Journal of Continuing Education in the Health Professions最新文献

Introduction: Despite the recognized need for effective mentoring for faculty in academic medicine, mechanisms driving successful mentoring interventions remain underexplored. Two consecutive cohorts of 20 academic medicine mid-career research faculty from 27 US medical schools participated in a randomized controlled trial of the yearlong C-Change Mentoring & Leadership Institute intervention. Participants convened quarterly for 2- and 3-day intensive sessions in 2020 to 2022.

Methods: We examined how this complex group peer-mentoring intervention produced positive changes in the perspectives, attitudes, and practices of individual faculty participants and the group. Qualitative data included ethnographic observations, participant writings, and semi-structured interviews. We used codebook thematic analysis to characterize changes in individuals and the group, paired with a realist evaluation framework to identify essential functions and activities within the C-Change Institute.

Results: The mechanisms that produced change consisted of four key functions, each involving multiple forms (or activities): (1) forming group culture through participatory activities, establishing psychological safety and mutual affirmation; (2) encouraging self-reflection through introspective exercises and structured storytelling; (3) forming empathic relationships, telling life stories, and discussing experiences of difference and power; and (4) envisioning a successful future through aligning personal values and professional goals, using structured stepwise short and long-term career planning. The authors illustrate the interactions of these functions and activities.

Discussion: This successful mentoring experiment of learning and career development in a changed culture provides a blueprint for broader culture change in academic medicine that must honor values, encourage reflective practice, team building, and relational leadership in career development.

Introduction: Although health care professionals develop a professional identity through intensive education and training programs in their fields, there is not the same formal process for developing a parallel identity as a teacher. Many educational programs include arts-based activities in their curriculum to promote professional identity formation, as art can foster reflection and self-discovery. This project explores the use of a capstone art assignment to offer an immersive and emotionally resonant method for identity development, drawing on creativity to access a more personal sense of self.

Methods: The Developing Expertise in Clinical Education curriculum connects educator skill development with professional identity formation, using a final drawing project to explore participants' emerging identities as teachers. Grounded in the ACGME Clinician Educator Milestones, early career health professions educators engaged in 6 months of professional development and coaching. Participants created visual representations and written descriptions of their envisioned roles as educators.

Results: Quantitative survey responses showed significant improvement (P ≤ .0001) across all domains-role, milestones, feedback, didactics, bias, and teaching-with large effect sizes (|r| > .8). Thematic analysis of visual and written reflections revealed three key themes: curriculum influence on identity, reflections on identity, and influence of identity on practice, illustrating how the drawing activity supported self-perception and integration of the educator role.

Discussion: Visual reflection can serve as a powerful tool to support identity formation among health professions educators. Arts-based methods may enhance professional development by fostering self-awareness, strengthening commitment to teaching, and supporting retention in academic medicine.

Abstract: The underpinnings of adult learning theory are foundational to continuing medical education (CME). Several widely studied learning theories are relevant to medical providers including deliberate practice, situated learning theory and community of practice, social cognitive theory and self-determination, adaptive expertise, and experiential learning theory. The Accreditation Council for Continuing Medical Education recognizes 11 types of CME activities each integrating these learning theories to some degree. Provider preferences are shaped by accessibility, cost, flexibility, and opportunities for networking leaving many balancing the convenience of online programs with the value of in-person interactions. The degree to which learning theories are integrated within CME activities is widely understudied despite their interwoven relationship and association to provider preferences. This analysis aims to (1) evaluate the degree various CME models integrate learning theory; (2) identify theory-led strengths and limitations of CME models; and (3) extrapolate themes for CME planners to strengthen theory integration. The three most common types of CME activities are enduring material (ie, web-based courses, web-based courses with simulation), live courses (ie, conferences, webinars, simulations), and regular scheduled series (ie, Project Extension for Community Healthcare Outcomes, speaker series). Integration of learning theory across 7 CME models was evaluated through a content analysis using a trichotomous classification system (fully integrated, partially integrated, or no integration). Results varied, with Project Extension for Community Healthcare Outcomes and live simulations having the highest degree of theory integration. A thematic analysis identified five themes for improving theory integration including feedback mechanisms, structured self-reflection, adaptability to promote autonomy, repeat exposure to complex skills, and practice of humility.

