Motivating learning and assessing outcomes in continuing medical education using a personal learning plan

Evaluation of the star family doctors training program: an observational cohort study of a novel continuing medical education program for general practitioners within a compact medical consortium: a quantitative analysis

INTRODUCTION

To determine the effectiveness of the Star Family Doctors Training Program, a comprehensive Continuing professional development (CPD) program for general practitioners (GPs) in a compact medical consortium.

PATIENTS AND METHODS

Observational cohort study with a quantitative analyses in primary health care institutions in Sichuan Province. The interventions were as following: (1) The Star Family Doctors Training Program is a full-time, local government allocation program certified by the Health Department of Sichuan Province, emphasizing small group learning and practice, and using standard patients and medical patient simulators; 30 participants were selected by their institutions. (2) The control group underwent a self-financed after-work CPD program using conventional lectures; 50 participants were self-selected. Short-term effectiveness assessed using immediate post-training tests and self-evaluations; long-term (1 year) effectiveness evaluated using self-reported surveys.

RESULTS

The study involved 80 GPs (28.75% men; mean age: 38.2 ± 9.2 years). The average post-training total score was higher in the STAR group than in the control group (72.83 ± 5.73 vs. 68.18 ± 7.64; p = 0.005). Compared to the controls, STAR participants reported seeing more patients (all p < 0.05), and had more patients who signed family-doctor contracts (p = 0.001) as well as increased patient satisfaction (p = 0.03), respectively. STAR-group trainees appraised the program higher and were more willing to recommend it to colleagues (90% vs. 64%, p = 0.011).

CONCLUSION

The Star Family Doctors Training Program achieved good responses and provides a reference for future CPD programs.

Coaching for Surgeons: A Scoping Review of the Quantitative Evidence

To characterize quantitative studies on coaching interventions for professional surgeons to understand how surgical coaching is defined; examine how different coaching programs are designed, implemented, and evaluated; and identify any relevant research gaps.

Background

Surgical coaching is gaining attention as an approach that could help surgeons optimize performance and improve overall wellbeing. However, surgical coaching programs and definitions of coaching vary widely between studies.

Methods

A systematic literature search of PubMed, Scopus, Web of Science, CENTRAL, clinicaltrials.gov, and WHO ICTRP was conducted according to the PRISMA-ScR framework to identify studies and registered clinical trials written in English. Original quantitative studies on coaching interventions for professional surgeons were included. Characteristics of the coachees, coaching programs, study designs, outcomes, and findings were charted and analyzed.

Results

From 2589 references, 8 studies (6 published; 2 registered trials) met inclusion criteria. Published studies targeted technical or nontechnical skills, included 2-26 surgeons as coachees, and used coaches who were surgeons. Two studies demonstrated that surgeons react positively to coaching. Studies showed inconsistent effects on technical/nontechnical skills. Only two studies measured patient adverse events and reported no significant positive impacts. The registered randomized trials targeted surgeons' physiological parameters or wellbeing and used professional coaches. These trials measure surgeon and patient outcomes.

Conclusions

There is an emerging interest in coaching programs to improve surgeons' performance by targeting their professional skills and personal factors. However, more randomized trials are needed to evaluate the impact of coaching interventions on patient outcomes and surgeon wellness.

Remediation Programs for Regulated Health Care Professionals: A Scoping Review

PURPOSE

Clinical competence is essential for providing safe, competent care and is regularly assessed to ensure health care practitioners maintain competence. When deficiencies in competence are identified, practitioners may undergo remediation. However, there is limited evidence regarding the effectiveness of remediation programs. The purpose of this review is to examine the purpose, format, and outcomes of remediation programs for regulated health care practitioners.

METHODS

All six stages of the scoping review process as recommended by Levac et al were undertaken. A search was conducted within MEDLINE, Embase, CINAHL, ERIC, gray literature databases, and websites of Canadian provincial regulatory bodies. Emails were sent to Registrars of Canadian regulatory bodies to supplement data gathered from their websites.

