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Outcomes-Based CME National CPD Accreditation Meeting

Outcomes-Based CME National CPD Accreditation Meeting. Dave Davis, MD Senior Director, Continuing Education & Performance Improvement. Thinking that lectures will change outcomes? Just plain dumb…. Outline. You first: -Your objectives -Your challenges Me next: -One useful model of CME/CPD

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Outcomes-Based CME National CPD Accreditation Meeting

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  1. Outcomes-Based CME National CPD Accreditation Meeting Dave Davis, MDSenior Director, Continuing Education & Performance Improvement

  2. Thinking that lectures will change outcomes? Just plain dumb….

  3. Outline • You first: -Your objectives -Your challenges • Me next: -One useful model of CME/CPD -Several Problems in CME & Ten minutes of research findings • All of us…..Overcoming the problems: the first annual Canadian CPD Outcomes exercise • Wrap-up

  4. a useful model:Nowlen’s Models of Continuing Education

  5. CME problem #1: the perception thing

  6. CME Problem 2: confusing dissemination with implementation • Diffusion: distribution of information and the practitioners’ natural unaided adoption of policies and practices • Dissemination: communication of information to clinicians to improve their skills • Implementation: putting a guideline in place, involves effective communication, overcomes barriers by administrative and educational techniques • (after Lomas)...

  7. Problem #3: not paying attention to the research, especially mine 

  8. Effective CME: what do the studies of CE say? The effect of interventions on performance and health care outcomesJAMA 1995;274:700-705 +PP refers the number of studies that showed positive effects Interv# refers to the number of studies with the particular interventions

  9. Does formal CME work?: graphic representation of effect of variables (JAMA 1999; 282:867-874) Interv# refers to the number of studies with the particular interventions +PP refers the number of studies that showed positive effects

  10. Another problem: no, or only self-assessment – e.g. regular rounds Golf game this aft… Charts overdue Teenage kids Diabetic ketoacidosis?patient on 5A Pre-eclampsia patient in ER

  11. Applying the Research… Adapted from Straus et al, EBM 2005 Implementation tools

  12. objective assessments, e.g., quality rounds… Our department's performance in XX management What’s the role of other team members in making this better? How could we do better? What’s the evidence? How do we compare with…?

  13. NO, okay maybe a few, targeted didactic lectures

  14. Putting it together: Pathman, PROCEED and a CME-based implementation planning guide Davis et al, BMJ, 2003

  15. Warning: interaction ahead • What’s the clinical problem? • How do you KNOW it’s a problem? Evidence, Data •  What are the barriers to fixing it? •  How WOULD you fix it? • - Awareness  • Agreement • Adoption • Adherence • Accountability • What Stakeholders will you need ‘at the table’ •  How will you know when it’s fixed? What metrics would you use? •  Other thoughts, ideas

  16. More information: ddavis@aamc.org E-mail www.aamc.org/initiatives/cei www.mededportal.org Web

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