by Brittany Palasik,
Doctor of Pharmacy Candidate, University of Maryland School of Pharmacy
My
parents are both pharmacists practicing in the state of Maryland. Over the years, I have attended many
continuing education sessions with them.
I have snored through most, but was intrigued by some of the topics
discussed. Some pharmacists are so
specialized now, that it seems useless to spend time learning topics that don’t
directly pertain to their specialty. How essential is it to learn topics that
seem unrelated to your scope of practice?
Continuing
education (CE) is required by law for many health professionals. The Accreditation Council for Continuing
Medical Education describes the importance of maintaining knowledge for health
professionals.1 Indeed, knowledge
has been moving forward increasingly fast and health professionals need to
continually learn the latest information in science and medicine. However,
many healthcare professionals complain about the extra work required and wonder
if CE is actually beneficial. I decided to investigate the pros and
cons of continuing education. Is it
really necessary? After all, aren’t we
all supposed to be learning on the job every day?
Why Require CE?
Fact: CE has been directly
correlated to positive health outcomes.2
In
a study completed by the American College of Surgeons, continuing education
resulted in reduced morbidity and mortality rates for surgeons performing
segmental colon resections as well as repair of ruptured abdominal aortic
aneurysms. Additionally, rates of
myocardial infarction were lower in cardiologists who had participated in
continuing education, than those who had not.2
Fact:
CE can improve knowledge in the short- and long-term.3
Twenty
eight different studies were examined by the Johns Hopkins Evidence-based
Practice Centre to determine the efficacy of continuing education. Twenty-two (79%) of the studies showed
knowledge improvement, whereas only 4 (14%) of the studies showed no difference
in knowledge (2 studies [7%] had mixed results). These same 28 studies were evaluated through
follow-up and resulted in 15 studies (68%) demonstrated long-term knowledge retention.3
Why shouldn’t we require CE?
Fact: CE programs can be biased.
All
too often health professions will obtain most of continuing education funding
from pharmaceutical companies. This can
introduce bias, as each company can influence the subject matter. Additionally, this can reduce the
availability of content that may be relevant for contemporary practice but
which is not within the business interests of the sponsor.2 For
example, a new guideline that is important for the healthcare community may not
be promoted through continuing education because the guideline does not favor
the use of more expensive brand-name products.
Fact: CE is time-consuming.
In
Maryland, 30 hours of approved continuing education must be completed by
pharmacists within 2 years in order to renew licensure. Two of these hours must be live sessions.4
Some pharmacists complain that 30 hours is a large amount of time to dedicate
to continuing education. Some
pharmacists and other healthcare professionals believe that they learn every
day through their work activities and this extra work should not be required.
For
those who believe CE should be required, the evidence suggests, that under
optimal conditions, continuing education is beneficial.3 But CE
isn’t without problems. Its potentially
biased and requires an investment of time and money. I think we can all agree
that poorly designed instruction that’s not engaging or relevant to the
audience is unlikely to lead to improvements in practice or patient care
outcomes. How can we ensure that
healthcare professionals are getting a snooze-free, informative, knowledge
refresher that improves their skills and the care of patients?
How can we improve
CE?
A
systematic review completed evaluated different forms of educational techniques
including live sessions, computer-based instruction (off-line and online
real-time), videos, audio recordings, handheld materials such as laminated
cards, and printed documents (articles and monograph).3 Simulations and other interactive lessons,
whether online or in person, were the most effective. There was no differences found in any of the
other instructional techniques when used alone. However, there was a significant
difference when instructional techniques were combined. So, by combining different techniques such as
videos, hand-outs, and live simulations, continuing education can produce
significant improvements in healthcare practitioner knowledge and skills. It was also shown that repetition led to
improvements in short and long-term knowledge retention.
There
are many recommendations to reduce the potential bias due to
commercialism. Increasing awareness
among healthcare providers regarding the potential bias within continuing
education programming seems to be the best first step. By revealing the possibility for bias,
professionals may be more apt to critically evaluate continuing education
programs. Other suggestions include
requirements mandated by the Accreditation Council for Continuing Medical
Education (ACCME):5
1.
Compiling a list of (that year’s) most important topics
2.
Requiring proper disclosure of amounts received for funding
3.
Limiting the amount of funding received from commercial entities or completely
removing commercial funding.
Lastly,
there has been a lot of hype about implementing the Continuous Professional
Development (CPD) Model. The CPD differs
from traditional CE in that it incorporates practice-based learning. The goal is to improve performance of
healthcare providers and to individualize objectives for a particular person or
organization.6
Figure 1
Source: https://www.acpe-accredit.org/pdf/images/CPDCycle2011Color.jpg
The CPD cycle (Figure 1) begins
with self-appraisal: the individual reflects upon his or her own experiences, strengths,
and weaknesses. Then the individual
creates a personalized learning plan, implements it (with documentation of
course!), and evaluates the efficacy of what’s been learned. The circle metaphorically represents the
never-ending cycle of knowledge and skill development in healthcare. As healthcare professionals, we have to continually
learn new advances and skills if we want to make a positive impact in patients’
lives.6
References
- Why Accredited CME is Important: CME That Supports a Lifetime in Medical Practice [Internet]. Chicago, IL: Accreditation Council for Continuing Medical Education; 2012 [cited 5 Feb 2014].
- Ahmed K, Wang TT, Ashrafian H, et al. The effectiveness of continuing medical education for specialist recertification. Can Urol Assoc J. 2013;7:266–272.
- Marinopoulos SS, Dorman T, Ratanawongsa N, et al. Effectiveness of continuing medical education. Evid Rep Technol Assess 2007;(149):1–69.
- Pharmacy Laws and Regulations for the State of Maryland. 14th ed. Baltimore, MD: Maryland Pharmacists Association; 2014. P. 297
- Harrison RV. The uncertain future of continuing medical education: commercialism and shifts in funding. J Contin Educ Health Prof. 2003;23:198-209.
- Rouse MJ. Continuing Professional Development in Pharmacy. J Am Pharm Assoc. 2004;44:517-520.
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