RESULTS

A total of 14 programs were identified, primarily for physicians (n = 8). Reasons for remediation varied widely, with some programs identifying multiple reasons for referral such as deficiencies in recordkeeping (n = 7) and clinical skills (n = 6). Most programs (n = 9) were individualized to address specific deficiencies in competence. The process of remediation followed three stages: (1) assessment, (2) active remediation, and (3) reassessment. Most programs (n = 12) reported that remediation was effective in improving competence.

CONCLUSIONS

Regulatory bodies should consider implementing individualized remediation programs to ensure that clinicians' deficiencies in competence are addressed effectively. Further research is indicated, using reliable and valid outcome measures to assess competence immediately after remediation programs and beyond.

Continuing Medical Education and Continuing Professional Development in the Republic of Armenia: The Evolution of Legislative and Regulatory Frameworks Post Transition

The collapse of the Soviet Union in 1991 left many ex-republics in a financial and administrative crisis for the ensuing two decades. Previously centralised processes like recertification of doctors and healthcare workers and continuing medical education fell by the wayside. Continuing medical education and continuing professional development in Armenia have evolved through multiple phases from Soviet, to immediate, mid and late-transitional post-Soviet periods, to current modernising efforts. This manuscript describes the phases of evolution of continuing medical education chronologically and details the legislative and regulatory framework surrounding each stage of development. Armenia is currently implementing a credit system of continuing medical education with the aim to introduce and adopt new and efficient approaches in this field. Continuing education credits fall into three categories: didactic or theoretical knowledge, practical skills and self-education/self-development. To recertify, professionals must collect credits from all three groups with specified minimum amounts according to their degrees. Armenia’s guiding principle is to harmonise the continuing medical education and professional development model with internationally accepted criteria in order to contribute to the international mobility of healthcare workers and to provide for true on-going professional development and knowledge that will benefit our doctors, nurses and above all our patients.

Current Practices and Existing Gaps of Continuing Medical Education among Resident Physicians in Abha City, Saudi Arabia

BACKGROUND

Continuing medical education (CME) is an everlasting process throughout the physician's working life. It helps to deliver better services for the patients.

OBJECTIVES

To explore CME among resident physicians in Abha City; their current practices, their opinions, and barriers faced.

METHODS

A cross-sectional study was conducted among resident physicians at the Ministry of Health hospitals in Abha City using a validated self-administered questionnaire. It included personal characteristics, current CME practices, satisfaction with CME, and barriers to attendance.

RESULTS

The present study included 300 residents from 15 training specialties. Their reported CME activities during the previous year were lectures and seminars (79.7%) followed by conferences (43.7%), case presentations (39.7%), workshops (34.0%), group discussion (29/7%), and journal clubs (27.3%). Astonishingly enough, very few (8%) attended online electronic CME activities. There were significant differences in CME satisfaction scores by different training specialties. Regarding residents' perceptions of the effectiveness of different CME activities (conferences/symposia, workshops/courses, and interdepartmental activities) the results showed that workshops and courses were significantly the most effective method compared to the other two methods in retention of knowledge, improving attitudes, improving clinical skills, improving managerial skills, and in improving practice behaviors. Barriers reported were being busy, lack of interest, high cost, and lack of suitable providers.

CONCLUSION

Based on the findings of this study, it is recommended that online learning be promoted as a CME format for trainees. There should be support of residents and clinicians through the provision of protected time for their CME activities outside their daily clinical commitments.

