. Ann Intern Med. 2004;141:771-80. LinkGoogle Scholar6. 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Assessment of clinical competence: written and computer-based simulations. Assessment and Evaluation in Higher Education. 1987;12:220-46. CrossrefGoogle Scholar11. Norcini JJ, Swanson DB, Grosso LJ, Webster GD. Reliability, validity and efficiency of multiple choice question and patient management problem item formats in assessment of clinical competence. Med Educ. 1985;19:238-47. [PMID: 4010571] CrossrefMedlineGoogle Scholar12. Mazzuca SA, Cohen SJ. Scoring patient management problems: external validation of expert consensus. Eval Health Prof. 1982;5:210-7. [PMID: 10255921] CrossrefMedlineGoogle Scholar13. Webster GD, Shea JA, Norcini JJ, Grosso LJ, Swanson DB. Comparison of methods for scoring patient management problems: use of external criteria to validate scores. Eval Health Prof. 1988;11:231-48. CrossrefGoogle Scholar14. Norcini JJ, Meskauskas JA, Langdon LO, Webster GD. An evaluation of a computer simulation in the assessment of physician competence. Eval Health Prof. 1986;9:286-304. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAuthors: John Norcini, PhDAffiliations: From Foundation for Advancement of International Medical Education and Research, Philadelphia, PA 19104.Disclosures: None disclosed.Corresponding Author: John Norcini, PhD, Foundation for Advancement of International Medical Education and Research, 3624 Market Street, Philadelphia, PA 19104; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeasuring the Quality of Physician Practice by Using Clinical Vignettes: A Prospective Validation Study John W. Peabody , Jeff Luck , Peter Glassman , Sharad Jain , Joyce Hansen , Maureen Spell , and Martin Lee Metrics Cited byThe Effects of ADHD Teacher Training Programs on Teachers and Pupils: A Systematic Review and Meta-AnalysisEvaluation of Patient Willingness to Adopt Remote Digital Monitoring for Diabetes ManagementDo Estimates of Treatment Risk Based on Clinical Vignettes Differ by Physician Gender?GPs' attitudes, beliefs and behaviours regarding exercise for chronic knee pain: a questionnaire surveyAdherence of French GPs to Chronic Neuropathic Pain Clinical Guidelines: Results of a Cross-Sectional, Randomized, "e" Case-Vignette SurveyComparing Announced with Unannounced Standardized Patients in Performance AssessmentReflective ability and moral reasoning in final year medical students: A semi-qualitative cohort studyTeachers' Recognition of Children's Mental Health ProblemsClinical Management of Musculoskeletal Injuries in Active Children and YouthVirtual standardized patients: an interactive method to examine variation in depression care among primary care physiciansL'évaluation des pratiquesInter-rater Reliability of Clinician-rated Outcome Measures in Child and Adolescent Mental Health ServicesEvaluating Physician Performance at Individualizing Care: A Pilot Study Tracking Contextual Errors in Medical Decision MakingMedical Knowledge: The Importance of Faculty Involvement and Curriculum in Graduate Medical EducationClinical Vignette-Based Surveys: A Tool for Assessing Physician Practice Variation 16 November 2004Volume 141, Issue 10Page: 813-814KeywordsComputersDiagnosis related groupsElectronic medical recordsForecastingHealth care qualityMotivationPatientsPsychometricsQuality improvementStatistical data ePublished: 16 November 2004 Issue Published: 16 November 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. 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