摘要
Performance assessment and monitoring systems are the process by which ophthalmologists demonstrate they are fit to continue practicing.Revalidation is the process by which licensed doctors are legally required to demonstrate to medical regulators that they are up to date and fit to practice in order to maintain their medical license,and began in the United Kingdom(UK)in 2012 following well-publicized events.Recertification is a different process which began in North America and demonstrates doctors have maintained competence,without involvement of external stakeholders.Arguments for and against the concept of performance assessment are reviewed.Stakeholders in performance assessment,whether part of the process or not,are doctors themselves,peers and other health care providers,patients,hospitals and health systems,medical regulators,and health policy makers.Early models of performance assessment included portfolios,credit accumulation,and closed-book examinations.Models are in evolution with the value of formative rather than summative assessments,and the need for methods of assessing procedural competency increasingly recognized.Emerging methods of performance assessment of practicing ophthalmologists include use of performance indicators,simulation,and workplace-based assessments.Alternate methods of assuring the public by improved detection of outliers are discussed.Despite weak evidence supporting performance assessments in demonstrating continuing competency to practice,the process is gradually being accepted worldwide.Further research into optimum methods of performance assessment and monitoring processes is required,along with cost-benefit analysis.
