Individually Designed Education and Assessment Services (IDEAS)
For further information please contact Cathy Means, Program
Administrator, at cjmeans@wisc.edu
or 608/263-6637.
Physician Assessment
This program began in 1986 when the Wisconsin Medical Examining Board approached
the University of Wisconsin Office of Continuing Professional Development in Medicine
and Public Health (OCPD) with the request that we develop the means by which a physician's
knowledge be tested. Since that time approximately 150 physicians have been through
individualized assessments based on the profiles of their respective practices.
Approximately 100 have undertaken education programs which were deemed necessary
following the assessment. The Program attempts to provide educational resolution to
problems which may arise between physicians and bodies who have the responsibility
of maintaining surveillance over his/her activities.
The elements of the assessment include:
- Test Stimulated Discussion (TSD)
- Chart Stimulated Recall (CSR)
- Standardized Patient Encounter (SPE)
TSD
A Test Stimulated Discussion (TSD) is a process by which a physician's responses to
selected questions are discussed by the physician and the assessor in order to attempt
to determine the physician's knowledge base related to the questions and his/her thought
processes leading to the selection of the option chosen by the physician.
The test question selection is based upon:
1. The profile of the physician's hospital and office practice (the diagnoses from
approximately 100 consecutive clinical encounters).
2. The areas of concern that precipitated the referral of the physician for the assessment.
The practice profile is derived prior to the assessment and the test questions selected.
The process on the day of the assessment is as follows:
1. The physician completes the test early on the day of the assessment.
2. While the physician is engaged in other activities the test is scored.
3. The physician's answer sheet is delivered to the assessor for review prior to the discussion.
The physician and the assessor meet for 1-1/2 hours and discuss the physician responses to
the test questions. The discussion usually starts with "I see that you selected
option _____ in question _____. Can you talk me through from the stem of the question as
to why you selected that option, rather than the other options?" Alternatively, the assessor
may ask "What would you have thought about question _____ if the serum potassium had been ?
The major judgments are made related to the physician's thought processes leading to the
selection of the answers. The actual score means very little.
CSR
Chart Stimulated Recall (CSR) is a process by which an assessor and the physician
being assessed discuss the content of a selection of the physician's records representative
of his/her hospitalized and/or office-based patients.
The actual records to be discussed are based upon:
1. The objectives of the assessment.
2. The profile of the physician's hospital and office practice.
The CPD Office and assessors select approximately ten appropriate cases and request the
hospital/clinic to send a copy of each record of the hospitalized and/or office-based
patients to the Office of Continuing Professional Development (OCPD), 750 Highland Avenue,
Room 4261, Madison, WI 53705.
The discussion with the assessor usually starts in one of several ways, "Looking at Mr./Ms. _______
record, I see that on May ____ you noted pitting edema over ______, what did that indicate
to you?" OR you ordered a serum ________, what were you looking for?" OR You ordered _______ be
given twice daily, what therapeutic effects were you hoping for?"
SPE
The Standardized Patient Encounter (SPE) is an approach to clinical assessment utilizing
a trained patient actor with an assigned clinical problem. The candidate must be able
to take a history, write a clinical note, write a letter to a referring physician (if applicable),
interpret physical and laboratory findings, develop an evaluation and treatment plan, and explain
that plan to the patient.
The encounter is videotaped. The assessor reviews the tape, the physician's notes,
and the comments from the standardized patients.
Final Report
The assessors write a report stating their observations and judgments about the physician's
knowledge base and ability to deal with clinical problems. The University of Wisconsin OCPD
assessment directors incorporate that information into the overall final assessment.
Individualized Programs
Due to the complex nature of disease and trauma, and the overall need for wellness, it is
important that practitioners have access to continuing education on the development and
update in diagnosis and treatment strategies. Individualized programs were created to
assist physicians with individual education needs.
Numerous physicians have taken part in individualized learning plans based on practice
needs and exposure to best practice guidelines. A planning process takes place for each
physician based on needs and an activity is designed to best meet the stated needs.
The physician, in turn, spends time at a designated facility interacting with a physician
mentor to meet the requirements of the proposed objectives. Physicians have commented
on the positive experiences and many have chosen to return for additional education.
For further information please contact Cathy Means, Program
Administrator, at cjmeans@wisc.edu
or 608/263-6637.
