The Accreditation Council for Continuing Medical Education (ACCME®) Menu of Criteria for Commendation was created to incentivise a variety of behaviours and outcomes from accredited providers. ACCME analysed data from among the 1,053 accreditation decisions made between November 2017 and March 2022, of which 122 had applied for commendation. Accredited providers plan for higher level outcomes in their activities at an increasing rate over the past five years. Since 2017, 49 (40%) of the 122 organisations that applied for commendation under ACCME's new Menu of Criteria for Commendation were awarded this distinction. Of the organisations applying for commendation, 62%, 48% and 31% sought commendation using the "performance", "quality" and "community health" criteria, respectively. The success rate for each of these criteria was 78%, 68% and 66% respectively. Accreditation incentives can change the performance of educational providers and augment the quality and efficacy of continuing education.
Our study evaluates the impact of feedback sent to specialists participating in eConsult services. eConsult Specialists from two eConsult services in Ontario, Canada, received feedback on their use of eConsult via bi-annual specialist reports. An 11-item survey was developed to evaluate the impact, content, and distribution process of these specialist reports. We distributed 742 specialist reports in March 2021 and surveyed the specialists in July 2021. Our findings show that specialists largely felt that the feedback received validated their efforts (83%) and that receiving the report made them more likely to continue to participate in the eConsult service (59%). Most did not feel judged (74%) or distressed (79%) by the reports, and 72% said that reporting the median self-reported billing time did not impact their own billing times. Overall, eConsult services can capture, report and aggregate data valuable to specialists and is useful for Continuing Professional Development. Benefits and lack of risk implementing this type of feedback should encourage other services to consider similar processes.
phenomenon of micro-credentials a new one. Small, short in duration, courses leading to different types of or are already domi-nant in many and training sectors, professions and labour market systems such as in diving instruction, and also very importantly in continuing professional development for health workers. Preliminary findings from the European Centre for the Development of Vocational Training’s (Cedefop) ongoing study on micro-credentials role in facilitating learning for employment shows that employer organisations in the in of
To facilitate the development of leadership competencies in a multidisciplinary group of 18 emerging bone experts from 6 European Countries and Brazil, to face future scenarios in the evolving field of fragility fractures, and to support secondary fracture prevention and improve patient outcomes. Changes brought by the COVID-19 pandemic have further highlighted this need. A 2.5-year community of practice (CoP) programme was established with two senior bone experts acting as mentors. The content was adapted during the COVID-19 pandemic. The education impact of the programme was assessed using an ethics-approved mixed-method design consisting of multiple sources of qualitative and quantitative data collected longitudinally. Quantitative data were analysed descriptively. Qualitative data underwent a thematic analysis. After participating in the programme, participants reported increased interprofessional collaboration and communication skills, better understanding of health economics and negotiation, application of adult learning principles to their work setting, development of competencies to critically appraise guidelines, enhanced abilities to facilitate behaviour change in others, and improved confidence leading their team through crisis situations. Although time was required for some physicians to get accustomed to the CoP concept and develop trust with other members, it was described as a beneficial real-world learning experience. An educational real-world CoP programme was effective in enhancing leadership competencies among future leaders in the bone field to improve care of fragility fracture patients. The results presented could guide the development of other CoPs in fragility fracture care as leadership competencies are increasingly required in that field.
COVID-19 pandemic created a need to improvise and redefine blended learning to be executed fully online. Background information on the effectiveness of fully online blended learning activities, especially for surgical disciplines is limited. This study describes a fully online blended learning course format on spinal surgery and aims to provide data regarding it effectiveness. Fully online blended courses on three topics of spinal surgery designed as six-week asynchronous and followed by 3-day live parts. Learning gaps (LGs) were identified with a survey at the beginning of asynchronous part, at its end, and at the end of the live part. The effectiveness of the asynchronous and live parts was assessed by LGs and a quiz, login statistics of learners and faculty and a post-course survey. Participants' LGs decreased in all courses, statistically significant in two. Faculty and learner login rates significantly correlated with each other. Faculty and learner satisfaction was very high. A fully online blended learning course can be delivered effectively on spine surgery with a high participant and faculty satisfaction rate. The asynchronous part contributes to learning significantly.
