Viewpoint: A Performance-Based Conception of Competence is Changing the Regulation of Physicians?? Professional Behavior
Bibliographic record
Abstract
It is the obligation of a profession to articulate the special meaning of competence in its field and to foster the good performance of its practitioners through education and discipline. External societal demands for increased accountability, and internal pressures for greater use of measurements of the processes and outcomes of clinical performance, are forcing the medical profession to reevaluate its view of competence and to change the way the profession "manages" the competence of its members. Traditionally, and predicated on the notion of "once in, good for life," medical education has focused on assuring the competence of trainees as they first enter independent professional life. In parallel, professional regulatory authorities have concentrated on apprehending the "false-positives" of the educational system. But viewed from a performance orientation, competence reflects situational relationships among doctors, their patients, and the systems in which they perform and, thus, is only partly dependent on the attributes of individual actors. This shift in thinking has major implications for the practice of medicine, particularly for the process of maintaining and improving performance. In jurisdictions throughout the world, recognition of the need for systematic and accountable ongoing education for practicing doctors is growing. This educational need should not be seen as a mark of weakness or failure but, rather, as the natural consequence of engagement in challenging practice. "Ars longa, vita breva." The profession must address the complex issues of education-in-practice with the same determination and creativity that it previously applied to education at entry to practice.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".