The Journal of the American Academy of Physician Assistants (JAAPA) recently declared that “the world of continuing medical education (CME) as we know it is about to change the way doctors think about CME, participate in it, how we measure the effectiveness of it, and how it is funded.”
The article predicts these kinds of changes based on the Institute of Medicine (IOM) December 2009 report, Redesigning Continuing Education in the Health Professions, which stated that “the current system of continuing education for health professionals is not working." As a result, IOM recommended “a new vision for CME based on continuing professional development (CPD) that emphasizes lifelong learning skills instilled in the classroom through point-of-care opportunities encountered as clinically practicing PAs.”
From these recommendations, AAPA revised its policies on CME “to better incorporate a new emphasis on CPD.” The revision focuses on a process for PAs “that includes ongoing identification of learning needs, development of a learning plan, acquisition of new knowledge and skills, application to practice, and reassessment."
First, PAs must identify their learning needs through skills such as self-assessment, clinical performance measurement, and self-reflection. They can do this by relying on assessment tools already available, such as clinical performance measurements, patient outcomes via patient surveys or peer reviews, and self-reflection that identifies knowledge deficits and also uncovers any behaviors or attitudes that need to be changed.
The second, step in the process is for PAs to identify a particular knowledge, skill, or behavior deficit, and then develop a proactive plan for addressing those needs. This would allow them to plan CME sessions or use point-of-care learning systems to find evidence-based articles that are specific to their needs.
To focus on professional development, AAPA then recommends that PAs acquire new knowledge and skills from different types of CME such as live media, multimedia, multiple exposures, and scenario-based learning simulations. While these new ways to convey medical advances and treatments show promise, a 2007 Agency for Healthcare Research and Quality report found that lecture-based CME was "generally effective not only in the acquisition or achievement of knowledge, attitudes, skills, behaviors, and clinical practice outcomes, but also in their retention." Regardless, all forms of CME convey important information to health care providers, and new ways to keep PAs, physicians and nurses engaged will benefit everyone.
After the first three steps are carried out, PAs must use their knowledge and skills by integrating them into local practice guidelines and protocols. AAPA suggests that using information technology can help PAs consistently deliver proper care through reminders.
Once these new behaviors are adopted, CPD must be maintained regularly because it “is dynamic and ever changing, much like the scientific and clinical information that is integrated into practice.” As a result, more CME programs are crucial for PAs to be up to date with all the new advances, especially as the increase in patients from health care reform will increasingly rely on their services due to a severe shortage of doctors.
Allied health professionals (nurse practitioners and physician assistants) will play a key role in delivering healthcare under the recently passed healthcare reform package.
While there are both good and bad ideas in the IOM report regarding CPD, some PAs have reported a positive changes since focusing on AAPA’s new process. The success so far with improving CME is important because a “lack of an effective means for continuously updating the clinical knowledge and skills of health professionals can jeopardize the quality of patient care.” As a result, CME providers and PAs should continue to work together to provide more programs that can integrate new knowledge and skills into everyday practice, which will assure PAs continued competence throughout their careers.