Marburger Bund (MB), the largest doctors’ union in Germany (and Europe), has for many years claimed that “CME [Continuing Medical Education] is an integral part of physicians’ professional practice. It is an element of quality assurance in medicine. All physicians should have equal access to CME, in particular irrespective of their level of training, function, or professional position. CME should be considered as part of physicians’ work performance. It should primarily take place during working hours. Doctors should have the opportunity to practise CME at the workplace (e.g. via the Internet). Cost of CME should be covered by the employer” [1]. To support this claim, before Covid, MB negotiated within its tariff contracts, paid educational leave of up to 5 days per year. This allows doctors to attend external CPD activities like medical congresses; but no major progress has been made in strengthening workplace education [2]. This might now change. In the past, experts have rated the digital maturity of the German health-care system as “inappropriate” [3,4]. However, it is only since the Covid pandemic stressed the entire system, that politicians have been willing to admit that the system as a whole could have performed better, if greater digitisation had facilitated an improved availability and speed of information across the health-care sector. Federal Government subsequently implemented the “Future of Hospital Care” law (“Krankenhauszukunftsgesetz”, KHZG, 5), which came into effect on 29 October 2020. KHZG allows Federal Government, together with the Federal States (“Bundesländer”), to offer 4.3 billion Euros to hospitals in order to modernise their digital infrastructure. Thus, KHZG has resulted in the greatest public investment in digitisation of the health-care system in Germany.
Public Affairs and Stakeholder Relations, EIT Health, Munich, Germany; Unit for Scientific Outreach and Innovation, Barcelona Institute for Global Health (Isglobal), Barcelona, Spain; Secretariat, European Patients' Academy on Therapeutic Innovation (EUPATI), Amsterdam, The Netherlands; Patients Engagement in Research, Institut de Recerca, Sant Joan de Deu, Barcelona, Spain; Robotics & Innovation Lab, School of Engineering, Trinity College Dublin, Dublin, Ireland; Department of Physiotherapy, Faculty of Health Sciences, Universidad de Granada, ibs. Granada, Granada, Spain; Education, EIT Health, Munich, Germany
The PinPoint Case Platform (PPCP) offers independent online case-based CME. To align with personal learning needs, a functionality of needs assessments (“QuickScan”) was developed, directing users to follow personalised case journeys. A randomised study was conducted, comparing its effectiveness, time efficiency and user experience with a format of non-individualised case-based learning. Forty-two residents in urology from five European countries were randomly assigned to follow non-individualised case-based learning (control group) or a needs assessment plus personalised case journeys on different topics in prostate cancer. After performing a pre- and post-assessment, both groups showed a similar increase in test scores (Mann-Whitney U = 247; p = .113), but the time needed for completing the learning exercise was significantly lower in the group with the personalised approach (median: 45 vs 90 minutes; Mann-Whitney U = 97.5; p = .0141). The quality of the two learning methods was similarly well received by both groups. In conclusion, learners who followed personalised case journeys learned similarly effective but more time efficient than non-individualised case-based learners. Future studies should determine if these findings can be extrapolated to board-certified physicians following CME activities.
