Search

Objectives: To evaluate the feasibility of a quality improvement programme aimed to enhance the client-centeredness, effectiveness and transparency of physiotherapy services by addressing three feasibility domains: (1) acceptability of the programme design, (2) appropriateness of the implementation strategy and (3) impact on quality improvement. Design: Mixed methods study. Participants and setting: 64 physiotherapists working in primary care, organised in a network of communities of practice in the Netherlands. Methods: The programme contained: (1) two cycles of online self-assessment and peer assessment (PA) of clinical performance using client records and video-recordings of client communication followed by face-to-face group discussions, and (2) clinical audit assessing organisational performance. Assessment was based on predefined performance indicators which could be scored on a 5-point Likert scale. Discussions addressed performance standards and scoring differences. All feasibility domains were evaluated qualitatively with two focus groups and 10 in-depth interviews. In addition, we evaluated the impact on quality improvement quantitatively by comparing self-assessment and PA scores in cycles 1 and 2. Results: We identified critical success features relevant to programme development and implementation, such as clarifying expectations at baseline, training in PA skills, prolonged engagement with video-assessment and competent group coaches. Self-reported impact on quality improvement included awareness of clinical and organisational performance, improved evidence-based practice and client- centeredness and increased motivation to self-direct quality improvement. Differences between self-scores and peer scores on performance indicators were not significant. Between cycles 1 and 2, scores for record keeping showed significant improvement, however not for client communication. Conclusions: This study demonstrated that bottom- up initiatives to improve healthcare quality can be effective. The results justify ongoing evaluation to inform nationwide implementation when the critical success features are addressed. Further research is necessary to explore the sustainability of the results and the impact on client outcomes in a full-scale study. [ABSTRACT FROM AUTHOR]

The authors of this article, an assistant professor and a professor of medical education, share their perspectives on developments that need to take place in order for the field of medical education to advance. They address the necessities of effective practical training, accurate and consistent assessment, higher standards in research, and the cultivation of constructive perspectives on assessment.

Discusses general issues of written assessment examinations within medical education. Most commonly used types of assessments; Major advantages and disadvantages; Five criteria used to evaluated the advantages and disadvantages of question types.