Journal of CME最新文献

The jigsaw method which utilises peer-teaching in small-group settings permits a facilitator to incorporate active learning strategies into their educational toolbox. In November 2022, we evaluated the impact of the jigsaw method with groups stratified by post-graduate year (PGY) level. We assessed pre and post learner confidence and medical knowledge during a facilitator-led workshop. Participants were stratified into three groups who presented on the following subtopics about osteoporosis in men: (1) history and physical examination (PGY1s), (2) lab work and imaging studies (PGY2s) and (3) management and interventions (PGY3s). We evaluated if stratifying by PGY level impacted learner medical knowledge and confidence in November 2022. We had an 80% response rate from 16 actual participants from a total of 20 possible participants. Authors found a statistically significant increases in residents' confidence and medical knowledge after the training for all questions, but broad application across a variety of learners is still needed. The jigsaw method showed improvement in learner confidence about osteoporosis in men and may be implemented in teams distributed by PGY levels. Distribution by PGY level allows each team to building on their current training level to educate their peers.

The Saudi Commission for Health Specialties (SCFHS), the regulatory agency for health professions in the Kingdom of Saudi Arabia (KSA), sought to evolve the continuing professional development (CPD) ecosystem for the country and to promote the concept of life-long learning for healthcare professionals. SCFHS audited its own CPD accreditation system, reviewed internationally recognised CPD accreditation criteria, adopted a new set of standards, and trained its staff and provider community in their adoption. SCFHS also deployed a range of programmes and grants to support healthcare educators and researchers engaged in CPD. SCFHS recruited and trained new staff and deployed an updated IT system to support system change. The adopted criteria and standards now align with best practices, as outlined by the Accreditation Council for Continuing Medical Education (ACCME) and the International Academy for CPD Accreditation. More than 170 educators have participated in programmes to learn effective CPD pedagogy. The adoption of new standards resulted in 396 providers seeking provider accreditation. The number of CPD accredited activities produced in the KSA and approved by the SCFHS has grown from 1,000 activities in 2002 to 10,500 in 2022. With leadership support, regulatory evolution to align with best practices supports healthcare educators and effectively expands of the diversity and quality of CPD.

The COVID-19 pandemic has had disruptive effects on all parts of the health-care system, including the continuing education (CE) landscape. This report documents, what has happened in six different CE accreditation systems to CE activities as well as learners. Complete lockdown periods in the first part of the COVID-19 pandemic have inevitably led to reductions in numbers of the then predominant format of education, i.e. onsite in-person meetings. However, with impressive speed CE providers have switched to online educational formats. With regard to learner interactions this has compensated, and in some systems even overcompensated, the loss of in-person educational opportunities. Thus, our data convincingly demonstrate the resilience of CPD in times of a global health crisis and offer important insights in how CPD might become more effective in the future.

COVID-19 accelerated continuing professional development (CPD) delivered online. We aimed to compare the impact of in-person versus online CPD courses on medical specialists' behavioural intentions and subsequent behaviour. In this comparative before-and-after study, medical specialists attended in-person courses on nine clinical topics. A second group attended an adapted online version of these courses. Behavioural intention and its psychosocial determinants were measured before and immediately after the courses. Behaviour change was measured six months later. Generalised estimating equation (GEE) models were used to compare the impact of course formats. A total of 82/206 in-person registrants (mean age: 52±10 years; 50% men) and 318/506 on-line registrants (mean age: 49±12 years; men: 63%) participated. Mean intention before in-person courses was 5.99±1.31 and 6.43±0.80 afterwards (average intention gain 0.44, CI: 0.16-0.74; p=0.003); mean intention before online courses was 5.53±1.62 and 5.98±1.40 afterwards (average intention gain of 0.45, CI: 0.30-0.58; p<0.0001). Difference in intention gain between groups was not statistically significant. Behaviour reported six months later was not significantly associated with post-course intention in either group. However, the intention difference increased significantly among those who said they had adopted the targeted behaviour (paired wilcoxon test: n = 40 and p-value=0.002) while it did not increase significantly in the group of those who had not adopted a targeted behaviour (paired wilcoxon test: n = 16 and p-value=0.223). In conclusion, the increase in intention of specialists after CPD courses was similar whether the course was in-person or online. Also, an increase in intention in both groups signalled more likelihood of adoption.

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.