Introducing Online Continuing Education in Radiology for General Practitioners

The aim of this study was to determine whether e-learning as a new teaching methodology was acceptable for general practitioners in continuous education courses of radiology. Generally, these courses are face-to-face with the corresponding time and place limitations. To overcome these limitations, we transformed one of these courses to an online one evaluating its acceptance. The course was about thorax radiology and it was delivered to 249 participants. The experiment was carried out in two phases: Phase 1, as a pilot testing with 12 general practitioners (G1), and Phase 2, with 149 general practitioners (G2), 12 radiologists (G3) and 76 medical residents (G4). All participants evaluated the course design, the delivering e-learning platform, and the course contents using a five-point Likert scale (satisfaction level from 1 to 5). Collected data was analysed using t, Mann-Whitney U and Kruskal-Wallis tests. In Phase 1, the rounded scores of all questions except one surpassed 3.5. In Phase 2, all the rounded scores surpassed 4.0 indicating that a total agreement on all items was achieved. All collected impressions indicate the high acceptance of the proposed methodology.

Integrating Sex and Gender into an Interprofessional Curriculum: Workshop Proceedings from the 2018 Sex and Gender Health Education Summit

Background: In the last 3 years, the National Institutes of Health (NIH) declared advancement of understanding the role sex as a biological variable has in research a priority. The burden now falls on educators and clinicians to translate into clinical practice the ensuing body of evidence for sex as a biological variable that clearly shows the effect of sex/gender on disease diagnosis and management. The 2018 Sex and Gender Health Education Summit (SGHE) organized an interdisciplinary and interprofessional workshop to (1) analyze common clinical scenarios highlighting the nuances of sex- and gender-based medicine (SGBM) in presentation, diagnosis, or management of illness; (2) utilize valid educational and assessment tools for a multiprofessional audience; and (3) brainstorm standardized learning objectives that integrate both. Materials and Methods: We describe the iterative process used to create these scenarios, as well as an interprofessional forum to develop standardized SGBM case-based objectives. Results: A total of 170 health education professionals representing 137 schools of Medicine, Dentistry, Pharmacy, Public Health, Nursing, Physical, and Occupational Therapy participated in this workshop. After attending the workshop, participants reported a significant increase in comfort level with using diverse educational modalities in the instruction of health profession learners. Recurrent themes included case-based learning, use of sex-neutral cases, simulation, and standardized patient scenarios for educational modalities; and self-assessment, peer assessment, and review of clinical documentation as used assessment tools. Materials created for the workshop included teaching SGBM case scenarios, methods of assessment, and sample standardized objectives. Conclusion: The SGHE Summit provided an interdisciplinary forum to create educational tools and materials for SABV instruction that may be applied to a diverse audience.

Assessment of general practitioners' needs and barriers in primary health care delivery in Asia Pacific region

Background

Primary health care is the key to achieve universal health coverage and health for all. The role of general practitioner is now more important than ever. Gaps exist between primary care doctors' needs and available resources. Primary care professionals everywhere in the world are expected to provide basic standard of care and fulfill the unmet needs of the population. "Needs assessment" is essential in order to develop plans that reflect clinical priorities, educational needs, patient-centered care, and effective and efficient utilization of resources.

Materials and Methods

A blend of qualitative (28 in-depth interviews) and quantitative (315 survey respondents) research helped to identify the educational gaps of general practitioners in the Asia Pacific (APAC) countries. Our in-depth methodology assessed perceived needs in order to inform educational tactics that will engage physicians and drive changes in clinical practice. Barriers to change and best practices were identified so that those barriers may be addressed by the educational strategy.

Results

Key findings include a strong need for education for chronic conditions such as mental illness, skin problems, diabetes, hypertension, and others. The majority of physicians indicated that they prefer education in all aspects of the disease, from screening and diagnosis to maintenance or referral. Most clinicians prefer live presentations and small groups over Internet-based formats. Sub-analysis based on demographic factors showed little differences in the perceived needs, but significant differences in barriers to best practices.

Conclusion

"Needs assessment" gives an insight into barriers, interest, and necessity related to education and skills in primary care and the best ways to deliver it.

Drivers of Continuing Education Learning Preferences for Veterans Affairs Women's Health Primary Care Providers

INTRODUCTION

Documented gaps in health professionals' training in women's health are a special concern for continuing education (CE). In the Veterans Affairs (VA) health care system, women veterans are a numerical minority, preferably assigned to designated women's health primary care providers (DWHPs). DWHPs need to maintain their knowledge and skills in women's health topics, in addition to general internal medicine topics. We explored drivers of VA DWHPs' learning preferences for women's health topics-ie, factors which influence greater and lesser learning interest.

