Journal of Continuing Education in the Health Professions最新文献

{"title":"Spaced Repetition Enhances Self-Rated Learning Confidence: A Large Randomized Trial Among Practicing Family Physicians.","authors":"Ting Wang, Zachary J Morgan, Andrew Bazemore, Warren P Newton, David W Price","doi":"10.1097/CEH.0000000000000615","DOIUrl":"10.1097/CEH.0000000000000615","url":null,"abstract":"<p><strong>Introduction: </strong>Metacognitive accuracy-the extent to which individuals' perceptions of their knowledge align with actual performance-is critical in clinical decision making. Overconfidence can lead to diagnostic errors, while insufficient confidence may delay decisions or prompt unnecessary testing, increasing health care costs. Although longitudinal knowledge assessments with spaced repetition have been shown to improve learning and knowledge transfer, their impact on metacognition remains underexplored. This study investigates changes in confidence under different spaced repetition strategies in a large cohort of family physicians.</p><p><strong>Methods: </strong>Data were drawn from the American Board of Family Medicine's Continuous Knowledge Self-Assessment, a longitudinal assessment administered quarterly. Participants rated their confidence on a 6-point scale after each question. In total, 16,751 physicians who completed assessments at baseline, quarter 6, and quarter 10 were included. Participants were randomized to control or intervention groups receiving repeated or clone questions at various intervals. One-sample t tests assessed confidence changes for questions initially answered incorrectly but subsequently answered correctly. Multivariate regression controls demographic factors.</p><p><strong>Results: </strong>Confidence increased significantly for repeated questions, with moderate effect sizes in single repetition groups and large effect sizes in two-time repetition groups. Clone questions also showed gains, though smaller in magnitude. After adjusting for clinician demographics, male and younger physicians generally reported higher confidence.</p><p><strong>Discussion: </strong>Spaced repetition enhances both learning and metacognitive accuracy. Two spaced repetitions yielded larger gains. These findings support incorporation of metacognitive-enhancing strategies into CME to improve clinician self-assessment and potentially reduce diagnostic error.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"16-22"},"PeriodicalIF":1.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life in Six Words: An Arts- and Narrative-Based Approach for Centering Patient Voices in a Health Care Education Session.","authors":"Marie L Neumann, Jessica Y Allen, Swapna Kakani, Marion F Winkler","doi":"10.1097/CEH.0000000000000621","DOIUrl":"10.1097/CEH.0000000000000621","url":null,"abstract":"<p><strong>Abstract: </strong>A participatory arts- and narrative-based approach for knowledge translation was utilized in a rare disease educational session at a medical conference, combining stakeholder storytelling with the presentation of relevant empirical evidence and frameworks to deepen clinicians' understanding of patient and caregiver quality of life. Before the conference, patient/caregiver perspectives were solicited via a six-word story creative writing prompt (n = 94); during the session, clinicians utilized these stories to cocreate three visual pieces representing the complexity of patient and caregiver experiences and symbolizing the common threads that appear when many \"rare\" experiences come together. Session attendees reported highly positive feedback, with most clinicians reporting that the knowledge gained from the session would result in a change in their clinical practice. We propose arts- and narrative-based approaches hold great promise for centering patient voices in health care education.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"71-74"},"PeriodicalIF":1.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Emergency Department Provider Experience Using the Revised Safer Dx for Self-Directed Feedback on Diagnostic Performance.","authors":"Joseph A Grubenhoff, Mairead Dillon, Alexandra T Geanacopoulos, Jennifer E Melvin, Kaitlin Widmer, Andrew P J Olson","doi":"10.1097/CEH.0000000000000632","DOIUrl":"10.1097/CEH.0000000000000632","url":null,"abstract":"<p><strong>Introduction: </strong>Well-calibrated diagnostic performance requires feedback on decisions. Emergency department and urgent care (ED/UC) clinicians infrequently receive diagnostic performance feedback. We explored clinician experience with self-directed diagnostic performance review compared with diagnostic safety expert review.</p><p><strong>Methods: </strong>Single-center, cohort study of pediatric ED/UC clinician self-directed case review involving possible diagnostic errors (DxEs). Participants reviewed their care of patients admitted within 10 days of an index ED/UC visit at risk of DxEs. The Revised Safer Dx provided structure for DxE identification and was compared with expert review by two diagnostic safety experts using Cohen kappa. Participants also reported their experience using the Revised Safer Dx.</p><p><strong>Results: </strong>During the 1-year study period, 187 patients at risk of DxEs received index visit care from 260 ED/UC eligible clinicians. Seventy-one clinicians submitted reviews for 97 patient-clinician encounters (37.4% response rate). Agreement on the presence of DxEs ranged from 84.8% to 87.5%; Cohen kappa for expert 1 = 0.51 (95% confidence interval = 0.25-0.76); expert 2 = 0.54 (95% confidence interval = 0.17-0.92) indicating moderate agreement. More than 60% of participants agreed that the Revised Safer Dx provided a useful framework for reviewing diagnostic performance regardless of the presence of a DxE. Participants self-identifying a DxE were significantly more likely to have altered their diagnostic approach than those who did not (75.0% vs 5.7%; P < .001).