Determining Physicians' Performance Continuing Medical Education and Other Interacting Variables

Participation informal continuing medical education (CME) is required by many organizations and state governments as the foremost means of assuring the quality of medical care. Analysis of the literature reveals that CME in all its forms is effective in improving competence, i.e., the ability to provide good care. However, that competence is not regularly reflected in physicians'habitual performance in the care of patients. A number offactors are known to narrow the gap between competence and performance, including clear specification of standards, individualfeedback on actual performance, and a professional environment conducive to the maintenance of high standards. In the presence of such factors, CMEcan improve physicians 'performance when directed to objectively identified def ciencies. However, public assurance of the quality of medical care can only be provided through certification that individual physicians'performance conforms to contemporary valid standards.