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To synthesize evidence relevant for informed decisions concerning cognitive testing of older physicians. Relevant literature was systematically searched in Medline, EMBASE, PsycInfo, and ERIC, with key findings abstracted and synthesized. Cognitive abilities of physicians may decline in an age range where they are still practicing. Physician competence and clinical performance may also decline with age. Cognitive scores are lower in physicians referred for assessment because of competency or performance concerns. Many physicians do not accurately self-assess and continue to practice despite declining quality of care; however, perceived cognitive decline, although not an accurate indicator of ability, may accelerate physicians' decision to retire. Physicians are reluctant to report colleagues' cognitive problems. Several issues should be considered in implementing cognitive screening. Most cognitive assessment tools lack normative data for physicians. Scientific evidence linking cognitive test results with physician performance is limited. There is no known level of cognitive decline at which a doctor is no longer fit to practice. Finally, relevant domains of cognitive ability vary across medical specialties. Physician cognitive decline may impact clinical performance. If cognitive assessment of older physicians is to be implemented, it should consider challenges of cognitive test result interpretation. [ABSTRACT FROM AUTHOR]

Introduction: A new multisource feedback (MSF) program was specifically designed to support physician quality improvement (QI) around the CanMEDS roles of Collaborator , Communicator , and Professional. Quantitative ratings and qualitative comments are collected from a sample of physician colleagues, co-workers (C), and patients (PT). These data are supplemented with self-ratings and given back to physicians in individualized reports. Each physician reviews the report with a trained feedback facilitator and creates one-to-three action plans for QI. This study explores how the content of the four aforementioned multisource feedback program components supports the elicitation and translation of feedback into a QI plan for change. Methods: Data included survey items, rater comments, a portion of facilitator reports, and action plans components for 159 physicians. Word frequency queries were used to identify common words and explore relationships among data sources. Results: Overlap between high frequency words in surveys and rater comments was substantial. The language used to describe goals in physician action plans was highly related to respondent comments, but less so to survey items. High frequency words in facilitator reports related heavily to action plan content. Discussion: All components of the program relate to one another indicating that each plays a part in the process. Patterns of overlap suggest unique functions conducted by program components. This demonstration of coherence across components of this program is one piece of evidence that supports the program's validity. [ABSTRACT FROM AUTHOR]

Objective: To identify recommendations from family physicians in Canada on how public health agencies and professional organizations might improve future crisis and emergency risk communications., Design: Qualitative content analysis., Setting: Canada., Participants: Sixteen family physicians who have experienced a public health crisis., Methods: Semistructured interviews were conducted with 16 family physicians practising in various regions across Canada who had experienced what they defined as a public health crisis. These events included environmental crises, like forest fires and hurricanes, and infectious disease crises, like the SARS (severe acute respiratory syndrome) and H1N1 outbreaks. Interview transcripts were coded using an inductive qualitative content analysis method, specifically focusing on recommendations from participants on how to improve risk communication to family physicians in the event of a future public health crisis., Main Findings: Based on their personal experiences, participants had many explicit recommendations on how to improve risk communication strategies in the event of a future public health crisis. These included having a single trusted source of information; having timely and succinct communication; having consideration for learners; ensuring access to information for all physicians; improving public health and family medicine collaboration; having crisis information for patients; and creating communication infrastructure before a crisis occurs., Conclusion: This research provides thoughtful and varied considerations and advice from practising family physicians on how to improve risk communication from public health agencies and professional organizations to this group in the event of a public health crisis. With improved communications between these bodies and family physicians, practitioners will be better informed and prepared to provide the best possible care to their patient populations during such events., (Copyright© the College of Family Physicians of Canada.)