Background:
Academic medical centers have tripartite missions focused on education, research, and clinical care. Promotion decisions are largely based on research accomplishments. Excellence in patient care in academia had not been well defined until recently, and it has been difficult to measure. Hospitalists work closely with each other and have opportunities to evaluate their peers' clinical aptitudes. We conducted this study to assess (1) hospitalists' self‐perceived efficacy in evaluating peers' clinical skills and (2) the domains of clinical excellence that are believed to be most at the core of clinical excellence.
Methods:
All 22 hospitalist physicians in the Division of Hospital Medicine were surveyed. Hospitalists were asked to (1) rate their own ability to assess their colleagues' clinical performance in 6 domains that have been established to define clinical excellence (communication and interpersonal skills, professionalism, humanism, diagnostic acumen, skillful negotiation of the health care system, passion for clinical medicine) and 2 hospitalistspecific domains (discharge summaries, and sign‐outs/handoffs), (2) assess each of their colleagues on these 8 domains, and (3) name 3 colleagues they would choose to care for their loved ones. Statistical analysis was performed using the Pearson coefficient and logistic regression.
Results:
The response rate to the survey was 100% (22 of 22). Two thirds of respondents were female, and they had been physicians for an average of 6.6 years. Hospitalists were confident in their ability to assess their peers' clinical skills; their self‐assessed abilities were highest for the domains of professionalism, communication and interpersonal skills, humanism, and passion about patient care, judged as either “good” or “excellent” for 77%, 73%, 64%, and 64%, respectively. There were strong correlations among all 8 domains (r > 0.5, P < 0.05), The mean composite score for clinical excellence (the 8 domains combined) was highly correlated with each individual domain (r > 0.5, P < 0.05), Being selected as a doctor that colleagues would choose to take care of their loved ones was highly correlated with a high score in the domains of humanism, diagnostic acumen, sign‐outs/handoffs, and passion for clinical medicine (r > 0.5, P < 0.05). The composite score for clinical excellence was also strongly correlated with the endorsement by peers as a physician that they would like to care for loved ones (r > 0.5, P < 0.05).
Conclusions:
By the nature of collaboration in patient care, hospitalists can assess the clinical skills of their peers. The correlation of specific skills and the composite clinical excellence score with being named as a doctor that colleagues would choose to take care of their loved ones provides additional validity for our assessment scale. Such measurements can allow hospitalist groups to identify top performers who could be recognized. rewarded, and held up as role models, as well as weaker performers who may need focused training or remediation.
Author Disclosure:
H. Bhogal, none; E. Howe, none; H. Torok, none; S. Wright, none.