Abstract: The Arkansas Naloxone Education and Training (ANET) program, based at the University of Arkansas for Medical Sciences, was developed to address the urgent need for opioid-overdose prevention across the state. Funded by the Substance Abuse and Mental Health Administration (SAMHSA), ANET uses a train-the-trainer model to equip health care professionals with the knowledge and tools necessary to deliver naloxone education in their local settings. In its first year, the program launched a three-module curriculum, accredited for continuing education, of health care professionals and delivered using an academic detailing teaching strategy, prioritized recruitment from counties through a needs assessment including the highest rates of opioids dispensed and of overdose deaths, and implemented a comprehensive evaluation plan that is grounded in an evidence-based framework that facilitates continuous evaluation and improvement (ie, RE-AIM framework-Reach, Effectiveness, Adoption, Implementation, and Maintenance). Knowledge and attitudes were assessed before and after health care professionals completed the training program. All trainers received technical support and outreach materials. The program also fostered strategic statewide partnerships to support recruitment, implementation, and community engagement. ANET is embedded within an academic medical center and aligned with continuing professional development infrastructure, offering a replicable model for community-centered overdose prevention. Lessons learned during the program's implementation underscore its potential to inform future design, delivery, and sustainability of similar interventions.

Introduction: Despite strong evidence supporting family-centered service (FCS), service providers (SPs) often face challenges in applying these practices in pediatric rehabilitation. This report describes the development of an online professional development module to support FCS implementation in clinical settings.

Methods: Module development was guided by best-practice recommendations for online knowledge translation, the Knowledge-to-Action model, and ADDIE instructional design principles. Focus group interviews were conducted with 14 SPs to identify training needs and preferences, including practical strategies for family engagement, which informed the content and structure of the module.

Results: The resulting module comprises five chapters that integrate evidence-based strategies, video demonstrations, real-world case examples, and learning activities. A hybrid navigation structure was implemented to support both structured learning and flexible access. A 2-week pilot test with eight SPs informed refinements to enhance usability and navigation.

Discussion: This study illustrates an iterative, user-centered approach to developing an online professional development resource that addresses the gap between FCS theory and practice. The module offers a practical, accessible tool to support SPs in adopting collaborative, family-centered approaches in pediatric rehabilitation. Future research should examine the module's long-term impact on provider behavior and outcomes for children, families, and organizations across contexts.

Introduction: Well-calibrated diagnostic performance requires feedback on decisions. Emergency department and urgent care (ED/UC) clinicians infrequently receive diagnostic performance feedback. We explored clinician experience with self-directed diagnostic performance review compared with diagnostic safety expert review.

Methods: Single-center, cohort study of pediatric ED/UC clinician self-directed case review involving possible diagnostic errors (DxEs). Participants reviewed their care of patients admitted within 10 days of an index ED/UC visit at risk of DxEs. The Revised Safer Dx provided structure for DxE identification and was compared with expert review by two diagnostic safety experts using Cohen kappa. Participants also reported their experience using the Revised Safer Dx.

Results: During the 1-year study period, 187 patients at risk of DxEs received index visit care from 260 ED/UC eligible clinicians. Seventy-one clinicians submitted reviews for 97 patient-clinician encounters (37.4% response rate). Agreement on the presence of DxEs ranged from 84.8% to 87.5%; Cohen kappa for expert 1 = 0.51 (95% confidence interval = 0.25-0.76); expert 2 = 0.54 (95% confidence interval = 0.17-0.92) indicating moderate agreement. More than 60% of participants agreed that the Revised Safer Dx provided a useful framework for reviewing diagnostic performance regardless of the presence of a DxE. Participants self-identifying a DxE were significantly more likely to have altered their diagnostic approach than those who did not (75.0% vs 5.7%; P < .001).

