Journal of Continuing Education in the Health Professions最新文献

Introduction: Burnout is pervasive among physicians and has widespread implications for individuals and institutions. This research study examines, for the first time, the effects of the Transcendental Meditation (TM) technique on academic physician burnout and depression.

Methods: A mixed methods randomized controlled trial was conducted with 40 academic physicians representing 15 specialties at a medical school and affiliated VA hospital using the TM technique as the active intervention. Physicians were measured at baseline, 1 month, and 4 months using the Maslach Burnout Inventory, Beck Depression Inventory, Insomnia Severity Index, Perceived Stress Scale, and Brief Resilience Scale. Repeated measures analysis of covariance was used to assess adjusted mean change scores for the 1- and 4-months posttests. Qualitative interviews were conducted at baseline and 4 months and compared with the quantitative measurements.

Results: Significant improvements were found for the TM group compared with controls at 4 months in total burnout ( p = .020) including the Maslach Burnout Inventory dimensions of emotional exhaustion ( p = .042) and personal accomplishment ( p = .018) and depression ( p = .016). Qualitative interviews supported quantitative outcomes. Physicians reported classic burnout and depression symptoms in baseline interviews. Those regularly practicing the TM technique reported relief from those symptoms. The control group did not state similar changes.

Discussion: Mixed methods findings suggest the TM technique is a viable and effective intervention to decrease burnout and depression for academic physicians. Larger longitudinal studies with a wider range of health care providers are needed to validate these findings for extrapolation to the greater medical community.

Introduction: The COVID-19 pandemic has profoundly altered the ways in which health care professionals engage with continuing professional development (CPD), but the extent to which these changes are permanent remains unknown at present. This mixed-methods research aims to capture the perspectives of health professionals on their preferences for CPD formats, including the conditions that inform preferences for in-person and online CPD events and the optimum length and type of online and in-person events.

Methods: A survey was used to gain a high-level perspective on health professionals' engagement with CPD, areas of interest, and capabilities and preferences in relation to online formats. A total of 340 health care professionals across 21 countries responded to the survey. Follow-up semistructured interviews were conducted with 16 respondents to gain deeper insights into their perspectives.

Results: Key themes include CPD activity before and during COVID, social and networking aspects, access versus engagement, cost, and time and timing.

Discussion: Recommendations regarding the design of both in-person and online events are included. Beyond merely moving in-person events online, innovative design approaches should be adopted to capitalize on the affordances of digital technologies and enhance engagement.

Background: Medical practitioners are important facilitators of advanced care planning but are often reluctant to engage in these conversations with patients and their families. Barriers to participation can be addressed through medical education for medical practitioners.

Introduction: The primary objective was to examine the extent to which digital educational interventions are used to foster advanced care planning skills. Secondary objectives include understanding the acceptability of these interventions and whether electronic health records can be used to personalize learning.

Methods: Online databases were used to identify relevant articles published from 2008 to 2021. Nine articles which evaluated the impact of digital learning for medical practitioners were selected. Studies eligible for inclusion in the review assessed changes in knowledge, attitudes, and practice regarding skills used in advanced care planning.

Results: All publications used a pre-post study design with education delivered solely online. Only three studies focused on completing advance care plans or directives (33%). All but two studies recorded improvements in knowledge and/or attitudes toward planning (78%) while three studies recorded improvements in clinical practice (33%). The review suggests prior clinical or personal experiences could be used to personalize education.

Discussion: The literature revealed that using digital education to develop advanced care planning skills is relatively unexplored despite the ability of this type of learning to improve professional knowledge and confidence. Digital devices can also improve access to relevant information at the point-of-care. Personalized interventions that incorporate prior clinical experiences, potentially extracted from health records, could be used to optimize outcomes.

Introduction: Research and scholarship are critical to advance the effective design, implementation, and evaluation of health professions education activities as well as to study outcomes and disseminate observations to the community. Yet, many educators are neither involved in nor equipped to conduct quality education research. This gap underscores the continuing education need to guide and train health professions educators to rigorously investigate, prepare, and report their educational research.

Methods: A novel session called the Education Research Accelerator was designed to increase knowledge about education research methods and resources and to improve participants' competence and performance in implementing studies. A panel helped prospective researchers develop ideas or advance projects toward completion by offering real-time feedback to pitched ideas; a live audience of learners participated virtually, expanding the impact of the session, facilitating connections, and potentially inspiring other research ideas. The outcomes of the Education Research Accelerator were evaluated immediately after the session and 18 months later.

Results: The Education Research Accelerator conferred favorable outcomes for participants' competence in designing education research studies and awareness of using available resources. Long-term follow-up confirmed actual benefits to use effective methodology to advance education research projects and to use resources and connections established in the Education Research Accelerator.