Net promoter Score (NPS) has been used in many fields, such as software, clinical care, and websites, as a measure of customer satisfaction since 2003. With a single question, NPS methodology is thought to determine brand loyalty and intent to act based on experiences with the brand or product. In the current study, accredited continuing medical education or continuing education (CME/CE) was the product. Providers of CME have utilised NPS rating (the individual score on a scale of 0 to 10) to collect data about the value of the experience a clinician has with CME activities, but there has been no research to examine what it actually is associated with. This study looked to understand – relative to other self-reported and assessment outcomes in CME, what does NPS at the activity level indicate? From 155 online CME programmes (29,696 target audience learners with complete data), potential outcomes of CME, including whether knowledge or competence improved via assessment score, mean post-confidence rating, and whether one intended practices changes and was committed to those changes, were examined as predictors of NPS. NPS is unique in that it cannot be calculated at the individual level; individual scores must be aggregated, and then the percentage who selected ratings of 0 to 5 is subtracted from the percentage who selected 9 or 10. Results showed that percentage of learners who are committed to change predicts 70% of the variance in NPS, which suggests NPS is a valid indicator of intention to act. These results have implications for how we might, as a field, incorporate the utilisation of a single standardised question to examine the potential impact of online CME and call for additional research on whether NPS predicts change in clinical practice.
Interprofessional continuing education in support of team-based care is a critical component of healthcare quality and safety. In an effort to develop and advance the field of interprofessional continuing education (IPCE), the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) collaborated to launch Joint Accreditation for Interprofessional Continuing Education™, the first and only accrediting body in the world to offer the opportunity to be simultaneously accredited to provide CE activities for multiple healthcare professions through a single, unified application process, fee structure, and set of accreditation standards. To date, seven additional professions have joined Joint Accreditation: athletic trainers, dentists, dieticians, optometrists, physician associates/physician assistants (PAs), psychologists, and social workers. With this expansion, jointly accredited organisations can choose to offer IPCE for up to ten professions without needing to attain separate accreditations. Jointly accredited providers are able to offer education that is designed for single professions, multiple professions, and interprofessional teams, as long as 25% of the education is interprofessional. This innovation facilitates and incentivises IPCE which leads to improved healthcare delivery and better patient outcomes. To effectively integrate interprofessional collaborative practice throughout healthcare systems across the world, IPCE needs to become an integral part of lifelong learning for all health professions. There are several jointly accredited organisations that operate outside of the USA, and interest in Joint Accreditation and IPCE continues to grow.
In a departure from the increasingly familiar virtual meetings conducted via collaboration apps the Fourteenth Annual European CME Forum (#14ECF) took place between 3 and 5 November 2021 using a blended model that relied mainly on a studio-based hub. A small group of faculty hosted plenary sessions in the studio with participation by attendees, panellists and workshop leaders via an interactive online meeting platform. The theme of the meeting was "The 3-legged stool: Achieving balance for effective CME. The plenaries focused on three linked topics, Rules and Regulations, Educational Design and Outcomes, and Funding and Independence. These were broadcast in high definition whilst interaction among participants, workshop leaders, and poster authors was achieved using an avatar-based conferencing platform. The breakout workshops covered topics including digital literacy, international collaboration, artificial intelligence, and diversity and inclusion. The meeting format was well accepted by participants and will form the basis for more hybrid-type meetings for future meetings.
To the Editor, Lifelong Learning (LL) is defined by the European Commission as all learning activity undertaken throughout life, with the aim of improving knowledge, skills and competences[1]. For healthcare professionals LL is essential for the provision of an optimal standard of patient care. Lifelong Learning in Healthcare (LLH) in Europe includes a variety of educational forms, Continuing Professional Development (CPD) including Independent Medical Education (IME), with or without formal accreditation, as well as non-accredited medical education activities offered by a variety of education providers and according to different national regulations. Some activities are either lead or funded by the pharmaceutical industry. This involvement of industry in medical education has been described in a detailed analysis[2]. The pharmaceutical industry has a longstanding commitment to engaging and innovating in LLH, partly to provide evidence to ensure its innovations are used safely and in the appropriate patient populations, but also due to its large geographical footprint to support or provide learning opportunities for healthcare professionals (HCPs) in countries with relatively limited access to LLH offerings. In addition, the pharmaceutical industry is frequently at the forefront of clinical research in association with academic investigators and supports the translation of scientific advancements into clinical practice. As the approach to LLH was not fully aligned across the pharmaceutical industry, and to ensure that the quality and conduct of industry funded or led LLH activities are appropriate, Article 16 of the EFPIA Code was published to ensure that LLH activities are distinct from promotional activities [3]. In addition EFPIA created a working group of industry specialists, and representatives from national associations who have produced a guideline for member companies to align on quality criteria[4]. Furthermore, to ensure a broadly-based input into the LLH quality guideline, external stakeholders, representing medical societies, academia, healthcare professionals, and patient organisations were invited to provide feedback on the industry LLH guideline during an Advisory Round Table meeting in 2020. The principles of ethical, transparent and responsible engagement, quality content and robust processes incorporated in the guideline have been well accepted also by other organisations[5] and are regarded as having relevance to all learning activities. By ensuring promotional activities are separate from LLH and introducing the quality guideline for EFPIA member funded or led LLH activities, it is expected that the greater transparency of industry LLH activities will ensure an aligned quality approach. The purpose of this recently published document is to provide further guidance for industry for the implementation of Article 16 of the EFPIA Code. The guideline must be read with the requirements and spirit of the Code in mind and applied in accordance with applicable country laws and regulations.