Discussion: ED/UC clinicians performing self-directed structured review for DxEs demonstrated moderate agreement with diagnostic safety experts indicating this method may aid diagnostic reasoning calibration. Promoting self-directed reviews may improve feedback delivery among ED/UC clinicians.

Introduction: Artificial intelligence (AI) is increasingly integrated into health professions education, yet its application in continuing professional development (CPD) oversight remains underexplored. Accrediting bodies play a critical role in ensuring that continuing education is trustworthy, unbiased, and aligned with professional standards.

Methods: This perspective synthesizes current literature and professional guidance to examine potential applications of AI in accreditation oversight. The analysis considers how AI could support efficiency, consistency, and insights across regulatory functions, while emphasizing the continued necessity of human judgment and governance.

Results: Opportunities for accreditor use of AI include screening reaccreditation materials, identifying high-risk activities for audit, synthesizing national trends, linking participation data with certification and licensure systems, and assessing providers' responsible use of AI tools. A structured framework of opportunities and risks highlights the promise of efficiency and data integration alongside challenges related to accuracy, equity, transparency, security, and public trust.

Discussion: Accrediting systems have an opportunity to model responsible AI use in ways that advance professional learning and safeguard the integrity of CPD. The responsible integration of AI, guided by principles of accountability, transparency, equity, and security, can help ensure that oversight is both efficient and trustworthy, while reinforcing the credibility of CPD systems worldwide.

Introduction: Systemic inequities in health care continue to negatively affect marginalized communities, highlighting the need for equity-oriented continuing professional development (CPD). The Critical Dialogues for Action (CDFA) Series was developed to foster health equity, accessibility, and social accountability through dialogue-based workshops. This evaluation aimed to assess the CDFA Series' planning and delivery outputs, and its short-term impacts on participants' attitudes, knowledge, and intentions to apply equity-informed practices.

Methods: A mixed-methods design was used, incorporating quantitative surveys and qualitative feedback from attendees, speakers, and planning committee members. Data sources included program evaluation surveys, postsession feedback surveys, and semistructured interviews. Descriptive statistics and thematic analysis were used to analyze the data, supported by visualizations and participant quotes.

Results: Survey respondents (n = 25) and postfeedback participants (n = 90) reported high satisfaction with the CDFA Series' content, relevance, and delivery. Quantitative results showed statistically significant increases in perceived knowledge after session participation (p = .014). Thematic analysis revealed increased awareness of equity principles, intent to apply new strategies in professional roles, and appreciation for inclusive, reflective dialogue. Speakers and committee members highlighted strong coordination and a desire for ongoing enhancements in diversity and engagement.

Discussion: Findings demonstrate the CDFA Series' effectiveness in supporting equity-focused learning and fostering a professional community of practice. These results underscore the potential of dialogue-based CPD initiatives to promote critical reflection and real-world application of health equity principles in diverse professional contexts.

Introduction: Rapid advances in, and availability of, generative artificial intelligence (AI) led to great interest in opportunities to create workplace efficiencies and augment health professions education. The purpose of this project was to identify the existing needs among continuing professional development (CPD) professionals and the organizational approaches necessary to support AI tool adoption.

Methods: During nine focus groups and two interviews conducted between April and July 2024, participants responded to questions focused on their knowledge of, and experiences using, AI tools. Interpretive phenomenological analysis was used to identify participants' experiences with technology and organizational barriers to implementation.

Results: Data revealed barriers to adoption at the individual, team, and organizational levels: (1) knowledge of organizationally licensed tools, (2) digital literacies, (3) organizational policy and communication, (4) role expectations and task clarification, and (5) defined organizational purposes.

Discussion: Although current literature supports the need to develop skills for a future with AI, nuanced roles and contexts for its use had not yet been explored, creating a gap in how we consider AI in CPD. This study revealed the importance of understanding how varied technologies referred to as AI work, and the legal, ethical, and pedagogical evidence required to evaluate tools within a broader digital literacy framework. This study also informs our understanding of the organizational systems, processes, communication plans, incentives, and consequences that hinder or support technology adoption.