Jocelyn Lockyer PhD Senior Associate Dean, Education

1. The Physician Achievement Review Program: A collaboration between the College of Physicians and Surgeons of Alberta and University of Calgary Jocelyn Lockyer PhD Senior Associate Dean, Education Professor, Department of Community Health Sciences University of Calgary

2. Background/Disclosure • No financial conflicts of interest to report • College of Physicians and Surgeons of Alberta—Physician Achievement Review Program • Since 1996 • Instrument development, testing, and assessment

3. Acknowledgements Collaborators • CPSA • John Swiniarski, Bryan Ward (deceased), Trevor Theman • Physician Performance Committee • University of Calgary • Research Team..Claudio Violato, Herta Fidler • Physician Advisor..Ray Lewkonia • Pivotal Research Inc • Steve Dennis

4. Purpose of presentation • Describe the Alberta Physician Achievement Review (PAR) Program • Discuss the evidence supporting PAR as a tool for screening and quality improvement • Describe dissemination and uptake by others within and outside Canada • Provide an opportunity to answer questions about PAR

5. What is the Physician Achievement Review (PAR) Program? • Multisource feedback program (aka 360 degree evaluation) • Questionnaire based assessment • Feedback about observable behaviors is obtained every 5 years from • 8 Physician colleagues (peers, referring MDs, referral MDs) • 8 Co-workers (e.g., nurses, pharmacists, dieticians) • 25 Patients • Self

6. MSF Self-assessment Medical colleagues Co-workers Patients

7. Why PAR? • First level screen which might • Provides physicians with data about their practices to guide improvement • Identify need for further assessments • Source of unique and useful data that can inform many of the CanMEDs roles, particularly • Communicator • Collaborator • Professional • Medical expert • Relatively inexpensive • Adaptable • Repeat administration (5 years)

8. PAR provides tailored feedback • General/family physicians (revised 2010) • Surgical specialists • Medical specialists • Pediatrics • Psychiatry • All other medical specialists • Anesthesiologists • “Episodic care” providers • Diagnostic Imaging • Laboratory Medicine

10. Is PAR a good assessment? Good assessment should offer • Validity or coherence • Reproducibility or consistency (reliability) • Equivalence • Feasibility • Educational effect • Catalytic effect • Acceptability • Norcini et al, Criteria for good assessment: Consensus statement and recommendations from the Ottawa 2010 Conference, Medical Teacher 2011

11. Assessment Criteria

12. Assessment Criteria

13. Assessment CriteriaFeasibility/Participation 1999-2011

14. Dissemination and adoption • Dissemination • >25 publications in peer review journals • Adopted • Nova Scotia (NS-PAR) • Manitoba (M-PAR) • Being Tested • British Columbia • Council of Teaching Hospitals of Ontario • Royal College of Physicians and Surgeons of Canada • Practice eligible route • Tested • Medical Council of Ireland • Netherlands (Internal Medicine) • Singapore (Emergency Medicine)

15. Summary—PAR is a • Questionnaire based assessment in which feedback about observable behaviors is provided by other physicians, co-workers (e.g., nurses, social workers), and patients • Program that meets criteria for a ‘good assessment’ • Initiative that can be adopted and used by others but attention needs to be paid to • Purpose • Quality improvement/formative assessment • How it functions in different settings with special reference to how physicians use the data to inform practice change

16. Questions