Implementation of Peer Review into a Physical Medicine and Rehabilitation Program and its Effect on Professionalism
Received 31 July 2009; accepted 26 November 2009.
Objective
To examine the effects of implementing a peer review evaluation system on residents' attitudes and perceptions of professionalism, a core competency of the Accreditation Council for Graduate Medical Education (ACGME), in a Physical Medicine and Rehabilitation (PM&R) program.
Design
Four classes of residents were divided prospectively into a control and an intervention group. All residents were asked to complete a survey regarding their attitudes and perceptions on both peer review and professionalism. Only 2 of these classes participated in a newly adopted peer review evaluation system, after which time all participants were again asked to fill out the surveys.
Setting
Residents were from a PM&R residency program at an urban tertiary care medical center.
Participants
All residents who completed the entire survey preintervention and postintervention were included.
Methods
The intervention was the introduction of peer review into residents' evaluation assessments. All residents filled out a survey with questions relating to peer review and professionalism before and after this intervention.
Main Outcome Measurements
Outcomes include understanding how residents perceive various attributes of professionalism, peer review, and the interconnection of the 2.
Results
Data analysis using SPSS was performed using survey scores for 46 residents preintrodution and postintroduction of a peer review evaluation system. Analysis revealed that residents who participated in the peer review process were more likely to agree that certain aspects of daily patient care, behaviors, and concepts were components of professionalism. However, they continued to believe that residents are ultimately not responsible for their colleagues' professionalism and that peer review might be harmful to a residency program.
Conclusion
This study introduces an interesting dichotomy. Peer review clearly influences resident outlook on professionalism and yet there is a high suspicion regarding its implementation. If appropriately implemented, peer review may be a potent method of enhancing the education of this ACGME requirement.
aDepartment of Physical Medicine and Rehabilitation, New York University, 400 E. 34th Street, Suite 600, New York, NY 10016†
bDepartment of Physical Medicine and Rehabilitation, New York University, New York, NY‡
cDepartment of Physical Medicine and Rehabilitation, New York University, New York, NY§
dNew York University School of Medicine, New York, NY¶
eDepartment of Physical Medicine and Rehabilitation, New York University, New York, NY∥
Address correspondence to: J.B.
Disclosure Key can be found on the Table of Contents and at www.pmrjournal.org
ABSTRACT