How Should Doctors Work and Maintain Their Lifelong Learning

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How Should Doctors Work and Maintain Their
Lifelong Learning ?

• IAMRA November 12, 2006

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Background

• Systems of CPD are increasingly designed to
• Assist physicians to maintain and expand their
  knowledge, skills, competencies over a lifetime
  of practice.
• Support promote (through tools and strategies)
  processes of lifelong practice reflection
• Facilitate the ability of physicians to
  demonstrate and document the outcomes of
  learning for practice

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Implications of this Evolution

• Central role practice based learning must
• play for CPD strategies of physicians to be
• Relevant to their scope of practice
• Address professional needs (perceived and
  unperceived)
• Enhance competencies required to sustain quality
  of practice.

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Implications of this Evolution

• Reconceptualization that

Practice Context
Learning Context
Professional Regulatory Bodies
National Education Colleges
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Implications of this Evolution

• Renewed models

Continuum of Lifelong Learning
Group Learning
Self-Directed Learning
Group CME is a resource to individual learning
Individual learning contributes to group
learning
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Implications of this Evolution

• New Skills Professional Expectations

Skills Ability to raise a question Knowledge
management Identification of unperceived
needs Expectations CPD is both intentional
and incidental Documentation of learning
outcomes
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Implications of this Evolution

• New Roles for Physician Organizations
• and Health Systems
• Build tools and strategies to assess
• Knowledge - Self-assessment
• Competence Simulations and 360 tools
• Health Outcomes Performance data

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Implications of this Evolution

• Intentional integration of multiple
• sequenced learning strategies
• Accredited Group Learning
• Self- Directed learning
• Guided Self- Assessment
• Practice Assessment

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Implications of this Evolution

• Increased focus on
• Health care teams
• Communities of Practice
• To facilitate strategies that promote
• Quality of care
• Patient safety
• Among others

Increasingly Inter - Professional
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Challenges of this Evolution

• Learner Perspective How to reflect on
• their practice and select from a menu of
• learning options that enable
• Increase in knowledge
• Sustain competence
• Enhance performance
• Produce improvements to practice

Develop evidence-based practices
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Challenges of this Evolution

• Provider Perspective How to serve and
• support physician learning through
• Rigourous needs assessment
• Aligning multiple learning strategies to meet
  identified needs
• Establish evaluation systems that measure
  outcomes beyond self-reported changes

Implement evidence-based education
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Challenges of this Evolution

• Regulatory Perspective To ensure,
• promote, and support engagement in a
• system of CPD that
• Measurable goals
• Relevant outcomes
• Enhances quality and safety of care

CPD as a Requirement for Quality Care
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New CPD System Integrated Within Canadian MOC
Systems

• 1995 The College of Family Physicains of
  Canada Implemented its MainPro Program
• 2000 The Royal College of Physicians and
  Surgeons of Canada launched its
• Maintenance of Certification Program
• Similar values, principles and goals

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FMRAC and CPD

• 2005 Federation of Medical Regulatory
  Authorities of Canada formed a National
  Working Group on Revalidation
• CPD is established as a foundation for the
  creation of a system of continuous quality
  improvement in physician learning

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DEFINITION OF REVALIDATION

• Revalidation is a quality assurance process
  in which members of the professional regularly
  provides satisfactory evidence of their
  commitment to continued competence in their
  practice as a condition of remaining licensed.

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PURPOSE OF REVALIDATION

• To reaffirm within a framework of professional
  accountability, that a physicians competence and
  performance are maintained in accordance with
  current professional standards

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SIX PRINCIPLES OF REVALIDATION

• Inclusive applicable to all physicians
• Fair - transparent process standardized tools
• Relevant - confirm competence within ones
  scope of practice
• Accountable - condition of licensure
• Transferable - across all provinces
• Formative constructive and educational

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How Should Doctors Work and Maintain their
Lifelong learning?

• By participating in systems of CPD that
• promote practice based learning and reflection
• Based on evidence-based education
• Appropriate values, goals and principles
• By effectively and efficiently using their
  practice as a stimulus to plan and document the
  areas and issues that they have reviewed which
  have contributed to their professional development

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How Should Doctors Work and Maintain their
Lifelong learning?

• By having opportunities to continuously assess
• their knowledge and skills (through
  self-assessment simulations) and their
  performance data (against current standards of
  care)
• By being connected to a community or peer
• group and to the evidence based resources
• that inform their decisions and judgments.

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Looking Forward to Your Comments and
Perspectives