Journal of Continuing Education in the Health Professions最新文献

Introduction: Supervising in the workplace plays a key role in increasing the skills of the trainee. The shift to competence-based medical education requires both clinical expertise and pedagogical skills from the supervisor. These are distinct types of expertise. We know only a little of how competencies of supervising develop in medical education. The aim of our study is to find out what kind of professional agency in supervision general practitioners describes before their supervisor training. Professional agency refers to the individual's skills, willingness, ability, and responsibility to act with others in the professional context.

Methods: Our participants wrote a presentation of themselves before starting a supervisor training module. We studied these texts with narrative positioning analysis to examine who they are as supervisors, that is, the kind of professional agency they describe.

Results: We found three types of descriptions of professional agency: traditional master-apprenticeship supervision, clinical skills supervising with a collegial relationship, and process-oriented dialogical supervision. Supervising is mostly described as supervising the trainee on clinical skills and participants have a will to be a good supervisor, but they also express uncertainty of achieving this goal.

Conclusion: The variation in general practice supervisors' agency and pedagogical skills poses challenges for training providers in how to tailor the training to suit the best to participants with different skills. However, it gives an excellent opportunity for fruitful peer-to-peer learning. With our findings, it is possible to further develop supervisor training.

Abstract: Health professionals' motivation is a key determinant of their continuing professional development (CPD) outcomes. Therefore, CPD providers must ensure that they design CPD activities to support health professionals' motivation; this process is referred to as motivational design. The aim of this article is to introduce CPD providers to the PACE (purpose, autonomy, confidence, engrossment) model of motivational design, and describe how we applied the PACE model to create two online modules for an interprofessional audience. The PACE model builds on other available models of motivation design by offering theoretically informed strategies to support autonomous motivation, a specific quality of motivation that is associated with more effective learning processes and outcomes. Our experience suggests that CPD providers can use the PACE model to guide their motivational design efforts. We also encourage CPD researchers to test the theoretical assumptions that inform the PACE model.

Abstract: To realize the transformative potential of artificial intelligence (AI) in health care, physicians must learn how to use AI-based tools effectively, safely, and equitably. Continuing professional development (CPD) activities are one way to learn how to do this. The purpose of this article is to describe a theory-based approach for assessing health professionals' motivation to participate in CPD on AI-based tools. An online survey, based on an AI competency framework developed from existing literature and expert consultations, was administered to practicing physicians in Ontario, Canada. Across eight subcompetencies for using AI-based tools (eg, appraise AI-based tools for their regulatory and legal status), the survey measured physicians' perception they could successfully enact the competency, the importance of the competency in meeting their practice needs, and the desirability of participating in CPD activities on the competency. Motivation scores were calculated by multiplying the three scores together. Ninety-five physicians completed the survey. The highest motivation scores were for the subcompetency of identifying AI-based tools based on clinical needs, while the lowest motivation scores were for appraising tools' regulatory and legal status. All AI subcompetencies were generally rated as important, and CPD activities were generally perceived as desirable. This survey demonstrates the utility of a theory-based approach for assessing physicians' motivation to learn. Although the survey results are context specific, the approach may be useful for other CPD providers to support decision making about future AI-related CPD activities.

Introduction: Despite increasing physician specialization, high-quality continuing professional development is needed for continual mastery learning, especially focused on multiple specialties. Board certification is considered a surrogate for competency, and some stakeholders consider it suboptimally aligned with its primary purpose. We set to explore the motivation for continued education and competence in physicians who are board certified in multiple specialties.

Methods: We performed a qualitative study using thematic analysis. Semistructured interviews were performed virtually. Landscapes of practice, an extension of communities of practice within sociocultural learning theory, was used as a theoretical framework.

Results: Fifteen internists and their related subspecialties performing continual board certification completed the study. We identified six themes describing the underlying motivation for why physicians maintain competency in multiple medical specialties: Social responsibility, Promise of expertise, Enhanced job opportunities, Widened expertise, Professional requirements, and Personal fulfillment.

Discussion: The landscape of medicine continues to evolve in how it is practiced. How a physician navigates this process, maintaining their competency, is a continuous lifelong learning process, and there are multiple ways. A portion of internal medicine physicians are motivated to practice in multiple specialties, recognizing the opportunities and challenges involved. The practical application of this study would include organizational-based education focused on hybrid learning (education explicitly focusing on overlapping or cross-discipline fields). Despite a plethora of educational opportunities, there is very little with the focus on cross-discipline education and training.

Introduction: Point-of-care ultrasound (POCUS) technology has evolved rapidly and is being embraced by many health professionals as a valuable clinical tool. Sonographers are now teaching ultrasound skills to other health professionals in the clinical setting, including doctors, nurses, midwives, paramedics, and physiotherapists. The purpose of this study was to understand the breadth of the opportunities, transitions, and challenges experienced by sonographer educators navigating new interprofessional teaching roles.

