Journal of Continuing Education in the Health Professions最新文献

Introduction: E-cigarettes (Vapes) represent the most common form of tobacco used by adolescents, with one out of every 29 (3.5%) middle school students and one in every 13 (7.8%) of high school students vaping daily. This project aimed to increase vape screening and prevention education in youth visits at pediatric practices, to increase provider comfort with the topic of vaping, and to evaluate this educational process.

Methods: A provider training and resource modules (talking points, billing codes, and shareable parent/teen-tailored resources) were developed. Providers (N = 32) completed an anonymous pre/postsurvey regarding their knowledge, comfort levels, barriers, and practices related to teen vaping. Key-informant interviews (N = 20) were conducted to identify barriers and seek solutions to incorporate risk counseling into daily practice. Monthly meetings were held to achieve Continuous Quality Improvement (CQI) in pediatric practices. The frequency of providing vaping information in the Depart Summary was monitored.

Results: Reported barriers to providing vape prevention counseling, including lack of knowledge, lack of resources, discomfort with topic, and patient resistance, were significantly reduced after participation. Time constraints continued to be the greatest barrier to preventive counseling. Physicians who indicated they often or always provide vape prevention information during a visit increased from 9 to 50 percent. Average resources provided increased from 1 to 94 per month.

Discussion: Tailored provider-training and resources increased physician knowledge of and confidence with the topic of vaping as well as the frequency of screening and preventive guidance provided to teens and their families.

Introduction: The rapidly changing hearing health landscape, paired with health system resource and delivery challenges, presents the need to develop innovative learning opportunities that prepare health care professionals to work as part of an interprofessional team.

Methods: An interprofessional team of clinicians and researchers developed an online learning module titled The Role of Audiologists in Team-Based Primary Care. To support quality improvement efforts, learners were asked to complete pre- and post-module surveys, which included multiple-choice knowledge questions and Likert-scale statements assessing self-efficacy, value, and knowledge of learners' premodule and postmodule completion.

Results: Forty-seven learners participated in a premodule and postmodule assessment. Pre-module to post-module responses increased for all three domains evaluated: knowledge, self-efficacy, and value. The findings were not significant for the value of audiology in team-based primary care, indicating the need for greater efforts to encourage buy-in among learners through experiential learning opportunities and integration of content into mandated training.

Discussion: Preliminary findings from this quality assessment highlight that a novel online learning module focused on the roles of audiologists in team-based primary care can affect learners' knowledge, self-efficacy, and values regarding the topic. Future evaluations assessing the impact of module implementation alongside in-person activities can further improve learners' outcomes.

Introduction: Metacognitive accuracy-the extent to which individuals' perceptions of their knowledge align with actual performance-is critical in clinical decision making. Overconfidence can lead to diagnostic errors, while insufficient confidence may delay decisions or prompt unnecessary testing, increasing health care costs. Although longitudinal knowledge assessments with spaced repetition have been shown to improve learning and knowledge transfer, their impact on metacognition remains underexplored. This study investigates changes in confidence under different spaced repetition strategies in a large cohort of family physicians.

Methods: Data were drawn from the American Board of Family Medicine's Continuous Knowledge Self-Assessment, a longitudinal assessment administered quarterly. Participants rated their confidence on a 6-point scale after each question. In total, 16,751 physicians who completed assessments at baseline, quarter 6, and quarter 10 were included. Participants were randomized to control or intervention groups receiving repeated or clone questions at various intervals. One-sample t tests assessed confidence changes for questions initially answered incorrectly but subsequently answered correctly. Multivariate regression controls demographic factors.

Results: Confidence increased significantly for repeated questions, with moderate effect sizes in single repetition groups and large effect sizes in two-time repetition groups. Clone questions also showed gains, though smaller in magnitude. After adjusting for clinician demographics, male and younger physicians generally reported higher confidence.

Discussion: Spaced repetition enhances both learning and metacognitive accuracy. Two spaced repetitions yielded larger gains. These findings support incorporation of metacognitive-enhancing strategies into CME to improve clinician self-assessment and potentially reduce diagnostic error.

