• Ray Lewkonia, Nigel Flook, Michel Donoff, and Jocelyn Lockyer.
• Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. rlewkoni@ucalgary.ca.
• BMC Med Educ. 2013 Sep 9; 13: 121.

BackgroundLicensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice.MethodsRetrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group.ResultsReports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings - practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence.ConclusionThis study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians.

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