Continuing Education in C the Health Professions

1 ContinuingEducationintheHealthProfession sProceedin gsof a Confe re nceChairedbySuzanneW. Fl etcher, , d byMaryHag er, Sue Russel l,and Suzanne che r, , , Jr . Fo undation is a privatephilanthropydedicatedto improvingthehealt h of individuals ,theFo undat ionhasfoc useditssupport principallyonprojectsand conferencesdesi gne d to en hance theed ucati on of healthprofessionals, is inth e publicdomainandmay bereproducedor co piedwithoutpermission. Cit ation,howeve r, is ap preciated:Hager M, Russell S, FletcherSW, tioninth e Health Pr of essio ns : Improvin g Healthcare ThroughLifelongLe arning,Proceedings of a Conf erenceSponso redbyth e Jo si ahMacy, ; 2007 Nov28 - Dec1; :Jo si ahMacy, ; yf Co nferen ce Sp on sor ed by th eJo si ah Macy, Jr.

2 Foundat io nCh airedby Suz an ne W. Flet ch er, M. D., mudaNov ember 2007 Edi ted by MaryHage r, Sue Ru sse ll ,an d Suz anne W. Fletcher, M. D., lish ed by theJosiahMacy,Jr. Fo un dat io n44 East64th Stree tNewYor k, NY 1006 5www. josi ahmacyfou nd ati on .o rg2008 ContinuingEducationintheHealthProfession s:ImprovingHealthcareThroughLifelongLear ningCEHP5-9 withfinaledits(forhiresPDF):050306 NeuroMngrph11/17/05AA 5/9/08 5:36 PM Page 1Pr efa ..4In tr od ..7Ch air ma n s Sum ma ry of the Co fer encePartici pa nt.

3 24 Con fer enceIm ag ..26I. AP PRO AC HE S TO KNOWLEDGEDEVELOPMENT WHAT WORKSANDWHATDO ES icians LearnandHowtoDesignLe ar ningExperiencesfo r Do nald E. Mo or e, Jr. ,Ph. D..30 Tra ns formin g Cont inuingMedicalEducationThroughMaintainenc eofCert ificatio F . Dan iel Duff y, M. D..63Di scussion te rnet Contin Denis e Baso w, ..82In formati csSk il ls Needed !.. Do nald Lin db erg, ..92 Remar DavidC. Slaw so n, ..94Di scussion . FI NA NC INGCO NTINUING Education :..WH O, HOW, A ND ..103 FinancialSupport forContin uing EducationintheHeal thPro fe ss R obert Stei nb rook , M.

4 D..104 Remar J ord an J. Coh en, ..127Di scussion I. DES IG NINGSY STEMSFO R LI IM PR OVE HE nuin g Health Prof essionalEducationDeliveryintheUnit edSt at DavidA. Davi s, M. D., and Tri na Loofbourrow, P am ela Mi tc hell , Ph .D. , , B. S..177Di scussion le of Cont ent s2 CEHP5-9 withfinaledits(forhiresPDF):050306 NeuroMngrph11/17/05AA 5/9/08 5:36 PM Page 2Th e MacyCo nferenceformat pr ovidesample timefor discussionand,afte rre adi ng co mm iss ionedba ckg roundpapers andhe ar ing remarkspreparedby the au th or s andsev era l pa rtici pants, the 36 par ticipantsseatedaroundth e tableof fe red countless informed observations,comments, scu ssi on High ligh ts se ctionsat the end of eachsessiongrouptheseco mm ent s acc ord ing to th em es th at emerged, though manycommentsmig hthav e be en pla cedin se ve ral ca teg , re marks.

5 Andcommentshav e bee n li gh tl y edited for brevity and clarity. On the finalday,partici -pan ts develo pedth e set of conclusionsandrecommendationsfoundin theEx ec utiv e Summ ar y and,agai n, beg inningon rni ngto WorkToget herto Improve M aryjoanD. Lad den , Ph .D. , ..182 Remar Carol Havens, ..189Di scussion . RE AC TIO N FRO M Grant S. Fl etc her, , M. J am es A. Cl ever, M. D..199 Su san W. Wes mi ller , M. S., R. N..200 R egi na Benjamin , M. D., M..203Di scussion MOVI NG nuin g Med icalEducation: DavidC.

