Journal of Continuing Education in the Health Professions最新文献

Introduction: Improving health care quality and patient safety are top priorities for the medical field. Robust continuing medical education (CME) programs represent major interventions to effectively teach quality improvement (QI) principles to practicing physicians. In particular, eLearning, a term describing online and distance learning interventions using digital tools, provides a means for CME interventions to reach broader audiences. Although there has been a focus on CME addressing QI, no knowledge synthesis has focused specifically on eLearning interventions. The purpose of this review was to examine the current landscape of eLearning interventions in QI-focused CME.

Methods: We conducted a scoping review using the framework developed by Arksey and O'Malley as revised by Levac. We searched five databases and identified 2467 prospective publications, which two authors independently screened for inclusion. From each included article, two authors independently extracted data on the instructional modalities and QI tools used and met regularly to achieve consensus.

Results: Twenty-one studies were included. Most studies used blended instruction ( n = 12) rather than solely eLearning interventions. Salient findings included the importance of coaching from QI experts and institutional support for planning and implementing eLearning interventions. Lack of protected time and resources for participants were identified as barriers to participation in CME activities, with small practices being disproportionately affected.

Discussion: Partnerships between CME developers and sponsoring organizations are vital in creating sustainable eLearning interventions for QI-focused CME. Remote coaching can be an effective strategy to provide ongoing support to geographically separated learners.

Abstract: Continuing professional development (CPD) for health professionals involves efforts at improving health of individuals and the population through educational activities of health professionals who previously attained a recognized level of acceptable proficiency (licensure). However, those educational activities have inconsistently improved health care outcomes of patients. We suggest a conceptual change of emphasis in designing CPD to better align it with the goals of improving health care value for patients through the dynamic incorporation of five distinct domains to be included in learning activities. We identify these domains as: (1) identifying, appraising, and learning new information [New Knowledge]; (2) ongoing practicing of newly or previously acquired skills to maintain expertise [New Skills and Maintenance]; (3) sharing and transfer of new learning for the health care team which changes their practice [Teams]; (4) analyzing data to identify problems and drive change resulting in improvements in the health care system and patient outcomes [Quality Improvement]; and (5) promoting population health and prevention of disease [Prevention]. We describe how these five domains can be integrated into a comprehensive conceptual framework of CPD, supported by appropriate learning theories that align with the goals of the health care delivery system. Drawing on these distinct but interrelated areas of CPD will help organizers and directors of learning events to develop their activities to meet the goals of learners and the health care system.

Introduction: Pediatric feeding disorder is increasing in prevalence, yet low clinician confidence regarding its management is a barrier to care. Targeted clinician training is needed as traditional didactic training programs are limited in both their accessibility and capacity to provide opportunities for the application of theory-based learning.

Methods: This study examined the experiences of a group of clinicians involved in a multidisciplinary PedFeed ECHO ® network, a virtual community of practice established to support speech pathologists, occupational therapists, dieticians, and psychologists in Queensland, Australia, working with children with pediatric feeding disorder. Sixteen clinicians (34% of the total PedFeed ECHO network) from different professional backgrounds, clinical settings, and locations participated in semistructured interviews three months post completion of eight ECHO sessions.

Results: Inductive thematic analysis revealed three themes: (1) broad-ranging outcomes of PedFeed ECHO, (2) participant experiences of PedFeed ECHO, and (3) facilitators for future success. PedFeed ECHO was viewed very positively and provided participants with a valuable opportunity for information sharing and collaboration as a multidisciplinary team. Participants described impacts on their professional practice, knowledge, confidence, and professional isolation, as well as service and patient-level impacts. Several facilitators for the success of future PedFeed ECHO cohorts were provided.

Discussion: Insights from participants will serve to improve the design and delivery of ECHO training for future cohorts. Monitoring clinical skill development over a longer period of time and exploring clinician perceptions regarding direct impact on patient care are needed to further validate the impact of ECHO.

Introduction: Professionals use Twitter because of its potential to support easy and rapid communication among like-minded people. It is also used widely by educators to support the establishment of professional learning spaces. This study investigates social interactions and knowledge construction in synchronous online discussions using the Twitter hashtag #MedEdChat.

Methods: Three synchronous Twitter discussions on #MedEdChat during the early part of the COVID-19 pandemic were analyzed. Social network analysis was conducted to capture the social interactions among their participants and network dynamics. Content analysis was used to examine the nature of tweets posted on #MedEdChat, including social-related, cognitive-related, and moderation-related tweets.

Results: In all three discussions, a small number of individuals dominated the interactions, while also serving as hubs for connections with others in more peripheral positions. Very few participants were isolated nodes who never interacted with others during the online discussions. Our content analysis suggested that parties to these discussions posted social-related posts the most, followed by cognitive-related ones. Social posts focused on others' messages, continuing threads, issuing compliments and greetings, and expressing emotions. Cognitive-related posts, on the other hand, mostly focused on information exchange/sharing or asking content-related questions to promote discussion (ie, triggering event).