When the COVID-19 pandemic caused face-to-face meetings to be cancelled, an industry-sponsored educational programme, designed to develop skills and expand knowledge of young experts in oncology and urology, was forced to partially move from face-to-face setting to virtual meetings. In our outcomes analysis, we aimed to better understand what drives behavioural change following a series of educational interventions based on the physical or virtual formats. Therefore, we performed a structured outcomes evaluation for each educational intervention, including the perspectives of the learner and the teaching faculty. Our main findings were that “relevance” is the strongest driver of recall, satisfaction and behavioural change. Social interactions amongst learners and between faculty and learners are possible in the digital world, and we observed a trend of the young learners in favour of digital learning, especially with improved technical platforms enabling social interaction. Other findings were that new skills are required by the teaching faculty and that hybrid formats were identified by all participants as the model of the future. When developing future educational programmes, these specific needs of learners and faculty need to be considered and offer opportunities to develop more personalised programmes in order to increase learning impact.
COVID-19 imposed significant limitations upon the 2021 U.S. National Resident Matching Program (NRMP), most important of which is the replacement of traditional in-person interviews with a virtual format. To determine the strengths, limitations, and overall utility of virtual interviews (VIs) for residency applicant selection, a 14-question electronic survey was administered to programme directors (PDs) of all American Council for Graduate Medical Education (ACGME)-accredited residency programmes, from December 2020 through March 2021. PDs were asked about their experience with VIs and the ability to assess residency applicants using the virtual format. A total of 1123 PDs (30% response rate) representing 30 different specialities responded to our survey. Compared to in-person interviews, VIs made it more challenging to assess applicants’ fit with the programme, emotional intelligence, commitment to speciality, and ability to function as a resident physician. Overall, only 15% of PDs believed that VIs were better than in-person interviews. Once travel restrictions are lifted and in-person interviews are possible, 67% of PDs plan on hosting dual-format residency interviews, while 26% and 5% of PDs will exclusively host in-person interviews and VIs, respectively. This result was significantly different between surgical and non-surgical programmes [35% of surgical PDs suggested they would offer in-person interviews exclusively, compared to 21% of non-surgical PDs, p < 0.0001]. Although proven to be cost and time-efficient, VIs were challenging in evaluating certain qualities of residency applicants. While this study was focused on U.S. residency matching, it provides important insights about the future of VIs in medical recruitment as a whole.
Offering relevant, evidence based continuing professional development (CPD) to ensure the continued competence of health professionals is a universal concern. This concern will become even more crucial in a world facing global health threats and in a context of internationalisation of learning environments. While accrediting systems (i.e. external quality assurance systems for CPD) share a common goal to promote high quality CPD, each system is shaped by national history and contexts. An international movement is working to enhance the convergence of accrediting principles and processes. One of the first steps is to know and understand each other. This article serves this goal by offering a descriptive comparison of two seemingly different CPD quality assurance systems – in France and in the USA of America. The descriptions were developed by members of the accrediting bodies in both countries. The main finding of this descriptive study is that, despite stark differences in historical contexts and governance schemes, both regulators share principles of quality and independence of CPD and have endorsed a leadership role in promoting effective strategies, including interprofessional continuing education and practices. The commonalities of goals and values revealed in the study support the efforts of the International Academy for CPD Accreditation related to the globalisation of both health issues and learning environments.
