Journal of CME最新文献

Aims of this assessment were to describe requirements for physicians to engage in CME/CPD; explore perceptions of In-Country SMEs of their CME/CPD systems; describe perceptions of In-Country physicians about interprofessional continuing education (IPCE) and independent CME/CPD; and provide recommendations that may be adopted to improve quality and effectiveness. This assessment used a mixed-methods approach that included 1:1 interviews with in-country subject matter experts and an electronic survey capturing qualitative and quantitative data from practicing in-country physicians. This assessment reflects a country invested in the education of its physician workforce. CME/CPD systems have embedded governance structures, organizations authorized to provide education, and a recognized credit system. Governing bodies have implemented regulations to limit influence from commercial interest organizations on CME/CPD, and there is opportunity to expand delivery systems to reach physicians across diverse geographic regions, better align content to individual physicians' gaps and learning needs, and reduce cost. There is opportunity to invest in IPCE within a country with a strong professional hierarchy system. This assessment reflects CME/CPD systems that are relatively mature and identifies several opportunities to expand and enhance systems to better meet educational needs of physicians and to positively impact practice and patient outcomes.

There was a renewed vigour among the participants attending the 16th Annual European CME Forum (#16ECF), which took place in the Hague, the Netherlands from 8-10 November 2023. This emanated from the meeting having reverted to an in-person format to promote engagement among attendees. The meeting was subdivided into three main sections to address this year's theme "Voices in CME-CPD": 1) Listening to others; 2) Listening to ourselves; 3) Listening to each other. The Forum unofficially began with the pre-meeting sessions led by two special interest groups and was then formally opened by the programme director. There were panel discussions on designing and implementing CME-CPD programmes, measuring and reporting outcomes, and valuing and defining independence, as well as smaller workshop and breakout sessions led by international presenters. Representatives for the Journal of CME presented on the 2023 Special Collection of articles, with this year's topic "Expanding the voices in CME-CPD" mirroring the meeting theme. Participants interacted with providers, accreditors and grantors, as well as poster authors and a local physician who attended to share a learner's perspective. The meeting concluded with the now familiar "CME unsession" to ensure everyone's voices were heard and no one left the meeting with any unanswered questions.

This study undertook an exploration of how Adaptive Mentoring Networks focusing on chronic pain, substance use disorders and mental health were supporting primary care providers to engage in compassionate care. The study utilised the Cole-King & Gilbert Compassionate Care Framework to guide qualitative semi-structured interviews of participants in two Adaptive Mentoring Networks in Ontario, Canada. Fourteen physician participants were interviewed including five mentors (psychiatrists) and nine mentees (family physicians) in the Networks. The Cole-King & Gilbert Framework helped provide specific insights on how these mentoring networks were affecting the attributes of compassion such as motivation, distress-tolerance, non-judgement, empathy, sympathy, and sensitivity. The findings of this study focused on the role of compassionate provider communities and the development of skills and attitudes related to compassion that were both being supported in these networks. Adaptive Mentoring Networks can support primary care providers to offer compassionate care to patients with chronic pain, substance use disorders, and mental health challenges. This study also highlights how these networks had an impact on provider resiliency, and compassion fatigue. There is promising evidence these networks can support the "quadruple aim" for healthcare systems (improve patient and provider experience, health of populations and value for money) and play a role in addressing the healthcare provider burnout and associated health workforce crisis.

Entrustable Professional Activities (EPAs) are an important tool to support individualisation of medical training in a competency-based setting and are increasingly implemented in the clinical speciality training for endocrinologist. This study aims to assess interrater agreement and factors that potentially impact EPA scores. Five known factors that affect entrustment decisions in health profesions training (capability, integrity, reliability, humility, agency) were used in this study. A case-vignette study using standardised written cases. Case vignettes (n = 6) on the topics thyroid disease, pituitary disease, adrenal disease, calcium and bone disorders, diabetes mellitus, and gonadal disorders were written by two endocrinologists and a medical education expert and assessed by endocrinologists experienced in the supervision of residents in training. Primary outcome is the inter-rater agreement of entrustment decisions for endocrine EPAs among raters. Secondary outcomes included the dichotomous interrater agreement (entrusted vs. non-entrusted), and an exploration of factors that impact decision-making. The study protocol was registered and approved by the Ethical Review Board of the Netherlands Association for Medical Education (NVMO-ERB # 2020.2.5). Nine endocrinologists from six different academic regions participated. Overall, the Fleiss Kappa measure of agreement for the EPA level was 0.11 (95% CI: 0.03-0.22) and for the entrustment decision 0.24 (95% CI 0.11-0.37). Of the five features that impacted the entrustment decision, capability was ranked as the most important by a majority of raters (56%-67%) in every case. There is a considerable discrepancy between the EPA levels assigned by different raters. These findings emphasise the need to base entrustment decisions on multiple observations, made by a team of supervisors and enriched with factors other than direct medical competence.

In 2021, UpToDate began offering continuing medical education (CME) planned and delivered by patients. The patient-authored medical topic reviews focus on lessons learned from interactions with the healthcare system and emphasise quality of life for those living with specific conditions. Having access to the patient voice at the point of care provides clinicians with a perspective that can improve patient-provider communication and promote shared decision-making. Participants who viewed the patient-authored topics were emailed a survey about the content; several responses indicated that the new topics were useful in clinical practice. While positive responses demonstrate that clinicians value the patient perspective, we also received replies from participants and from the patient authors themselves indicating there is more work to be done in developing patient-led CME. As more patients are invited to join the conversation, their expertise will be increasingly recognised as integral to CME.