METHODS

We conducted semistructured telephone interviews with DWHPs across six VA health care systems. Interviews were audio recorded, transcribed, and coded in ATLAS.ti. We synthesized results by grouping relevant coded sections of text to form emergent themes.

RESULTS

Among the 31 DWHPs interviewed, reported drivers of learning interests among women's health topics were (1) high frequency of clinical incidence of particular issues; (2) perceived appropriateness of particular issues for management in primary care settings; and (3) perceived appropriateness of particular issues for partial management in primary care. Lower interest in particular women's health topics was associated with (1) perceived existing competency or recent training in an issue and (2) perceived need for specialty care management of an issue.

DISCUSSION

Understanding drivers of DWHPs' CE learning priorities lays a foundation for developing CE programming that will be of interest to women's health primary care providers. Attention to drivers of learning interests may have applicability beyond women's health, suggesting a general approach for CE programming that prioritizes high-volume topics within the practice scope of target providers.

Can Individualized Learning Plans in an advanced clinical experience course for fourth year medical students foster Self-Directed Learning?

BACKGROUND

Residency programs have utilized Individualized Learning Plans (ILPs) to customize resident education while undergraduate medical education has not done so in a meaningful way. We discuss the use of ILPs within a fourth year medical school course to facilitate self-directed learning (SDL).

METHODS

At Stony Brook University School of Medicine, an ILP component was added to the Advanced Clinical Experience (ACE) course for fourth year students. Each completed an ILP outlining personal learning goals and strategies to achieve them. An adaptation of the Motivated Strategies for Learning Questionnaire (MSLQ) (Duncan T and McKeachie W, Educ Psych 40(2):117-128, 2005 and Cook DA et al., Med Ed 45:1230-1240, 2011) was used to measure success of ILPs in improving SDL. Qualitative data analysis was conducted on the ILPs and self-reflections.

RESULTS

Forty-eight students participated. Two of the four SDL sub-domains identified on the MSLQ showed improvement; self-efficacy (p = .001) and self-regulation (p = .002). 'Medical Knowledge' was the competency most frequently identified as an area of concentration (90 %) and professionalism was selected least frequently (4 %). A higher percentage (83 %) of students who reported complete achievement of their ILP goals also reported feeling better prepared for entering residency.

CONCLUSIONS

ILPs improve SDL strategies among medical students and may serve as useful tools to help shape future learning goals as they transition to residency training.

Ticking the boxes: a survey of workplace-based assessments

Aims and method To survey the quality of workplace-based assessments (WPBAs) through retrospective analysis of completed WPBA forms against training targets derived from the Royal College of Psychiatrists' Portfolio Online. Results Almost a third of assessments analysed showed no divergence in assessment scores across the varied assessment domains and there was poor correlation between domain scores and the nature of comments provided by assessors. Of the assessments that suggested action points only half were considered to be sufficiently 'specific' and 'achievable' to be useful for trainees' learning. Clinical implications WPBA is not currently being utilised to its full potential as a formative assessment tool and more widespread audit is needed to establish whether this is a local or a national issue.

Continuing medical education for general practitioners: a practice format

Introduction

Our current knowledge-based society and the many actualisations within the medical profession require a great responsibility of physicians to continuously develop and refine their skills. In this article, we reflect on some recent findings in the field of continuing education for professional doctors (continuing medical education, CME). Second, we describe the development of a CME from the Academic Center for General Practice (ACHG) of the KU Leuven.

Methods

First, we performed a literature study and we used unpublished data of a need assessment performed (2013) in a selected group of general practitioners. Second, we describe the development of a proposal to establish a CME programme for general practitioners.

Results

CME should go beyond the sheer acquisition of knowledge, and also seek changes in practice, attitudes and behaviours of physicians. The continuing education offerings are subject to the goals of the organising institution, but even more to the needs and desires of the end user.

