Clinical Experience and Quality of Health Care
Authors: Geoffrey R. Norman, Kevin W. Eva
Journal: Annals of Internal Medicine (2005)

Letters5 July 2005Clinical Experience and Quality of Health CareGeoffrey R. Norman, PhD and Kevin W. Eva, PhDGeoffrey R. Norman, PhDFrom McMaster University, Hamilton, Ontario L8S 4L8, Canada.Search for more papers by this author and Kevin W. Eva, PhDFrom McMaster University, Hamilton, Ontario L8S 4L8, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-1-200507050-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The article by Choudhry and colleagues (1) showing a consistent negative relationship between experience and performance is controversial. Although few will be surprised that recent graduates do better on knowledge tests or are more likely to adhere to practice guidelines, the relationship to patient outcomes, particularly mortality, is much more difficult to dismiss. In particular, the single unequivocal study, by Norcini and colleagues (2), observed “a 0.5% increase in mortality for every year [since graduation].” Taken at face value, this is a terrifying statistic. If a recent graduate has a 10% in-hospital mortality rate, then someone who ...References1. Choudhry NK, Fletcher RH, Soumerai SB. Systematic review: the relationship between clinical experience and quality of health care. Ann Intern Med. 2005;142:260-73. [PMID: 15710959] LinkGoogle Scholar2. Norcini JJ, Kimball HR, Lipner RS. Certification and specialization: do they matter in the outcome of acute myocardial infarction? Acad Med. 2000;75:1193-8. [PMID: 11112721] CrossrefMedlineGoogle Scholar3. Norcini JJ, Lipner RS, Kimball HR. Certifying examination performance and patient outcomes following acute myocardial infarction. Med Educ. 2002;36:853-9. [PMID: 12354248] CrossrefMedlineGoogle Scholar4. Hartz AJ, Kuhn EM, Pulido J. Prestige of training programs and experience of bypass surgeons as factors in adjusted patient mortality rates. Med Care. 1999;37:93-103. [PMID: 10413397] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From McMaster University, Hamilton, Ontario L8S 4L8, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: The Relationship between Clinical Experience and Quality of Health Care Niteesh K. Choudhry , Robert H. Fletcher , and Stephen B. Soumerai Clinical Experience and Quality of Health Care Elizabeth W. Loder Clinical Experience and Quality of Health Care Niteesh K. Choudhry , Robert H. Fletcher , and Stephen B. Soumerai Clinical Experience and Quality of Health CareClinical Experience and Quality of Health Care Martin A. Samuels and Allan H. Ropper Clinical Experience and Quality of Health Care Roy M. Poses and Joseph A. Diaz Clinical Experience and Quality of Health Care Ronald S. Szabo Metrics Cited ByAccepting Diagnostic Suggestions by Residents: A Potential Cause of Diagnostic Error in MedicineThe American College of Chest Physicians Evidence-Based Educational Guidelines for Continuing Medical Education InterventionsClinical Diagnostic Reasoning 5 July 2005Volume 143, Issue 1Page: 85-86KeywordsClimbingConflicts of interestDeath ratesGraduate medical educationHealth care qualityStatistical data ePublished: 5 July 2005 Issue Published: 5 July 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...