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Importance of neuropsychological screening in physicians referred for performance concerns
INTRODUCTION: The literature suggests that 6–12% of practicing physicians are dyscompetent. Dyscompetence can manifest as failures in direct provision of care, but also issues with interpersonal and communications skills and professionalism. There is a growing literature suggesting the value of neur...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257926/ https://www.ncbi.nlm.nih.gov/pubmed/30475869 http://dx.doi.org/10.1371/journal.pone.0207874 |
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author | Williams, Betsy White Flanders, Philip Welindt, Dillon Williams, Michael V. |
author_facet | Williams, Betsy White Flanders, Philip Welindt, Dillon Williams, Michael V. |
author_sort | Williams, Betsy White |
collection | PubMed |
description | INTRODUCTION: The literature suggests that 6–12% of practicing physicians are dyscompetent. Dyscompetence can manifest as failures in direct provision of care, but also issues with interpersonal and communications skills and professionalism. There is a growing literature suggesting the value of neurocognitive screening in physicians with clinical competency issues. The contribution of such screening in physicians with workplace behavioral issues is not as established. The aim of this exploratory study was to examine patterns of performance on a commonly used neuropsychological screening instrument. Performances differences, if present, could have implications for remediation and/or monitoring. METHODS: Published data on a computerized neurocognitive screening instrument (MicroCog) for normative physician samples, published data on physicians referred for clinical competency issues, and newly collected data on physicians with workplace behavioral issues were analyzed. A two-way analysis of variance (Sample X Index) and post-hoc paired comparisons were conducted. A second analysis was performed employing an aggregated estimate of normative physician performance. RESULTS: Results revealed a significant main effect for Sample and Index and a significant interaction effect. The second analysis of variance employing the pooled samples (Sample X Index) was conducted. The workplace behavior issues sample differed significantly from each of the samples. The Sample by Index interaction was significant. DISCUSSION: Significant differences in performance on a neurocognitive screening instrument were found between non-referred physicians and physicians with behavioral or medical/technical competency concerns. Those with workplace behavioral issues performed significantly better than those with medical/technical issues, but significantly worse than non-referred physicians. Using these findings, 2.0% of the normal sample versus 35.1% of the medical/technical sample, and 10.9% of the behavioral sample would fail the screen using typical, conservative cutoffs. Further study of the potential role of neurocognitive factors in physicians referred for behavioral comportment issues is warranted. |
format | Online Article Text |
id | pubmed-6257926 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-62579262018-12-06 Importance of neuropsychological screening in physicians referred for performance concerns Williams, Betsy White Flanders, Philip Welindt, Dillon Williams, Michael V. PLoS One Research Article INTRODUCTION: The literature suggests that 6–12% of practicing physicians are dyscompetent. Dyscompetence can manifest as failures in direct provision of care, but also issues with interpersonal and communications skills and professionalism. There is a growing literature suggesting the value of neurocognitive screening in physicians with clinical competency issues. The contribution of such screening in physicians with workplace behavioral issues is not as established. The aim of this exploratory study was to examine patterns of performance on a commonly used neuropsychological screening instrument. Performances differences, if present, could have implications for remediation and/or monitoring. METHODS: Published data on a computerized neurocognitive screening instrument (MicroCog) for normative physician samples, published data on physicians referred for clinical competency issues, and newly collected data on physicians with workplace behavioral issues were analyzed. A two-way analysis of variance (Sample X Index) and post-hoc paired comparisons were conducted. A second analysis was performed employing an aggregated estimate of normative physician performance. RESULTS: Results revealed a significant main effect for Sample and Index and a significant interaction effect. The second analysis of variance employing the pooled samples (Sample X Index) was conducted. The workplace behavior issues sample differed significantly from each of the samples. The Sample by Index interaction was significant. DISCUSSION: Significant differences in performance on a neurocognitive screening instrument were found between non-referred physicians and physicians with behavioral or medical/technical competency concerns. Those with workplace behavioral issues performed significantly better than those with medical/technical issues, but significantly worse than non-referred physicians. Using these findings, 2.0% of the normal sample versus 35.1% of the medical/technical sample, and 10.9% of the behavioral sample would fail the screen using typical, conservative cutoffs. Further study of the potential role of neurocognitive factors in physicians referred for behavioral comportment issues is warranted. Public Library of Science 2018-11-26 /pmc/articles/PMC6257926/ /pubmed/30475869 http://dx.doi.org/10.1371/journal.pone.0207874 Text en © 2018 Williams et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Williams, Betsy White Flanders, Philip Welindt, Dillon Williams, Michael V. Importance of neuropsychological screening in physicians referred for performance concerns |
title | Importance of neuropsychological screening in physicians referred for performance concerns |
title_full | Importance of neuropsychological screening in physicians referred for performance concerns |
title_fullStr | Importance of neuropsychological screening in physicians referred for performance concerns |
title_full_unstemmed | Importance of neuropsychological screening in physicians referred for performance concerns |
title_short | Importance of neuropsychological screening in physicians referred for performance concerns |
title_sort | importance of neuropsychological screening in physicians referred for performance concerns |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257926/ https://www.ncbi.nlm.nih.gov/pubmed/30475869 http://dx.doi.org/10.1371/journal.pone.0207874 |
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