The COVID pandemic hastened the urgency for continuing medical education providers to offer digitised learning options in their portfolios. Although digitisation offers a wealth of potential benefits for delivering CME, including individualised learning paths as well as convenience and ease of access, challenges also remain. The American College of Cardiology (ACC) digitised much of its CME portfolio, including converting several in-person courses to virtual formats, providing self-study programs and products for asynchronous review of focused clinical topics, and delivering its Annual Scientific Session and Expo virtually two consecutive years. The ACC is using data collected from these recent experiences to rebuild its digitally transformed CME portfolio, focusing on unique learning strategies that offer a global healthcare professional community access to high quality digitised continuing education.
The European Examination in Core Cardiology (EECC) is a knowledge-based postgraduate examination for cardiology specialists in Europe. It is designed to assess if a trainee has gained sufficient knowledge for independent specialist practice in core cardiology. A critical evaluation of the ECCC was undertaken using current educational theory. Miller's Pyramid was considered, and the Utility Equation was employed in a mixed methods approach. The utility analysis findings were that the EECC measured well on reliability and validity although improvement could be made in educational impact, cost-effectiveness and accessibility. Recommendations for enhancement were then put forward. No assessment instrument is perfect, and it is important to remember that the EECC is one component of assessment strategy for specialist trainees, complementing other evidence of professional competence. After appraisal, while improvement can be made, the EECC fulfils its ambitions of assessment.
Royal Brompton & Harefield Hospitals, Imperial College London, Guys & St Thomas’ NHS Foundation Trust, London, UK; William Harvey Institute, Queen Mary's University of London, London, UK; Institute of Cardiovascular Health, University College London, London, UK; Barts Health NHS Trust, UK; Department of Cardiovascular Sciences, University of Leicester, Clinical Sciences Wing, Glenfield Hospital, Leicester, UK; Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK; Liverpool Heart and Chest Hospital, Liverpool, UK; British Cardiovascular Society, London, UK; Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds & Leeds Teaching Hospitals NHS Trust, Leeds, UK
Healthcare professionals need to maintain their knowledge and skills to deliver the best possible care to patients. Medical societies play an important role as providers of continuing medical education (CME) and have actively continued this role during the COVID-19 pandemic adapting the delivery of education to virtual meetings and courses. The Biomedical Alliance in Europe CME Experts Committee conducted two surveys to collect information on the delivery of CME, generally, and during the COVID-19 pandemic from the member medical societies. In this article, we will present the most relevant data collected and share some reflections based on this analysis.
In this article, we examine the adaptation of learning among scientists and healthcare professionals in conferences and symposia from face-to-face to fully virtual meetings accelerated in the last years. Advantages and limitations for both settings have been described in different research studies but the effectiveness of learning can be reflected similarly by applying five fundamental principles of learning, which are based on empirical research in cognitive psychology. From a practical context, we compared the individual learning outcomes from two satellite symposia conducted face-to-face in 2019 and virtually in 2021 at the European Congress of Urology, EAU. Although both conference formats were almost identical, the five principles of learning were applied in both symposia. There were also some differences due to adaptation to online conferences, and our findings suggest that the virtual conference was perceived as significantly more effective than the face-to-face conference on all five criteria, and digital learning is a valid alternative to face-to-face conferences. What still needs to be better understood and analysed is the informal learning that is taking place during conferences, but suggesting an active design of any digital event by combining “technical literacy· with “learning literacy” will enable us to better analyse and study the impact of learning using the five learning principles in the design of other events in the future.
