Mayo Clinic Proceedings published this free 2012 article by SG Adams (University of Texas Health Science Center) and colleagues
on an educational change intervention on chronic obstructive pulmonary disease
(COPD) among primary care clinic. What’s more, our own Alliance for CE in the
Health Professions president, Ed Dellert, is a co-author!
There was a clear educational gap among target clinicians: The authors report that, “before the
program, 173 of 320 participants (54.1%) had never used the Global Initiative
for Chronic Obstructive Lung Disease recommendations for COPD.” Those of us who
collect educational outcomes data can applaud the tremendous follow-up survey’s
response rate of 48.7% of the 313 participants. We all struggle with the
problematic use of self reported performance data in CEhp outcomes articles;
the authors even acknowledge this, stating, “physician self assessment is
unreliable” (Methods). Yet, this article is impressive because of its inclusion
of the word “completely: “Of the follow-up survey respondents, 92 of 132
(69.7%) reported completely implementing at least one clinical practice change.”
This helps us appreciate the knowledge and comprehension data reported as
increasing significantly, as well as the value of improved self-confidence
developed through CME/CEhp. Confidence is a measure of competence (Moore’s
Level 4), and competence is, to me, “the glue that sticks” knowledge to performance-in-practice.
The initiative featured
systematic instructional design methods using the Analysis, Design,
Development, Implementation, and Evaluation (ADDIE) approach. This construct was followed
by a team of educators and medical experts from multiple disciplines,
particularly from the American College of Chest Physicians and American Academy
of Nurse Practitioners. Especially interesting for us instructional designers,
the team used “self-directed learning” and “case and problem-based learning”
before ever beginning “lecture-based learning” (Table 1), indicating that they incorporated
the benefits of exploration in scientific learning that ideally occurs before the didactic introduction of terms
(per the Learning Cycle teaching model).
To challenge medical educators, I ask that we all continue to look for and
share CEhp studies that feature professional instructional design that other
clinical sites and educational teams can reproduce. This will help us highlight
Why We Matter. So I close with the image that my educational outcomes colleague,
Wendy Turell, tweeted (@WTevalu8), showing Ed Dellert discussing Why We Matter at the Alliance Industry Summit
in May 2015.
PubMed Central: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538496/
MeSH *Major* terms: Clinical Competence; Education, Medical, Continuing; Physicians, Primary Care/education; Pulmonary Disease, Chronic Obstructive/diagnosis; Pulmonary Disease, Chronic Obstructive/therapy
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