Promoting self-directed learning for continuing medical education

Self-directed delivery modes for continuing medical education (CME) are the most effective approaches for improving physician performance. However, instructor-directed programs are still the most popular methods used for CME. The purpose of the study was to assess the utilization, preferences and barriers to use of nine different CME delivery methods by physicians. A self-administered survey of all licensed physicians in Nevada was conducted over a three-month period. Results were analyzed using SPSS for windows (version 10). In-person conferences (92%) and journal review (64%) were the most frequently utilized modes of instruction. Rural physicians were more likely to use interactive video. The top three ranked preferences were in-person conference, print-based self-study and CD-ROM. It is concluded that computer training, dedicated time in the workplace for self-directed methods, and the development of more interactive CD-ROM and Internet programs will encourage the use of self-directed CME.     

Use of the pause procedure in continuing medical education: A randomized controlled intervention study

During lectures, a pause procedure (the presenter pauses so students can discuss content) can improve educational outcomes. We aimed to determine whether (1) continuing medical education (CME) presentations with a pause procedure were evaluated more favorably and (2) a pause procedure improved recall. In this randomized controlled intervention study of all participants (N?=?214) at the Mayo Clinic Internal Medicine Board Review course, 48 lectures were randomly assigned to an intervention (pause procedure) or control (traditional lecture) group. The pause procedure was a 1-min pause at the middle and end of the presentation. Study outcomes were (1) presentation evaluation instrument scores and (2) number of recalled items per lecture. A total of 214 participants returned 145 surveys (response rate, 68%). Mean presentation evaluation scores were significantly higher for pause procedure than for traditional presentations (70.9% vs 65.8%; 95%CI for the difference, 3.5–6.7; p?p?=?.01). In a traditional CME course, presentations with a pause procedure had higher evaluation scores and more content was recalled. The pause procedure could arm CME presenters with an easy technique to improve educational content delivery.     

Twelve tips for effective online discussions in continuing medical education

Online discussions for continuing medical education are increasing but many are ineffective. Close attention needs to be paid to the requirements of the learner and the wider healthcare organizational context within which continuing medical education takes place. There is a preference for structured and facilitated online discussions by this group of doctors. The essential skills for effective online facilitation are outlined.     

The use of the opinion leader in continuing medical education

This paper describes a process evaluation of an opinion leader (OL) project for a geriatric medical education program in dementia. Structured interviews with OLs were conducted to understand their experience as formal OLs from their initial training to the project's completion. Thirteen of 15 physicians involved in an OL project were interviewed. The adoption of a formal educational OL role was not an easy transition for most identified OLs. Some physicians struggled with the role and would have preferred more specific guidance. For this subject some content expertise was felt to be essential. Strong project leadership and some measures of success are important to sustain the OL commitment to a project. More attention needs to be devoted to the appropriate selection and training of OLs for educational projects to ensure that they have the relevant clinical expertise and skills to be effective and feel comfortable adopting a formal OL role.     

Competency-based medical education and continuing professional development: A conceptualization for change

Competency-based medical education (CBME) is as important in continuing professional development (CPD) as at any other stage of a physician’s career. Principles of CBME have the potential to revolutionize CPD. Transitioning to CBME-based CPD will require a cultural change to gain commitment from physicians, their employers and institutions, CPD providers, professional organizations, and medical regulators. It will require learning to be aligned with professional and workplace standards. Practitioners will need to develop the expertise to systematically examine their own clinical performance data, identify performance improvement opportunities and possibilities, and develop a plan to address areas of concern. Health care facilities and systems will need to produce data on a regular basis and to develop and train CPD educators who can work with physician groups. Stakeholders, such as medical regulatory authorities who are responsible for licensing physicians and other standard-setting bodies that credential and develop maintenance-of-certification systems, will need to change their paradigm of competency enhancement through CPD.     

A cross-sectional study of learning styles among continuing medical education participants

Purpose: Experiential learning has been suggested as a framework for planning continuing medical education (CME). We aimed to (1) determine participants’ learning styles at traditional CME courses and (2) explore associations between learning styles and participant characteristics.

Materials and methods: Cross-sectional study of all participants (n?=?393) at two Mayo Clinic CME courses who completed the Kolb Learning Style Inventory and provided demographic data.

Results: A total of 393 participants returned 241 surveys (response rate, 61.3%). Among the 143 participants (36.4%) who supplied complete demographic and Kolb data, Kolb learning styles included diverging (45; 31.5%), assimilating (56; 39.2%), converging (8; 5.6%), and accommodating (34; 23.8%). Associations existed between learning style and gender (p?=?0.02). For most men, learning styles were diverging (23 of 63; 36.5%) and assimilating (30 of 63; 47.6%); for most women, diverging (22 of 80; 27.5%), assimilating (26 of 80; 32.5%), and accommodating (26 of 80; 32.5%).

Conclusions: Internal medicine and psychiatry CME participants had diverse learning styles. Female participants had more variation in their learning styles than men. Teaching techniques must vary to appeal to all learners. The experiential learning theory sequentially moves a learner from Why? to What? to How? to If? to accommodate learning styles.     

An e-Delphi study generates expert consensus on the trends in future continuing medical education engagement by resident,practicing, and expert surgeons

Abstract

Background: The Delphi method is a demonstrated way to gather structured expert opinions to forecast, plan, and prioritize around a given topic. It builds consensus through iterative rounds.

Aims: The goal of this study was to build consensus-based predictions for the year 2022 about: future trends in surgeon continuing medical education (CME); the role of technology in learning for surgeons of different experience levels (trainee/resident, practicing, expert); and CME funding models.

Methods: A three round e-Delphi method was employed for this study. Panelist identities were anonymized, and controlled feedback and consensus rules were employed. Fifteen international expert panelists’ input was collected via electronically distributed, open-ended questionnaire (Round 1) and 5-point Likert scale ranking surveys (Rounds 2 and 3), in a series of nine questions (Round 1) and 26 and 25 summary statements (Rounds 2 and 3, respectively). Summary statements were collated via key words and ideas collected from panelist’s input. Mean, median, standard deviation, and 95% confidence intervals were calculated.

Results: Response rate was 100% for each round. Consensus in Round 2 was 61% and 88% in Round 3. Seven key finding statements with supporting background information was the result.

Discussion: Reliable, affordable internet access was identified as a likely barrier to education for certain regions, even in 5 years’ time. The use of similar educational resources were identified for all levels of surgeon, what varied was the reliance on a particular resource by each level of surgeon.

Conclusion: Institutes of employment were predicted to have ended CME funding for expert surgeons by 2022. Industry sponsored CME was predicted to have a continued role for trainee/residents and practicing surgeons.     

New horizons for e-learning in medical education: ecological and Web 2.0 perspectives

An ecological and a Web 2.0 perspective of e-learning provides new ways of thinking about how people learn with technology and also how new learning opportunities are offered by new technology. These perspectives highlight the importance of developing connections between a wide variety of learning resources, containing both codified and tacit knowledge. New adaptive technology has the potential to create personalized, yet collective, learning. The future implications for e-learning in medical education is considered.