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Transcript of Continuing Professional Development for Health Professionals Khalid Bin Abdulrahman, MD, DPHC, ABFM,...
Continuing Professional Development
for Health Professionals
Khalid Bin Abdulrahman, MD, DPHC, ABFM, MHSc (MEd)
Associate Professor of Family Physician
Director of Medical Education CenterCollege of Medicine , KSU
Keeping Up"No one, who wishes to practice medicine,either with safety to others, or credit to himself,will incline to remain ignorant of any discoverywhich time or attention has brought to light. But it iswell known that the greatest part of those who areengaged in the actual prosecution of this art, haveneither leisure nor opportunity for very extensivereading.
Sr. Andrew Duncan, 1773, Medical and Philosophical Commentaries
By the end of this session you will be able to:
• Define what is CPD and CME?• Recognize why physicians change their
performance?• Understand how physicians change their
performance? How physicians learn?• Recognize does CME make a different in
medical practice and patient care?
• What are the factors that affect decision making to participate in formal CME ?
• What are the obstacles to participation in CME?
What is CPD
What is CPD?
CPD is a process of lifelong learning for all individuals and teams which meets the needs of patients and delivers the health outcomes and healthcare priorities of the health sector and which enables professionals to expand and fulfill their potential.
Continuing - life long learning, an ongoing process regardless of your age or the stage of your career
Professional - focused on yourpersonal / individual competence at work / in a professional role
Development - improve your personal skills to improve patient care and your career progression
What is CPD?
Another definition of CPD:
• CPD is a systematic, ongoing, cyclical process of self directed learning
• It includes everything you learn which enables you to do your job (current or future) more effectively
• It is a partnership between the individual and the organisation
• The main responsibility for your development lies with you. The organisation for whom you work has a responsibility for helping you to meet the development needs which relate to performance in your current job
• CPD is a general concept and can be used by everyone (pharmacists, technicians, assistants and other support staff)
What is CME
Definition• CME is a continuing process that involves
practicing physicians, practice environments, learning resources, and interventions designed to improve the ability of physicians to provide better medical care to patients
Davis DA, Fox RD. The Physician as Learner: Lining Research to Practice. American Medical Association, Chicago, Ill, 1994
The Broader Definition
• Attendance at formal CME activities is part of a broader search for information
• The search includes not only participation in formal conferences, but reading, consulting with peers & experts and other form of SDL
Why physicians change their performance?
What are the factors that affect decision making to participate in
formal CME ?
Decision-making modelContext of medical practice
Awareness of needs
Attitudes toward education
Goals and expectations
Opportunities and barriers
Decision to attend
The Purpose of Participation
• To keep up with advances in medicine
• To validate previous learning
• To review or refresh previous learning
• To prepare for board examinations
• To obtaining CME credits
• To reduce the possibility of malpractice
• To get away from busy practice
• To get fun and recreation
• To returning back to academic medicine
What are the obstacles to participation in CME?
Obstacles to Participation
• Constrains of practice
* Heavy patient load
• Conflict with family and community responsibilities
• Cost of CME and loss of patient income
What might make it difficult for you to practise CPD and document it?
• Time
• Motivation
• Lack of understanding of what’s involved / how to do it
• Money / resources (people)
• Lack of mentors / facilitators
• Lack of administrative support
• Unwillingness to include personal information in portfolio?
• Lack of knowledge of benefits
• Lack of a formal appraisal / performance review system
• Perceptions of others’ (e.g. senior managers’) roles
Shift towards learner-centred education
• Old think– Passively listening to
lectures– Educator decides
topic– Read a journal or
text book– Errors should be
forgotten / denied
• New think– Actively participate in
learning– You decide the topic– Problem solving,
simulated cases– Errors are a learning
experience
Wyatt JC. Clinical Knowledge… in the Information Age London: RSM, 2001
Does CME make a different in medical practice and patient care?
Reviews of the evidence :
“Our data show some evidence that interactive CME sessions that enhance participant activity and provide the opportunity to practice skills can effect change in professional practice and, on occasion,health care outcomes.
Based on a small number of well-conducted trials, didactic sessions do not appear to be effective in changing physician performance.”
Davis D et al. Impact of formal continuing medical education: do… continuing education activities change physician behaviour or health care outcomes? JAMA 1999 Sep 1;282(9):867-74
Emerging evidence supports complex interventions
the complex educational intervention
exemplified the best form of knowledge translation (the integration
of knowledge into practice), moving the practitioner from
Davis D. Clinical practice guidelines and the translation of knowledge: the science of continuing medical education. CMAJ 2000; 163 (10 ):1278-9
– awareness of new guidelines
– to agreement with the guidelines and
– finally to adoption and adherence,
following well-defined patterns of adoption and based on principles of adult learning applied to CME.
Davis D. Clinical practice guidelines and the translation of knowledge: the science of continuing medical education. CMAJ 2000; 163 (10 ):1278-9
What content and how to update?
“Of 217 drug therapy guidelines developed or endorsed by Canadian organizations in the period 1994–98, only 15% met half or more of the authors' criteria for rigour in the developmental process, and only 7% were rated
by independent reviewers as sound”
Time to weed the CPG garden CMAJ 2001;165(2):141, 143
How to interact?
A critical mass of practitioners can benefit from a virtual community.
Roberts C, Fox N. General practitioners and the Internet: modelling a 'virtual community'.
Fam Pract 1998 Jun;15(3):211-5
PCDQ – Learning from your own clinical data
www.pcdq.org
Online CME: Family Practice
Last Updated April 25, 2004.
http://www.cmelist.com/family_practice.htm
How do you go about it?
• The CPD cycle
The CPD cycle is very important and underpins and provides a framework for all CPD activities
The CPD cycle
Reflection
• Identify your development needs
• Reflect or think about what you have done, how you did it and how you could do it better or differently, or apply that insight in the future
• Takes practice to develop
How might you do this?
• Critical incident analysis (positive and negative)Personal SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis
• With your line manager during your appraisal
Planning• How will you meet the development
needs you have identified? • What level of competence do you need to
achieve? • What is your preferred style of learning? • How important are these needs in
relation to each other? • What style of learning will you use?
Ways of meeting your development needs
Overhead 6
Lectures Audit
Action learning sets
Study days Meetings Reading
Computer assisted learning
Action
• Do what you have planned and record it
How might you record your CPD? • In any way that suits and works for you
• Computer
• Notebook
• Portfolio – whatever documentation you use is your portfolio
• May use resources and portfolios already available
Evaluation
• This is a very important stage to complete the cycle where you assess how effective your learning has been
• Consider– Have you achieved your intended outcomes? – How has your practice changed as a result?– If it hasn’t, what are the reasons? Are you
How might you use / apply the knowledge / skills in the future?
Evaluation/ action form
When did you last participated in educational event:• What messages did you take home?• Have you acted on them?
Issues studied today: (1) (2) (3)• What did you like?• What did you dislike?• What would you act on?• Reflection is the “mantra” through the entire process
Challenges for CME
relevance to practice
changes physician behavior
based on current best scientific evidence
CME has value when it results in….
–quality patient care
–state-of-the-art patient care
–evidence-based patient care
Usefulness Equation
Usefulness = Relevance x ValidityWork
--Allen Shaughnessy, David Slawson, 1994
Thank you