The importance of measuring competency-based outcomes: standard evaluation measures are not surrogates for clinical performance of internal medicine residents.

Background: Despite recent emphasis on educational outcomes, program directors still rely on standard evaluation techniques such as tests of knowledge and subjective ratings.

Purposes: To assess the correlation of standard internal medicine (IM) residency evaluation scores (attending global evaluations, In-Training examination, and Mini-Clinical Examination Exercise) with documented performance of preventive measures for continuity clinic patients.

Methods: Cross-sectional study of 132 IM residents attending an IM teaching clinic, July 2000 to June 2003, comparing standard evaluations with chart audit.

Improving the quality of clinical care for patients with osteoporosis.

Osteoporosis, leading to hip fractures and other fragility fractures, is prevalent in countries with a high life expectancy. Fractures have a high associated societal cost and disease burden. As a result, many countries have established screening guidelines for osteoporosis, especially targeting those at a higher risk.

Implementing achievable benchmarks in preventive health: a controlled trial in residency education.

Purpose: To evaluate the Preventive Health Achievable Benchmarks Curriculum, a multifaceted improvement intervention that included an objective, practice-based performance evaluation of internal medicine and pediatric residents' delivery of preventive services.

Method: The authors conducted a nonrandomized experiment of intervention versus control group residents with baseline and follow-up of performance audited for 2001-2004. All 130 internal medicine and 78 pediatric residents at two continuity clinics at the University of Alabama School of Medicine, Birmingham, participated.

Measuring resident physicians' performance of preventive care. Comparing chart review with patient survey.

Background: The Accreditation Council for Graduate Medical Education has suggested various methods for evaluation of practice-based learning and improvement competency, but data on implementation of these methods are limited.

Objective: To compare medical record review and patient surveys on evaluating physician performance in preventive services in an outpatient resident clinic.

Design: Within an ongoing quality improvement project, we collected baseline performance data on preventive services provided for patients at the University of Alabama at Birmingham (UAB) Internal Medicine Residents' ambulatory clinic.

Differences in preventive health quality by residency year. Is seniority better?

Background: It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively.

Objective: To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training.

Design: Cross-sectional study.