Journal of Continuing Education in the Health Professions最新文献

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.

Introduction: In health care, cost-effectiveness analysis evaluates changes in health outcomes as a function of costs. The cost-effectiveness of continuing professional development for health care providers has not been historically well characterized despite substantial investment. This literature review identified publications considering the costs and cost-effectiveness of accredited continuing medical education activities.

Methods: Searches were conducted for English language records in PubMed and the gray literature using a 10-year lookback period from March 10, 2023. Search terms included concepts related to continuing medical education, cost, effect, and utilization. One reviewer conducted title/abstract screening, full-text review, and data extraction, with direction and adjudication of search and screening concepts provided by the lead advisor. Publications were categorized as related to costs of an educational intervention (Concept 1) and/or the impact of education on health care costs (Concept 2). Results were summarized using descriptive statistics.

Results: A total of 668 database records were screened, 125 (19%) underwent full-text review, and 25 of 125 (20%) were accepted; 7 of 351 (2%) gray literature sources were accepted for a total of 32 included records. The most common reason for rejection was not being an accredited activity. Of the 32 records, 27 (84%) were related to Concept 1 only, 3 (9%) to Concept 2 only, and 2 (6%) to both Concepts 1 and 2. Approximately half (n = 19, 59%) mentioned costs without supporting data.

Discussion: These findings show that considerations of cost and cost-effectiveness are rare in the accredited continuing medical education literature, which may limit how the value of continuing medical education is characterized.

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.

Practice inquiry (PI) is a structured method of discussion that helps primary care clinicians explore uncertainty and learn from challenging cases. An understanding of what aspect of PI primary care clinicians value could guide leaders who are contemplating implementation of collaborative discussion formats in their clinical systems. We administered a survey examining clinicians' perceptions of PI in a large nationwide membership-based primary care service. Two hundred ninety-six surveys (61%, N = 296/482) were received from participants and 69 surveys (75%, N = 69/92) were received from facilitators. Most respondents (>70% across five queries) felt that PI led to enhancement of knowledge and management skills and helped them become more comfortable managing uncertainty. Colleagues in PI groups provided validation and reassurance, valuable health system information, and insights into reasoning and patient-clinician relationships. Participants and facilitators outlined ways PI sessions could be improved (eg, case follow-up) and how the organization could support PI sessions (eg, enhanced facilitator training). This is the first program evaluation of PI in a large, community primary care setting. Future directions include examining what group-level characteristics mediate PI efficacy and how clinicians and patients fare after PI discussions. Such insights could inform enhancements to the group facilitation process.

Introduction: Peer mentoring programs can be a valuable support mechanism for new faculty transitioning from clinical practice to academia. Mentors play a crucial role in this process. This study described mentors' perceived competence in 21 areas of the mentor role and their experiences as mentors following the first year of a structured peer mentoring program.

Methods: This study employed a mixed-methods approach, using the Mentoring Competency Assessment-21 alongside open-ended questions. These instruments were electronically administered to a convenience sample consisting of eight mentors with varying experience ranging from 2 to 16 years in the nursing program at a mid-sized university, following an intentional first-year peer mentoring program.

Results: The highest-performing items were "Establishing a relationship based on trust" (M 6.50, SD 0.53), "Considering how personal and professional differences may impact expectations" (M 6.25, 0.83), and "Acknowledging your mentee's professional contributions" (M 6.13, SD 0.99). The lowest scores were focused on estimating scientific knowledge and scholarly productivity. Responses to the Mentoring Competency Assessment-21 indicated that mentors felt at least moderately competent in the various aspects of the faculty mentor role. Mentors valued the professional development and supporting materials provided by the development team. An identified area for improvement was the support provided to assist the mentees' scholarly development.

Discussion: This study underscores the importance of supportive materials, such as handbooks and regular communication, in fostering mentor competence and facilitating successful nursing faculty peer mentoring programs. Future research implications include assessment of mentor competence by mentees and long-term follow-up of program outcomes.

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, and interleaving, which are quite relevant to continuing professional development. Spreading out study and practice separated by cognitive breaks (distributed practice), testing oneself to check mastery and memory of previously learned information (retrieval practice), and mixing the learning of separate but associated information (interleaving) represent strategies that are underutilized in continuing professional development. Participants and planners alike can benefit from learning science recommendations to inform their decisions. Elaboration, the subject of this article, is another evidence-based strategy that relates to how one studies or practices priority information.

Introduction: Demand for genetic testing has expanded exome sequencing (ES) utilization into subspecialty clinics without genetics providers. This trend forces non-genetics physicians (NGPs) to facilitate patient consent for genetic testing. However, research on NGPs' knowledge of consent elements (CK) required for ES has not been explored.

Methods: Columbia University NGPs were invited to take a survey (premodule survey [PrS]) assessing CK for ES. Educational modules on ES were then created and sent to NGP participants. A postmodule survey (PoS) was sent to NGPs a month later to assess the change in CK scores. Alpha was set at ≤0.05.

Results: Nineteen participants completed the PrS and PoS. Overall PrS CK scores were low (mean = 8, SD 1.6). There was no difference in PrS CK scores between attendings and residents/fellows (P = .2), and PrS CK scores did not correlate with time since medical school graduation (P = .9). PoS CK scores were higher than PrS CK scores (P = .03). Most NGPs (74%) were satisfied with the module.

Conclusions: Our findings suggest a need for continuing education of both new and experienced NGPs on best practices for consenting for ES. An online module with information tailored to different specialties could be an effective format for delivering this education.

Abstract: Point-of-care ultrasound proficiency requires the integration of spatial anatomic knowledge, technical hands-on image acquisition, and the ability to interpret images and incorporate findings into clinical decision-making. Effectively teaching these skills requires a structured approach. This article presents a comprehensive framework for designing a point-of-care ultrasound course tailored to continuing professional development. We demonstrate how applying the learning theories of cognitivism, behaviorism, and constructivism can facilitate the educational experience. In addition, we offer guidance on maintaining learner engagement, organizing didactic sessions, and delivering standardized feedback.