General practitioners' self assessment of knowledge

BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7144.1609 (Published 23 May 1998) Cite this as: BMJ 1998;316:1609

This article has a correction. Please see:

The vast range of clinical conditions means that doctors cannot know everything

  1. Adrian Edwards, Lecturer,
  2. Michael Robling Matthews, Research officer,
  3. Sarah Matthews, Clinical fellow,
  4. Helen Houston, Senior lecturer,
  5. Clare Wilkinson, Senior lecturer
  1. Division of General Practice, University of Wales College of Medicine, Cardiff CF3 7PN
  2. Department of General Practice, University of Manchester, Manchester M14 5NP
  3. Exeter Postgraduate Medical Centre, Exeter EX2 5DW
  4. Goodfellow Unit, Department of General Practice, University of Auckland, Private Bag 92019, Auckland, New Zealand

    EDITOR—Factual recall is only one element of a needs assessment that should be taken into account in developing continuing medical education programmes for general practitioners. A poor correlation of self assessed knowledge with performance in a knowledge test, as shown by Tracey et al,1 does not invalidate the rationale for a needs assessment. The knowledge tests used by Tracey et al do not reflect the range of practical issues relevant to patient management. Knowledge of practical management that is relevant to the concerns and questions likely to be raised by patients, and confidence and experience in dealing with specific conditions, are the needs that should be assessed in planning continuing medical education programmes.

    In two studies evaluating guidelines in primary care, one set for the use of magnetic resonance imaging for common orthopaedic conditions (182 general practitioners)2 and the other for the management of breast conditions in primary care (113 general practitioners),3 we undertook needs assessments with the participating practices. In each study doctors rated their confidence in using magnetic resonance imaging or managing breast conditions respectively and identified problems from recent clinical practice, and knowledge of practically relevant issues was assessed. In the first study the doctors indicated their frequency of using magnetic resonance imaging. Good knowledge of the contraindications for magnetic resonance imaging was associated with higher self assessed knowledge (P<0.05) and confidence (P<0.01) and frequency (P<0.05) of using magnetic resonance imaging in practice. Knowledge of lifetime risk of breast cancer was associated with confidence in dealing with breast conditions (P<0.05). Knowledge was also associated with membership of the Royal College of General Practitioners (P<0.01)

    General practitioners can correctly assess their knowledge and needs if the relevant aspects are explored. Identifying needs from personal experience is …

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