Abstract: Faculty development programs are an important part of career building and professional fulfillment for health professionals. A framework that addresses the centrality of fulfillment at work for diverse medical careers is lacking, yet necessary, for faculty development programs to have a comprehensive positive impact. A conceptual framework for faculty development to support meaningful careers for all individuals was, therefore, constructed through an exploration of the literature on professional fulfillment, career planning, and development across career paths, stages, and identity groups, as well as forms of professional career support such as mentoring. An exploration of fulfillment revealed the role of meaningful work as both anchor and guide for the framework. The key elements of the framework that emerged included an individualized career planning process, curricula to address both cross-cutting competencies and specific career path needs, a robust and multidirectional career support community, and a process of career construction continuing over a professional lifespan. This faculty development framework that aims to construct meaningful careers is of value to institutions that are committed to professional fulfillment for faculty in all career paths and stages and can be adapted to health care providers in different settings.

Introduction: Open-ended feedback from learners offers valuable insights for adapting continuing health education to their needs; however, this feedback is burdensome to analyze with qualitative methods. Natural language processing offers a potential solution, but it is unclear which methods provide useful insights. We evaluated natural language processing methods for analyzing open-ended feedback from continuing professional development training at a psychiatric hospital.

Methods: The data set consisted of survey responses from staff participants, which included two text responses on how participants intended to use the training ("intent to use"; n = 480) and other information they wished to share ("open-ended feedback"; n = 291). We analyzed "intent-to-use" responses with topic modeling, "open-ended feedback" with sentiment analysis, and both responses with large language model (LLM)-based clustering. We examined outputs of each approach to determine their value for deriving insights about the training.

Results: Our results indicated that because the "intent-to-use" responses were short and lacked diversity, topic modeling was not useful in differentiating content between the topics. For "open-ended feedback," sentiment scores did not accurately reflect the valence of responses. The LLM-based clustering approach generated meaningful clusters characterized by semantically similar words for both responses.

Discussion: LLMs may be a useful approach for deriving insights from learner feedback because they capture context, making them capable of distinguishing between responses that use similar words to convey different topics. Future directions involve exploring other methods involving LLMs, or examining how these methods fare on other data sets or types of learner feedback.

Introduction: This study evaluated the impact of F inancial and I nsurance N avigation Assist ance- Train ing - a pilot interprofessional training program to facilitate cost of care (CoC) conversations and address health-harming social determinants of health in a pediatric hematology-oncology clinic.

Methods: A pre-post study design was used to evaluate the impact of F inancial and I nsurance N avigation Assist ance- Train ing on an interprofessional health care team's (clinicians, social workers, financial navigator, and legal advocates) knowledge, attitudes, and behaviors related to CoC conversations and screening, referring, and collaborating with interprofessional team members. Data were collected via surveys administered at baseline/pretraining, immediate post-training, and 12-month post-training.

Results: Most health care team members (n= 21) reported improvement in their knowledge of available financial (66.7%) and legal resources (86.7%) and ability to address social needs (93.3%), financial needs (93.3%), and facilitate CoC conversations with patients and caregivers (66.7%).

Discussion: Improvements in attitudes and behaviors toward engaging in CoC conversations, screenings, and referrals were relatively improved as a result of the training. However, there was a lower positive rate for actual behaviors around routine screening and initiating discussions on out-of-pocket costs, suggesting a need to address barriers. Study findings highlight the importance of interprofessional education in helping health care teams address social determinants of health through effective CoC conversations.

Introduction: Advances in genomics are transforming clinical practice, but there are too few genetics professionals to meet increasing demand. Moreover, many nongeneticist clinicians feel unprepared to incorporate genetics into practice. This study assessed clinicians' unmet genomics educational needs at a single academic institution.

Methods: Qualitative interviews with Department and Division leaders informed a survey distributed to all clinicians at the institution. Survey questions focused on current practices, confidence, and desired educational resources around genetics and genomics. Data were analyzed using descriptive statistics and Fisher exact tests. Results were shared with an expert panel of Genetics-Genomics Champions to help meet educational needs across specialties.