Methods: Sonographers, who had participated in an initial phase Delphi study defining sonographer competencies in POCUS education, were invited to participate in a follow-up interview. Semi-structured interviews were conducted, and the interview data were thematically analyzed to understand the experiences and perceptions of participants.

Results: Twenty sonographer educators were interviewed. Participants were clinically experienced sonographers from Australia and New Zealand with diverse professional experience in clinical teaching, university academic, ultrasound leadership, health management, and corporate roles. The transition to teaching interprofessional cohorts of learners in different clinical settings was substantial. The experiences of sonographers undertaking these new roles were described under the themes of "sonographer perceptions"; "educator knowledge"; "understanding learners"; "teaching dynamics"; and "ultrasound evolution."

Conclusion: This study is the first to describe the experiences of sonographers engaged in interprofessional POCUS teaching. The results provide insight into the training needs of sonographers in this emerging area and will be used to inform the development of continuing education resources.

Introduction: Health care providers (HCPs) use reflection to intervene in complex, ambiguous clinical situations. Yet, there is scant evidence about the circumstances when HCPs use reflection and how they perceive reflection within their continuing professional development. We selected a narrative inquiry approach to study how HCPs perceive reflection's role in learning in four health professions.

Methods: We invited 26 health professionals to a narrative interview conducted by a student in one of the four selected professions: medicine, nursing, occupational therapy, and speech-language pathology. The narrative events that make up the stories were analyzed and interpreted using structural analysis based on the narratives' historic-empirical and psycho-semantic dimensions.

Results: Physicians told us that reflection bolsters their clinical performance and confidence. Nurses told us that reflection allowed them to develop resilience as they sought to integrate their work setting and gain autonomy. Occupational therapists spoke of how reflection spurred them to innovate and extend the scope of their practice to advocate for their patients' health better. Speech-language pathologists described how they reflect on "educating" other HCPs about their profession and enhancing their communication skills with patients.

Discussion: The communicative power of storytelling allowed us to fathom what is hard to describe in words: how reflection builds clinical and psychosocial skills and introspective capacity. Hence, findings provide empirical evidence of reflection's perceived role in maintaining professional skills that make HCPs effective in complex, ambiguous situations.

Abstract: Despite intensive attempts to create scholarship equity at academic medical centers, clinician educators continue to face a challenging professional promotion environment that puts them at risk for burnout, stalled career advancement, and abandonment of academic medicine altogether. Coaching, which has a wealth of supportive evidence from outside of medicine, is distinguished by (1) being driven by the agentic coachee that is inherently capable, creative, and resourceful, (2) not requiring the coach and coachee to have shared content expertise, and (3) not being centered around transfer of expertise from the more knowledgeable or experienced party to the recipient. Initial evidence from within medicine indicates that coaching reduces burnout and improves learner self-reflection, teaching effectiveness, goal setting, reflective capacity, professional identity formation, career planning, and development of adaptive expertise. In this article, faculty coaching is presented as a powerful means to help clinician educators overcome the myriad challenges to professional advancement and career fulfillment. The current evidence in support of coaching-both within and outside of medicine-is reviewed. Finally, a conceptual model is provided, as are guidelines demonstrating specific roles, behaviors, and responsibilities for faculty coaches and coachees.

Introduction: Respiratory therapists (RTs) must apply competencies to address the health care needs of the public. Although all competencies are deemed essential, scholarly practice requires that professionals critically assess their practices, integrate evidence-based literature, and enhance the care they deliver to patients. Though scholarly practice is also associated with professional empowerment, role satisfaction, and improved patient care, it is rarely measured. The purpose of this study was to develop, pilot, and generate preliminary validity evidence of a tool designed to measure scholarly practice among RTs.

Methods: We used DeVellis' nine-step scale development process and exploratory factor analysis to develop the tool. The results of a scoping review and qualitative study were used to generate an item pool and pilot test it with 81 RTs across Canada. The refined tool was tested on a larger sample (n = 832) and analyzed using exploratory factor analysis.

Results: Using principal axis factoring with Promax rotation, we retained 18 items across 4 factors, explaining 56.7% of the variance in the data (31.7%, 10.2%, 8.6%, 6.2%): (Factor 1) professional development and credibility, (Factor 2) elements supporting scholarly practice, (Factor 3) the perceived impact of scholarly activities on practice, and (Factor 4) scholarly practitioner identity and ability. Internal consistency of the final 18-item scale was suitable overall (Cronbach alpha = 0.879) and for each factor (F1 = 0.888; F2 = 0.774; F3 = 0.842; F4 = 0.746).

Discussion: Our results provide preliminary evidence for a scholarly practice tool that can encourage self-reflection and/or foster peer-based reflection. Using the tool with other health care professionals and conducting confirmatory factor analysis could generate additional validity evidence.