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  • June 2014
  • Article
  • JAMA Surgery

Informal Peer Interaction and Practice Type as Predictors of Physician Performance on Maintenance of Certification Examinations

By: Melissa A. Valentine, S. Barsade, Amy C. Edmondson, A. Gal and R. Rhodes
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Abstract

Context: Physicians can demonstrate mastery of the knowledge that supports continued clinical competence by passing a Maintenance of Certification exam. Exam performance depends on professional learning and development, which may be enhanced by informal routine interactions with colleagues. Some physicians, such as those in solo practice, may have less opportunity for peer interaction, negatively influencing their exam performance.
Objective: To determine the relationship between level of peer interaction, group and solo practice and maintenance of certification exam performance.
Design, Setting, and Participants: Longitudinal cohort study of 568 physicians taking the 2008 maintenance of certification exam. Survey responses reporting level of physicians' peer interactions and practice type were related to maintenance of certification exam scores, controlling for initial Qualifying Exam scores, practice type and personal characteristics.
Main Outcome Measure: Maintenance of certification exam scores and exam pass-fail status.
Results: Of the 568 physicians in the study sample, 557 (98%) passed the exam. Higher levels of peer interaction were associated with a higher score (β, 0.91, 95% CI 0.31-1.52) and higher likelihood of passing the exam (OR 2.58, 95% CI, 1.08-6.16). Physicians in solo practice (vs. group practice) had fewer peer interactions (β, -0.49, 95% CI, -0.64 to -0.33), received lower scores (β -1.82, 95% CI, -2.94- -0.82) and were less likely to pass the exam (OR 0.22, 95% CI, 0.06-0.77). Level of peer interaction moderated the relationship between solo practice and maintenance of certification exam score: solo practitioners with high levels of peer interaction achieved maintenance of certification exam performance on par with group practitioners.
Conclusion: Physicians in solo practice had poorer maintenance of certification exam performance. However, solo practitioners who reported high levels of peer interaction performed as well as those in group practice. Peer interaction is important for professional learning and quality care.

Keywords

Training; Health Care and Treatment; Performance; Social and Collaborative Networks; Learning; Health Industry

Citation

Valentine, Melissa A., S. Barsade, Amy C. Edmondson, A. Gal, and R. Rhodes. "Informal Peer Interaction and Practice Type as Predictors of Physician Performance on Maintenance of Certification Examinations." JAMA Surgery 149, no. 6 (June 2014): 597–603.
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About The Author

Amy C. Edmondson

Technology and Operations Management
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