Conclusions

Integrated education is crucial to meet the conditions for efficient and effective continuing education. The ACHG KU Leuven decided to offer a postgraduate programme consisting of a combination of teaching methods: online courses (self-study), contact courses (traditional method) and a materials database.

The Future of Pediatric Obesity

The National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention reports a steady increase in obesity over the last 30 years. The greatest increase was seen in 15 to 19 year olds, whose obesity prevalence almost doubled from 10.5% to 19.4%. The solution to pediatric obesity requires a multidisciplinary approach addressing cultural norms, technologic advances, and family engagement. Future treatment strategies to combat the obesity epidemic will have to extend beyond the health care provider's office. Behavior modification remains the key component to pediatric obesity prevention and treatment.

Twelve tips for developing, implementing, and sustaining medical education fellowship programs: Building on new trends and solid foundations

Medical education fellowship programs (MEFPs) are a form of faculty development contributing to an organization's educational mission and participants' career development. Building an MEFP requires a systematic design, implementation, and evaluation approach which aligns institutional and individual faculty goals. Implementing an MEFP requires a team of committed individuals who provide expertise, guidance, and mentoring. Qualified MEFP directors should utilize instructional methods that promote individual and institutional short and long term growth. Directors must balance the use of traditional design, implementation, and evaluation methodologies with advancing trends that may support or threaten the acceptability and sustainability of the program. Drawing on the expertise of 28 MEFP directors, we provide twelve tips as a guide to those implementing, sustaining, and/or growing a successful MEFP whose value is demonstrated by its impacts on participants, learners, patients, teaching faculty, institutions, the greater medical education community, and the population's health.

Practice improvements based on participation in simulation for the maintenance of certification in anesthesiology program

BACKGROUND

This study describes anesthesiologists' practice improvements undertaken during the first 3 yr of simulation activities for the Maintenance of Certification in Anesthesiology Program.

METHODS

A stratified sampling of 3 yr (2010-2012) of participants' practice improvement plans was coded, categorized, and analyzed.

RESULTS

Using the sampling scheme, 634 of 1,275 participants in Maintenance of Certification in Anesthesiology Program simulation courses were evaluated from the following practice settings: 41% (262) academic, 54% (339) community, and 5% (33) military/other. A total of 1,982 plans were analyzed for completion, target audience, and topic. On follow-up, 79% (1,558) were fully completed, 16% (310) were partially completed, and 6% (114) were not completed within the 90-day reporting period. Plans targeted the reporting individual (89% of plans) and others (78% of plans): anesthesia providers (50%), non-anesthesia physicians (16%), and non-anesthesia non-physician providers (26%). From the plans, 2,453 improvements were categorized as work environment or systems changes (33% of improvements), teamwork skills (30%), personal knowledge (29%), handoff (4%), procedural skills (3%), or patient communication (1%). The median word count was 63 (interquartile range, 30 to 126) for each participant's combined plans and 147 (interquartile range, 52 to 257) for improvement follow-up reports.

CONCLUSIONS

After making a commitment to change, 94% of anesthesiologists participating in a Maintenance of Certification in Anesthesiology Program simulation course successfully implemented some or all of their planned practice improvements. This compares favorably to rates in other studies. Simulation experiences stimulate active learning and motivate personal and collaborative practice improvement changes. Further evaluation will assess the impact of the improvements and further refine the program.

Relationship among knowledge acquisition, motivation to change, and self-efficacy in CME participants

INTRODUCTION

The relationship among an individual's sense of self-efficacy, motivation to change, barriers to change, and the implementation of improvement programs has been reported. This research reports the relationship among self-efficacy, motivation to change, and the acquisition of knowledge in a continuing medical education (CME) activity.

METHODS

The measure of individual sense of self-efficacy was a 4-item scale. The measure of motivation was a 6-item scale following on the work of Prochaska and colleagues. The knowledge acquisition was measured in a simple post measure. The participants were enrolled in a CME activity focused on HIV. 