</p><p><strong>Discussion: </strong>ED/UC clinicians performing self-directed structured review for DxEs demonstrated moderate agreement with diagnostic safety experts indicating this method may aid diagnostic reasoning calibration. Promoting self-directed reviews may improve feedback delivery among ED/UC clinicians.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"23-28"},"PeriodicalIF":1.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved Activity Evaluations: An Iterative Process Using the Rasch Model.","authors":"Anthony Gage, Sarah A Nisly","doi":"10.1097/CEH.0000000000000620","DOIUrl":"10.1097/CEH.0000000000000620","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional evaluation models, often linear and outcome-focused, are increasingly inadequate for the complexities of modern medical education, which demands more comprehensive and nuanced assessment approaches.</p><p><strong>Methods: </strong>A standardized continuing professional development activity evaluation instrument was developed and implemented. An iterative process was performed, using a repeat Rasch analysis, to improve reliability of the evaluation instrument. Category Probability Curves and Test Information Function were generated by the Rasch analysis to refine the construction of the assessment. All educational activities completed between 2022 and 2024 were eligible for inclusion. The study incorporated a diverse range of educational activities and included multiple health care professions.</p><p><strong>Results: </strong>The pilot analysis included 250 educational activities with 26,554 individual learners completing evaluations for analysis. Initial Rasch findings demonstrated a need to remove redundancies and change from a five to four-point rating scale. The final instrument validation included 21 activities and 529 learners. Improvement was seen in reliability after modifications, with an increase in Cronbach alpha from 0.72 to 0.80.</p><p><strong>Discussion: </strong>Use of psychometrics to improve assessments can yield a more reliable and less redundant evaluation instrument. This research demonstrates a psychometrically informed, flexible evaluation tool that can inform future educational efforts and serve as a data driven metric to enhance the quality of continuing professional development programs.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"4-8"},"PeriodicalIF":1.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to Design a Point-of-Care Ultrasound Training Course Using Educational Theories.","authors":"Todd Cutler, Paula Roy-Burman, Jina Bai, Laura Chen, Elaine Y Gee, Gregory Mints, Irene Ma, Tanping Wong","doi":"10.1097/CEH.0000000000000603","DOIUrl":"10.1097/CEH.0000000000000603","url":null,"abstract":"<p><strong>Abstract: </strong>Point-of-care ultrasound proficiency requires the integration of spatial anatomic knowledge, technical hands-on image acquisition, and the ability to interpret images and incorporate findings into clinical decision-making. Effectively teaching these skills requires a structured approach. This article presents a comprehensive framework for designing a point-of-care ultrasound course tailored to continuing professional development. We demonstrate how applying the learning theories of cognitivism, behaviorism, and constructivism can facilitate the educational experience. In addition, we offer guidance on maintaining learner engagement, organizing didactic sessions, and delivering standardized feedback.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"44-49"},"PeriodicalIF":1.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vape Counseling at Pediatric Practices: The Rethink Vape Toolkit.","authors":"Paul T Harrell, Ann L Edwards, Natasha K Sriraman, Rebecca J Slimak, Anisha S Vanka, Amy C Paulson, Kelli J England","doi":"10.1097/CEH.0000000000000614","DOIUrl":"10.1097/CEH.0000000000000614","url":null,"abstract":"<p><strong>Introduction: </strong>E-cigarettes (Vapes) represent the most common form of tobacco used by adolescents, with one out of every 29 (3.5%) middle school students and one in every 13 (7.8%) of high school students vaping daily. This project aimed to increase vape screening and prevention education in youth visits at pediatric practices, to increase provider comfort with the topic of vaping, and to evaluate this educational process.</p><p><strong>Methods: </strong>A provider training and resource modules (talking points, billing codes, and shareable parent/teen-tailored resources) were developed. Providers ( N = 32) completed an anonymous pre/postsurvey regarding their knowledge, comfort levels, barriers, and practices related to teen vaping. Key-informant interviews ( N = 20) were conducted to identify barriers and seek solutions to incorporate risk counseling into daily practice. Monthly meetings were held to achieve Continuous Quality Improvement (CQI) in pediatric practices. The frequency of providing vaping information in the Depart Summary was monitored.</p><p><strong>Results: </strong>Reported barriers to providing vape prevention counseling, including lack of knowledge, lack of resources, discomfort with topic, and patient resistance, were significantly reduced after participation. