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Tavares W, Sockalingam S, Valanci S, Giuliani M, Davis D, Campbell C, Silver I, Charow R, Jeyakumar T, Younus S, Wiljer D. Performance Data Advocacy for Continuing Professional Development in Health Professions. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:153-158. [PMID: 37824840 DOI: 10.1097/acm.0000000000005490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
ABSTRACT Efforts to optimize continuing professional development (CPD) are ongoing and include advocacy for the use of clinician performance data. Several educational and quality-based frameworks support the use of performance data to achieve intended improvement outcomes. Although intuitively appealing, the role of performance data for CPD has been uncertain and its utility mainly assumed. In this Scholarly Perspective, the authors briefly review and trace arguments that have led to the conclusion that performance data are essential for CPD. In addition, they summarize and synthesize a recent and ongoing research program exploring the relationship physicians have with performance data. They draw on Collins, Onwuegbuzie, and Johnson's legitimacy model and Dixon-Woods' integrative approach to generate inferences and ways of moving forward. This interpretive approach encourages questioning or raising of assumptions about related concepts and draws on the perspectives (i.e., interpretive work) of the research team to identify the most salient points to guide future work. The authors identify 6 stimuli for future programs of research intended to support broader and better integration of performance data for CPD. Their aims are to contribute to the discourse on data advocacy for CPD by linking conceptual, methodologic, and analytic processes and to stimulate discussion on how to proceed on the issue of performance data for CPD purposes. They hope to move the field from a discussion on the utility of data for CPD to deeper integration of relevant conceptual frameworks.
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Okpalauwaekwe U, Holinaty C, Smith-Windsor T, Barton JW, MacLean C. From field of dreams to back to the future? Exploring barriers to participating in continuing professional development (CPD) programs. BMC MEDICAL EDUCATION 2024; 24:106. [PMID: 38302979 PMCID: PMC10835933 DOI: 10.1186/s12909-024-05038-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND In 2009, Yvonne Steinert et al., at McGill University, published a study exploring barriers to faculty development (FD) participation among urban faculty. Over a decade later, we set out to replicate and expand on that study to learn what has changed in continued professional development (CPD) and what the current barriers are to participation in CPD for specialists and family physicians in rural and urban locations. METHODS Informed by a collaborative inquiry research framework, we invited faculty across rural and urban Saskatchewan to focus groups and interview sessions. The results were analyzed for themes. RESULTS Thirty-four faculty members from both rural and urban areas participated in this study. Of these, 50% were female, 74% practiced in urban areas, and 56% had over 20 years of experience. Frequently cited reasons for nonparticipation included time constraints, organizational and logistical challenges, poor resonance with material and presenters, and lack of recognition for teaching provided. Racism contributed to feelings of disconnectedness among physician faculty members. CONCLUSION Even after more than a decade, our research uncovered consistent reasons for nonparticipation in locally organized CPD events. New findings highlighted feelings of disconnectedness, notably stemming from racism and workplace discrimination. However, with recent societal developments brought about by the COVID-19 pandemic, can we ride these major waves of change to a new future of engagement? The pandemic led to a shift to virtual and hybrid professional development programs, presenting both benefits and challenges. Additionally, the peri-COVID anti-racism movement may positively address previously unidentified reasons for nonattendance. Harnessing these major changes could lead to a new future of engagement for continued professional development.
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Affiliation(s)
- Udoka Okpalauwaekwe
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7M 3Y5, Canada.
| | - Carla Holinaty
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7M 3Y5, Canada
| | - Tom Smith-Windsor
- College of Medicine, Victoria Hospital, Prince Albert, SK, S6V 5T4, Canada
| | - James W Barton
- College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada
| | - Cathy MacLean
- Department of Academic Family Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7M 3Y5, Canada.
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Bakwa Kanyinga F, Gogovor A, Dofara SG, Gadio S, Tremblay M, Daniel SJ, Rivest LP, Légaré F. Evaluating the impact of continuing professional development courses on physician behavioral intention: a pre-post study with follow-up at six months. BMC MEDICAL EDUCATION 2023; 23:629. [PMID: 37661265 PMCID: PMC10476392 DOI: 10.1186/s12909-023-04597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Continuing professional development (CPD) for health professionals includes educational activities to maintain or improve skills. We evaluated the impact of a series of CPD courses by identifying factors influencing physicians' intention to adopt targeted behaviors and assessing self-reported behavior adoption six months later. METHODS In this pre-post study, eligible participants attended at least one in-person course at the Fédération des Médecins Spécialistes du Québec annual meeting in November 2019. Before and afterwards, participants completed CPD-REACTION, a validated questionnaire based on Godin's integrated model for health professional behavior change that measures intention and psychosocial factors influencing intention. We used Wilcoxon signed-rank test to compare pre- and post-course intention scores and linear regression analyses to identify factors influencing intention. We also compared the post-course intention scores of participants reporting a behavior change six months later with the scores of those reporting no behavior change six months later. Qualitative data was collected only six months after courses and responses to open-ended questions were analyzed using the Theoretical Domains Framework. RESULTS A total of 205/329 course attendees completed CPD-REACTION (response rate 62.3%). Among these participants, 158/329 (48%) completed the questionnaire before CPD courses, 129/329 (39.2%) only after courses and 47/329 (14.3%) at 6 months. Study population included 192 physicians of whom 78/192(40.6%) were female; 59/192(30.7%) were between 50 and 59 years old; and 72/192 (37.5%) were surgical specialist physicians. Mean intention scores before (n = 158) and after (n = 129) courses were 5.74(SD = 1.52) and 6.35(SD = 0.93) respectively. Differences in mean (DM) intention before and afterwards ranged from - 0.31(p = 0.17) to 2.25(p = 0.50). Multivariate analysis showed that beliefs about capabilities (β = 0.15, p = 0.001), moral norm (β = 0.75, p < 0.0001), and beliefs about consequences (β = 0.11, p = 0.04) influenced post-course intention. Post-course intention was correlated with behavior six months later (DM = 0.63; p = 0.02). Qualitative analysis showed that facilitators to behavior adoption after six months were most often related to the TDF domains of beliefs about capabilities. Most frequent barriers to adoption related to lack of resources. CONCLUSIONS Overall, scores for intention to adopt targeted behaviors increased after the courses. CPD providers could increase participants' intention by including interventions that emphasize beliefs about capabilities, moral norm and beliefs about consequences.
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Affiliation(s)
- Felly Bakwa Kanyinga
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, G1J 2G1, Canada
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
| | - Amédé Gogovor
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, G1J 2G1, Canada
| | - Suélène Georgina Dofara
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
| | - Souleymane Gadio
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada
| | - Martin Tremblay
- Continuing Professional Development Directorate, Fédération des Médecins Spécialistes du Québec, Montreal, QC, H5B 1G8, Canada
| | - Sam J Daniel
- Continuing Professional Development Directorate, Fédération des Médecins Spécialistes du Québec, Montreal, QC, H5B 1G8, Canada
| | - Louis-Paul Rivest
- Department of Mathematics and Statistics, Faculty of Science and Engineering, Université Laval, Quebec City, QC, G1V 0A6, Canada
| | - France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, 2480 Chemin de la Canardière, Quebec City, QC, G1J 2G1, Canada.
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, G1J 2G1, Canada.
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Dale CM, Cioffi I, Novak CB, Gorospe F, Murphy L, Chugh D, Watt-Watson J, Stevens B. Continuing professional development needs in pain management for Canadian health care professionals: A cross sectional survey. Can J Pain 2023; 7:2150156. [PMID: 36704362 PMCID: PMC9872952 DOI: 10.1080/24740527.2022.2150156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Continuing professional development is an important means of improving access to effective patient care. Although pain content has increased significantly in prelicensure programs, little is known about how postlicensure health professionals advance or maintain competence in pain management. Aims The aim of this study was to investigate Canadian health professionals' continuing professional development needs, activities, and preferred modalities for pain management. Methods This study employed a cross-sectional self-report web survey. Results The survey response rate was 57% (230/400). Respondents were primarily nurses (48%), university educated (95%), employed in academic hospital settings (62%), and had ≥11 years postlicensure experience (70%). Most patients (>50%) cared for in an average week presented with pain. Compared to those working in nonacademic settings, clinicians in academic settings reported significantly higher acute pain assessment competence (mean 7.8/10 versus 6.9/10; P < 0.002) and greater access to pain specialist consultants (73% versus 29%; P < 0.0001). Chronic pain assessment competence was not different between groups. Top learning needs included neuropathic pain, musculoskeletal pain, and chronic pain. Recently completed and preferred learning modalities respectively were informal and work-based: reading journal articles (56%, 54%), online independent learning (44%, 53%), and attending hospital rounds (43%, 42%); 17% had not completed any pain learning activities in the past 12 months. Respondents employed in nonacademic settings and nonphysicians were more likely to use pocket cards, mobile apps, and e-mail summaries to improve pain management. Conclusions Canadian postlicensure health professionals require greater access to and participation in interactive and multimodal methods of continuing professional development to facilitate competency in evidence-based pain management.
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Affiliation(s)
- Craig M. Dale
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada,Tory Trauma Program, Sunnybrook Health Sciences Centre, Toronto, Canada,CONTACT Craig M. Dale Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, #130–155 College Street, Toronto, ON M5T1P8, Canada
| | - Iacopo Cioffi
- Faculty of Dentistry, University of Toronto, Toronto, Canada
| | | | - Franklin Gorospe
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada,Toronto General Hospital, University Health Network, Toronto, Canada
| | - Laura Murphy
- Department of Pharmacy, University Health Network, Toronto, Canada,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Deepika Chugh
- Faculty of Dentistry, University of Toronto, Toronto, Canada,Department of Dentistry, Mount Sinai Hospital, Toronto, Canada
| | - Judy Watt-Watson
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Bonnie Stevens
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada,Research Institute, The Hospital for Sick Children (SickKids), Toronto, Canada
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Magwenya RH, Ross A. Developing a CPD model for Eswatini-a participatory action research study. BMC MEDICAL EDUCATION 2023; 23:45. [PMID: 36670420 PMCID: PMC9854159 DOI: 10.1186/s12909-023-04016-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Continuing professional development (CPD) is a key aspect to fulfil a commitment to lifelong learning for professionals registered with the Medical and Dental Council, the intention being to promote the health of patients and develop clinical expertise. The absence of formal CPD requirements for practitioners in Eswatini has resulted in a move to introduce an accredited system. METHODS The qualitative study followed a participatory action research (PAR) methodology using a cooperative inquiry group of 10 medical practitioners in Eswatini to investigate how the current CPD program could be improved and formalised. PAR entailed four stages; observation, reflection, planning and action, using a semi-structured format to explore the areas of concern. RESULTS Reflecting on the current situation resulted in three ways to improve CPD being identified: (1) adopt a formal, compulsory CPD model; (2) recognise achievements by practitioners who endeavour to improve their skills/knowledge through Entrustable Professional Activities, and (3) ensure that CPD is relevant to the workplace by using Quality-Improvement CPD (QI-CPD) and reflective diaries. These would be done by involving local practitioners, using adult learning principles and ensuring continuous evaluation and improvement of the CPD model. CONCLUSIONS There was general agreement on the need for a formalised CPD system to improve skill levels and provide an open platform to enhance patient care in a resource constrained setting. The findings provided information that can be used to plan and action its implementation through engagement with the country's doctors in various forums and through ongoing research.
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Affiliation(s)
| | - Andrew Ross
- Department Family Medicine, University of KwaZulu Natal, Private Bag 7 Congella 4013, Durban, South Africa
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Chan TM, Sherbino J, Sockalingam S. Blueprints for Connection: A Meta-Organizational Framework for Layering Theory, Philosophy, and Praxis Within Continuing Education in the Health Professions. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 43:S41-S46. [PMID: 38054491 DOI: 10.1097/ceh.0000000000000533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
ABSTRACT As a field, Continuing Professional Development (CPD) lies at the intersection of many disciplines. Tensions can occur as scholars from fields ranging from education to quality improvement seek to advance the practices and workplaces of health care professionals. Owing to the diversity of people working to affect change within the field of CPD, it remains a very challenging space to collaborate and understand the various philosophies, epistemologies, and practice of all those within the field.In this article, the authors have proposed a meta-organizational framework for how we might re-examine theory, application, and practice within the field of CPD. It is their belief that this proposal might inspire others to reflect on how we can cultivate and invite diverse scientists and scholars using a range of theories to add to the fabric of the field of CPD.
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Affiliation(s)
- Teresa M Chan
- Dr. Chan: Dean of the School of Medicine and Vice President of Medical Affairs, Toronto Metropolitan University. She is also Associate Clinical Professor, Division of Emergency Medicine and Division of Education & Innovation, Department of Medicine, McMaster University, Hamilton, Ontario, Canada, Faculty of Health Sciences, McMaster University and an Adjunct Scientist, McMaster Education Research, Innovation, and Theory (MERIT) program, Hamilton, Ontario, Canada, Dr. Sherbino: Professor, Department of Medicine; Assistant Dean, Health Professions Education Research; Faculty of Health Sciences, McMaster University, and Dr. Sockalingam: Professor and Vice Chair, Education, Department of Psychiatry, University of Toronto, and Chief Medical Officer, Vice President Education and Senior Scientist , Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Hespe CM, Brown E, Rychetnik L. Learning from the implementation of a quality improvement intervention in Australian general practice: a qualitative analysis of participants views of a CVD preventive care project. BMC PRIMARY CARE 2022; 23:79. [PMID: 35421935 PMCID: PMC9011978 DOI: 10.1186/s12875-022-01692-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/04/2022] [Indexed: 11/23/2022]
Abstract
Background Quality improvement collaborative projects aim to reduce gaps in clinical care provided in the healthcare system. This study evaluated the experience of key participants from a Quality Improvement Program (QPulse) that focussed on cardiovascular disease assessment and management. The study goal was to identify critical barriers and factors enabling the implementation of a quality improvement framework in Australian general practice. Methods This qualitative study examined in-depth semi-structured interviews with nineteen purposively-selected participants of the QPulse project. Interviewees were from General Practices and the local supporting organisation, a Primary Health Network. Interviews were analysed thematically using the Complex Systems Improvement framework, focusing on five domains: strategy, culture, structure, workforce and technology. Results Despite reported engagement with QPulse objectives to improve cardiovascular preventive care, implementation barriers associated with this program were considerable for all interviewees. Adoption of the quality improvement process was reliant on designated leadership, aligned practice culture, organised systems for clear communication, tailored education and utilisation of clinical audit and review processes. Rather than practice size and location, practice culture and governance alignment to quality improvement predicted successful implementation. Financial incentives for both general practice and the Primary Health Network were also identified as prerequisites for systematised quality improvement projects in the future, along with individualised support and education for each general practice. Technology was both an enabler and a barrier, and the Primary Health Network was seen as key to assisting the successful utilisation of the available tools. Conclusions Implementation of Quality Improvement programs remains a potential tool for achieving better health outcomes in General Practice. However, enablers such as financial incentives, individualised education and support provided via a supporting organisation, and IT tools and support are crucial if the full potential of Quality Improvement programs are to be realised in the Australian healthcare setting. Trial registration ACTRN12615000108516, UTN U1111-1163–7995. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01692-0.
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