6 Leac h, M. D..210Di scussion fer enceConc lu si on s and iti onalReferences Sug ges ted by ConferencePart ici pant ogra ph ical Sketchesan d Sta tements of Potential Conflict s ter es t of Co nfer en ce Par ti ci pa withfinaledits(forhiresPDF):050306 NeuroMngrph11/17/05AA 5/9/08 5:36 PM Page 3 Pre , ing my tenu re as pres ident of the MacyFou ndati on, we fun dedeffo rt s to impro ve undergraduate he alt h pr ofes sion al an d evengr adua te med ical educati on. However, it seemeddifficu lt, if notimp ossib le, to find a us eful ent ry point on co nt in ui ng ed ucat ion,even tho ugh it wa s a mas sive en terp rise that was mand at ed verybroa dly.

7 Wha t is more,I rep eatedly bumped up agai ns t the fact thatmuchof th e fu nd ing for conti nui ng medi cal ed ucati on (CM E) wasbeingprovi ded by pharmaceut ic al comp any spons ors. Decadesear lier tha t wa s tru e, of course,but not to anyw here near the ex ten tth at had co me to be the cas e. In fact , as I inq ui red of co lleag uescloserto th e issue than I was, I got es timatesthat 60-90per cent ofall CME wa s su pport ed by indus try. In deed,so pervasive was thatmechanism of sup port that al most no al ternative sou rces rem ain ile th ere was not hi ng intri nsi cal ly wr on g wi th that sta te of affai rs ,it tendedto be festoonedby ass oci ated pheno menahavi ng lit tle todo with edu cati on per se, such as free lu nches , gi fting of ot her sort s,or even mor e attr act ive subs idi es such as opp ortun iti es to qual if y forCME cr edi ts by en rol li ng in cours es offeredin desi rable spot withfinaledits(forhiresPDF).

8 050306 NeuroMngrph11/17/05AA 5/9/08 5:36 PM Page 45 Clear ly ther e wa s roomfor cons ider abl e concernaboutthe plann ingof of fer ings fo r lif e-l ong learning, not to men ti on pos si ble di stort ionof obj ect ivi ty of CM E contentdes ig n and del becamein cr easingly troubl ed as , over ti me, req ui rements by stat elice nsingbod ies to accu mul ate arb itrar y hoursof CME cr edit becamevirt ua lly un iver sal , and yet they cou ld be sati sfi ed rat her rand om ly,or at least with ou t any consi stency or qu ali ty con trol as to form atand content.

9 Th e wel l-es tabl ished Po werPointpres ent at io n for mathad becomenear ly uni vers al , and th ere was litt le evident imp etu sor sup port fo r other form s of learning, especially at poi nts of thos e wo rriso me tr ends in CM E content,qual it y, and rel evanceto pra ctic e wer e ev ol vi ng at a ti me when bench-to-bedside tra nsla -tiona l resear ch wa s bei ng prom ot ed an d wh en bi omed ical ad vancesmad e the need fo r pert inent life- lon g learn in g experiencesevermor e urgent an d imp ort ha pp y ch ance, I got int o a di scu ss io n of thesecon cernswit hDr.

10 Suzan ne Fl etcherearl y in 2006,at a time when I was tr yin g tofor mula te pl an s for the fina l Ma cy Conferenceto be held pr io r to myret ir ementat th e end of as ked if she with her lo nglead ersh ip of a lar ge Harvard CME cours e th oughtth at wou ld bea timelyand usefu l topi c for a conference,she endorsedth e id eavig oro usl y. Be tte r yet wh en I bega n to plan, the fir st step cho os in ga ch air pe rso n fel l neat ly into nne s enthusia sm wasmat che d by he r ene rg y, and she agr eed to chair th e plan nin g,convening, an d su bsequentmonograph prep arat io is volu me, th en, is the product of th e resu ltant MacyConf erence,he ld in So uthh am pton , Ber mu da fr om November28 to Dece mbe r 1,Os bornCEHP5-9 withfinaledits(forhiresPDF):050306 NeuroMngrph11/17/05AA 5/9/08 5:36 PM Page 520 07.