RESULTS

The CME activities had a significant effect on knowledge. Preliminary analysis demonstrates a relationship among the self-efficacy measure, the motivation to change measure, and global intent to change. Specifically, as reported earlier, the sense of efficacy in effecting change in the practice environment is predictive of a high level of motivation to change that, in turn, is predictive of formation of intent to change practice patterns. Interestingly, there were also relationships among the self-efficacy measure, the motivation to change measure, and knowledge acquisition. Finally, as expected, there was a significant relationship between knowledge and intent to change practice. 

DISCUSSION

Further inspection of the motivation to change construct suggests that it mediates the self-efficacy constructs' effect on intent as well as its effect on knowledge acquisition. This new finding suggests that the proximal construct motivation completely masks an important underlying causal relationship that appears to contribute to practice change as well as learning following CME-self-efficacy.

Continuing medical education revisited: theoretical assumptions and practical implications: a qualitative study

BACKGROUND

Recent research has evidenced that although investment in Continuing Medical Education (CME), both in terms of participation as well as financial resources allocated to it, has been steadily increasing to catch up with accelerating advances in health information and technology, effectiveness of CME is reported to be rather limited. Poor and disproportional returns can be attributed to failure of CME courses to address and stimulate an adult audience.

METHODS

The present study initially drew on research findings and adult learning theories, providing the basis for comprehending adult learning, while entailing practical implications on fostering effectiveness in the design and delivery of CME. On a second level, a qualitative study was conducted with the aim to elucidate parameters accounting for effectiveness in educational interventions. Qualitative data was retrieved through 12 in-depth interviews, conducted with a random sample of participants in the 26th European Workshop of Advanced Plastic Surgery (EWAPS). The data underwent a three level qualitative analysis, following the "grounded theory" methodology, comprising 'open coding', 'axial coding' and 'selective coding'.

RESULTS

Findings from the EWAPS study come in line with relevant literature, entailing significant implications for the necessity to apply a more effective and efficient paradigm in the design and delivery of educational interventions, advocating for implementing learner-centered schemata in CME and benefiting from a model that draws on the learning environment and social aspects of learning.

CONCLUSIONS

What emerged as a pivotal parameter in designing educational interventions is to focus on small group educational events which could provide a supportive friendly context, enhance motivation through learner-centered approaches and allow interaction, experimentation and critical reflection. It should be outlined however that further research is required as the present study is limited in scope, having dealt with a limited sample.

The key to using a learning or skill acquisition plan

A learning plan is a tool to guide the development of knowledge, skills and professional attitudes required for practice. A learning plan is an ideal tool for both supervisors and mentors to guide the process of teaching and learning a medical ultrasound examination. A good learning plan will state the learning goal, identify the learning activities and resources needed to achieve this goal, and highlight the outcome measures, which when achieved indicate the goal has been accomplished. A skill acquisition plan provides a framework for task acquisition and skill stratification; and is an extension of the application of the student learning plan. One unique feature of a skill acquisition plan is it requires the tutor to first undertake a task analysis. The task steps are progressively learnt in sequence, termed scaffolding. The skills to develop and use a learning or skill acquisition plan are also learnt, but are an integral component to the ultrasound tutors skill set. This paper will provide an outline of how to use and apply a learning and skill acquisition plan. We will review how these tools can be personalised to each student and skill teaching environment.

Relationship among practice change, motivation, and self-efficacy

INTRODUCTION

The relationship between an individual's sense of self-efficacy, motivation to change, and the implementation of improvement programs has been reported. This research reports the relationship among self-efficacy, motivation to change, and intent to implement continuing medical education (CME) activity learnings.

METHODS

The measure of individual sense of self-efficacy was a 4-item scale. The measure of motivation was a 4-item scale following on the work of Johnson, et al. The self-efficacy scale has been confirmed for structure, and together the 2 scales provide indicators of 3 underlying variables-2 self-efficacy constructs and a motivation variable. In addition, a global intent to implement measure was collected.