Discussion: By examining social dynamics and discourse moves in Twitter-supported online synchronous discussions using the #MedEdChat hashtag, this study found that Twitter has the potential to facilitate professional learning spaces in which a few highly active individuals serve as portals for connections and interactions among all discussants. In addition, in such communities, social-related and cognitive-related tweets could promote social interactions and knowledge construction.

Abstract: Although continuing education (CE) plays an important role in educating health care providers on diversity, equity, and inclusion (DEI), little is known about the DEI initiatives promoted and implemented by providers of CE. Surveys were electronically administered to accredited pharmacy continuing education providers (CEPs) from 2021 to 2023. Survey items were assessed providers' current efforts and best practices for incorporating DEI into organizational culture and educational programming. Frequencies and percentages were calculated for categorical responses, and a general interpretivist approach was used to code open-ended response items and describe themes. Overall, 50 and 33 responses were received in 2021/2022 and 2023, respectively. The most common step taken by programs to advance DEI was to engage pharmacists and/or pharmacy technicians in DEI discussions. Qualitative analysis described categories and themes as follows: best practices (CE programming DEI strategies, organizational DEI strategies), DEI goals (mission statement and DEI strategic plan, developing CE, continuing pharmacy education committee and task force, and faculty development and guidance), and accrediting body support (sharing best practices and training and technical support). Although CEPs described current efforts and best practices related to DEI in CE, organizations involved in CE accreditation can continue to explore ways to support DEI initiatives.

Abstract: The rapid rise of artificial intelligence (AI) is transforming society; yet, the education of health care providers in this field is lagging. In health care, where AI promises to facilitate diagnostic accuracy, and allow for personalized treatment, bridging the knowledge and skill gaps for providers becomes vital. This article explores the challenges of AI education, such as the emergence of self-proclaimed experts during the pandemic, and the need for comprehensive training in AI language, mechanics, and ethics. It advocates for a new breed of health care professionals who are both practitioners and informaticians, who are capable through initial training or through continuing professional development of harnessing AI's potential. Interdisciplinary collaboration, ongoing education, and incentives are proposed to ensure health care benefits from AI's trajectory. This perspective article explores the hurdles and the imperative of creating educational programming designed specifically to help health care professionals augment their practice with AI.

Introduction: Although the Continuing Professional Development (CPD) field has rapidly expanded in scope, breadth, and depth, there is a gap in how we understand CPD leadership and the role of the leader. Previous scholarship indicates that there is neither an agreed on set of competencies for CPD leadership roles nor a distinct pathway towards those roles. This study is aimed at answering the following question: How is leadership described or defined in CPD and what are the contextual issues that are and/or should be shaping its evolution?

Methods: Conducted between 2020 and 2022, CPD leadership program learners and CPD leaders with a range of leadership expertise were identified using convenience and purposive sampling and invited to participate in this study. Semistructured interviews were conducted with consenting participants. Interviews were recorded, transcribed, and analyzed using a qualitative thematic template analysis approach.

Results: Seventeen interviews were conducted. There were multiple components identified that were important to CPD leadership, such as being visionary, or having strong collaboration skills with some components, such as adaptability and flexibility appearing more unique to the CPD context. The role of CPD leadership and the pathway to CPD leadership remain highly variable.

Discussion: Attaining a CPD leadership position predominantly involves some degree of "serendipity." While CPD leaders may fundamentally need basic and common leadership skills, an essential attribute of the CPD leader is to effectively respond to the context and the unique needs of the health system. We recommend better articulating and valuing the role of the CPD leader within the health system.

Introduction: The Canadian Medical Protective Association (CMPA)'s Commitment to Change in Test-Results Follow-Up (CTC-TRFU) program aims to provide physicians with resources to enhance their test results follow-up systems for improved patient safety. Framed around the Transtheoretical Model, the program involves a 6-month multimodal educational intervention involving individual and group coaching sessions, action planning, and reflection surveys.

Methods: This study evaluates the CTC-TRFU program's impact by analyzing survey responses and course documents, focusing on three main outcomes: physicians' perceived barriers and challenges, changes in their confidence and commitment, and implemented practice changes with perceived impact on patient safety. Participants were Canadian physicians who enrolled through the CMPA's open-access registration, with a particular emphasis on those facing challenges in test result follow-up.

Results: One hundred two physicians have enrolled in the program. Of these physicians, 34 (33.3%) have successfully completed the program and 28 (27.5%) are actively enrolled. Among the 34 physicians who successfully completed the program, an overwhelming majority of 97.1% (n = 33) expressed their belief that the improvements made to their test follow-up system significantly enhance patient safety within their practice. We observed a significant increase in confidence in the robustness of the physician's follow-up system from program registration to completion ( P < .001). Physicians reported catching specific missed test results (55.9%, n = 19), including various laboratory reports and diagnostic imaging like abnormal mammograms or missing MRI/CT results.

Discussion: Physicians who participated in the CTC-TRFU program reported meaningful practice changes, which we believe underscores the value of comprehensive, longitudinal continuing patient safety CPD initiatives. These findings indicate the potential for future studies to explore the long-term impact of similar programs and their scalability.