Results: Of the 215 survey respondents, 72% were faculty, 24% were trainees, and 4% were clinical staff, representing 18 departments. Less than half felt confident using genetics in the clinic. About 81% desired more training, which did not differ by role ( P = .27) or department ( P = .98). The Genetics-Genomics Champions proposed delivering just-in-time content via e-consults, online materials, and departmental meetings.

Discussion: This study highlights clinicians' need and desire for more genetics training. It also underscores the importance of consulting genetics-savvy clinicians to identify challenges and solutions for addressing cross-specialty genetics education needs.

Abstract: The science of learning (learning science) is an interprofessional field that concerns itself with how the brain learns and remembers important information. Learning science has compiled a set of evidence-based strategies, such as distributed practice, retrieval practice, interleaving, and elaboration, which are quite relevant to continuing professional development (CPD). Spreading out study and practice separated by cognitive breaks (distributed practice), testing oneself to check mastery and memory of previously learned information (retrieval practice), mixing the learning of separate but associated information (interleaving), and making connections between concepts one is trying to learn and other known concepts (elaboration) represent strategies that are underused in CPD. Participants and planners alike can benefit from learning science recommendations to inform their decisions. Contextual learning, the subject of this article, is another evidence-based strategy that supports the study and practice of important information. By better understanding how the context in which one learns later affects retention and performance, CPD participants and planners can make more informed educational decisions.

Abstract: Academies highlight the educational mission that is often second to clinical and basic science scholarship on health professions campuses. They help bridge the gap between faculty development and continuing professional development. Owing to their popularity, academies have proliferated across the United States and Canada during the past 3 decades. Yet the evidence of the extent to which academies have had impact on their organizations remains largely underdeveloped. In this article, the authors used logic modeling as a framework to align the research mission, programming, and longitudinal goals of the Duke Academy for Health Professions, Education and Academic Development across the span of a decade. Furthermore, we used bibliometric analysis as a program evaluation tool. Through three different case examples, we share how bibliometrics may be used to track faculty publications in health professions education journals and to assess the impact of an academy's investment on its members and the institution at large. Finally, we illustrate that longitudinal implementation of scholarship and grants programming can be an effective strategy for fostering the development of health professions education research and encouraging scholarly innovation.

Introduction: Sex and racial/ethnic disparities in academic medicine are an intractable and inordinate reality. The purpose of our study was to analyze the 56-year trends in sex and racial/ethnic demographics in academic dermatology in the United States.

Methods: Data from the Association of American Medical Colleges Faculty Roster between 1966 and 2021 were analyzed to trend the representation of sex and race/ethnicity by academic ranks, leadership positions, and tenure statuses using linear regression. In addition, differences in representation using 56-year means were assessed using the Mann-Whitney test for sex and Kruskal-Wallis test followed by the Dunn multiple comparisons test for race/ethnicity.

Results: In 2021, academic dermatologists were 66.71% (1072/1607) White, 20.97% (337/1607) Asian, 2.86% (46/1607) Black, and 2.49% (40/1607) Hispanic. From 1966 to 2021, the total number of academic dermatologists increased from 107 to 1607 [mean +26.92 (95% CI 25.15-28.70) per year, P < .001]. Specifically, annual proportional increases for groups were women +0.93 (0.90-0.96)% ( P < .001); Asians +0.38 (0.34-0.42)% ( P < .001); Blacks +0.01 (0.01-0.02)% ( P < .001); and Hispanics +0.01 (0-0.02)% ( P = .001).

Discussion: Despite these increasing trends, in 2021, the most recent year for which data were provided, there remained a far greater proportion of male and/or White physicians in senior academic ranks (65.35% male and 75.85% White professors), leadership positions (79.52% male and 66.27% White chairpersons), and tenure (67.17% male and 77.78% White). Although there have been efforts to improve diversity and inclusion in academic dermatology over the 56-year study period, sex and racial/ethnic disparities persist.