RESULTS

Preliminary analysis demonstrates a significant relationship between a self-efficacy construct, the motivation to change construct, and global intent to change. Specifically, the sense of efficacy in effecting change in the practice environment is predictive of a high level of motivation to change, which, in turn, is predictive of formation of an intent to change practice patterns.

DISCUSSION

Further inspection of the motivation to change construct suggests that it mediates the self-efficacy constructs' effect on intent. This is consistent with an earlier report on the relationship among self-efficacy, barriers to change, and stated intent. This new finding suggests that the proximal construct motivation completely masks an important underlying causal relationship that appears to contribute to practice change following CME: self-efficacy. A focus on the participants' sense of self-agency may provide a path to practice change.

Estimating health care cost savings from an educational intervention to prevent bleeding-related complications: the outcomes impact analysis model

INTRODUCTION

Investments in continuing medical education (CME) exceed $2 billion annually, but few studies report the economic impact of CME activities. Analysis of patient-level economic outcomes data is often not feasible. Accordingly, we developed a model to illustrate estimation of the potential economic impact associated with CME activity outcomes.

METHODS

Outcomes impact analysis demonstrated how costs averted from a CME symposium that promoted prevention of bleeding-related complications (BRC) and reoperation for bleeding (RFB) in cardiac and thoracic operations could be estimated. Model parameter estimates were from published studies of costs associated with BRC and RFB. Operative volume estimates came from the Society of Thoracic Surgeons workforce data. The base case predicted 3 in 10 participants preventing one BRC or RFB in 2% or 1.5% of annual operations, respectively. Probabilistic sensitivity analysis (PSA) evaluated the effect of parameter uncertainty.

RESULTS

92% of participants (n = 133) self-reported commitment to change, a validated measure of behavior change. For BRC, estimates for costs averted were $1,502,769 (95% confidence interval [CI], $869,860-$2,359,068) for cardiac operations and $2,715,246 (95% CI, $1,590,308-$4,217,092) for thoracic operations. For RFB, the savings estimates were $2,233,988 (95% CI, $1,223,901-$3,648,719).

DISCUSSION

Our economic model demonstrates that application of CME-related learning to prevent bleeding complications may yield substantial cost savings. Model prediction of averted costs associated with CME allows estimation of the economic impact on outcomes in the absence of patient-level outcomes data related to CME activities.

Continuing professional development crediting system for specialists in laboratory medicine within 28 EFLM national societies

Introduction:

Continuing professional development (CPD) with corresponding crediting system is recognized as essential for the laboratory medicine specialists to provide optimal service for the patients. Article presents results of the survey evaluating current CPD crediting practice among members of European Federation of Clinical Chemistry and Laboratory Medicine (EFLM).

Materials and methods:

A questionnaire had been forwarded to presidents/national representatives of all EFLM members, with invitation to provide information about CPD programmes and crediting policies, as well as feedback on individual CPD categories, through scoring their relevance.

Results:

Complete or partial answers were received from 28 of 38 members. In 23 countries, CPD programmes exist and earn credits, with 19 of them offering access to non-medical scientists. CPD activities are evaluated in all participating countries, regardless to the existence of an official CPD programme. Among participating members with mandatory specialists’ licensing (22/28), CPD is a prerequisite for relicensing in 13 countries. Main categories recognized as CPD are: continuing education (24 countries), article/book (17/14 countries) authorship and distance learning (14 countries). The highest median score of relevance (20) is allocated to professional training, editor/authorship and official activities in professional organizations, with the first category showing the least variation among scores.

Conclusions:

Majority of EFLM members have developed CPD programmes, regularly evaluated and accompanied by crediting systems. Programmes differ in accessibility for non-medical scientists and impact on relicensing eligibility. Continuing education, authorship and e-learning are mainly recognized as CPD activities, although the professional training is appreciated as the most important individual CPD category.