Conclusions: Although further study is needed, the Education Research Accelerator model is a novel intervention to enhance learning, forge needed connections, and increase the sophistication of conducting education research. We propose that the model can be replicated and applied in other settings.

Introduction: During recent years, health care organizations have paid increasing attention to onboarding because of recruitment challenges. Organizational initiatives are frequently monitored and evaluated using questionnaire data, and to produce high-quality data, reliable instruments are paramount. We aimed to investigate the content validity and reliability of the Danish Onboarding Questionnaire, including cognitive interviewing and test-retest analyses.

Method: We investigated content validity, including face validity and the content validity index, and reliability for the percentage of agreement. To analyze the cognitive interview data, thematic analysis was applied, followed by the question-and-answer model to categorize the problems revealed. To test reliability, the percentage of agreement was calculated with an accepted deviation of 1 on test-retest data.

Results: Regarding the mental processes, multiple items were identified to be challenged regarding comprehension (clarification of concepts and understanding), judgment (ambiguity and relevance), and response (anonymity and personal information). The mental process retrieval was not represented. The subscale content validity index/Ave was found to be 0.935, representing a "good" level of content validity. With an accepted deviation of 1, the mean agreement was 97.7%.

Discussion: Questionnaire items causing uncertainties or challenges are potential sources of deteriorated content validity and should be revised. We suggest that the Danish Onboarding Questionnaire-34 undergo an item reduction, which might increase its validity and reliability.

Introduction: There is limited evidence on educational needs and preferences of pediatric health care professionals regarding transition from pediatric to adult health care.

Methods: We distributed an anonymous online survey to physicians and advanced practice providers at a large, free-standing children's hospital and associated primary care network to assess attitudes, practices, and educational preferences about transition. We analyzed data with descriptive statistics, chi-square, and logistic regression.

Results: A total of 178 providers responded (20% response rate) across 31 specialties (66% attending physicians, 19% fellows, and 15% advanced practice providers). Less than half (43%) were comfortable in their knowledge of transition, with fellows reporting significantly lower comfort than attendings ( P < .05). In total, 47% reported annually discussing transition with their patients (fellows: 17% vs. attendings: 50%, P < .05). Educational topics of greatest interest included legal (71%) and financial concerns (69%), whereas preferred educational formats included Grand Rounds/lectures (68%) and webinars (63%). Facilitators to transition included lists of local adult providers for transition (89%), parent/family educational resources (88%), and a medical summary template in the electronic health record (85%).

Discussion: Major gaps exist in attitudes and practices related to transition. Identified educational strategies may serve as targets to improve the transition process through educational interventions.

Introduction: : Deprescribing is a complex process involving patients and healthcare providers. The aim of the project was to examine the learning needs and preferences of healthcare providers and students to inform the development of an interprofessional deprescribing education program.

Methods: : An online survey of pharmacists, nurses, nurse practitioners, family physicians, and associated students practicing or studying in Nova Scotia was conducted. Respondents were recruited by purposive and snowball sampling to have at least five respondents within each professional/student group. Questions captured participant's self-reported comfort level and professional role for 12 deprescribing tasks and their learning preferences.

Results: : Sixty-nine respondents (46 healthcare providers and 23 students) completed the questionnaire. Average comfort levels for all 12 deprescribing tasks ranged from 40.22 to 78.90 of 100. Respondents reported their preferred deprescribing learning activities as watching videos and working through case studies. Healthcare providers preferred to learn asynchronously online, while students preferred a mix of online and in-person delivery.

Discussion: : Learning needs related to deprescribing tasks and roles were identified, as well as preferences for format and delivery of education. Development of an education program that can provide a shared understanding of collaborative deprescribing tailored to learner preferences may improve deprescribing in practice.

Abstract: Supporting faculty in their professional development is a central mission of academic medical centers (AMCs), assisted by routine assessment of faculty development. However, AMCs face barriers to standard faculty assessment, particularly among large departments with diverse faculty roles. We report on the development, implementation, and utilization of a standardized, web-based faculty annual career review (FACR) process deployed within the Department of Medicine at a large AMC, composed of 22 divisions and 1400 faculty. The FACR process was developed to achieve the following goals: Creation of a trackable review of professional goals and barriers to professional development; provide longitudinal faculty reflection on professional growth; and provide data to identify faculty development needs to target initiatives. The FACR was initiated in 2008. We provide specific case examples of utilization of the FACR data for targeted faculty development initiatives, including (1) division benchmarking; (2) targeting career opportunities to individual faculty members; and (3) longitudinal data analysis of 5-year trends of FACR response, including subanalysis by gender, to target faculty development initiatives across the DOM. In summary, we demonstrate successful development, implementation, and utilization of a web-based standard faculty annual review program within a large AMC that allows for systematic evaluation and reflection of professional development by faculty members and their supervisors and allows for data collection and analysis to help target faculty development initiatives.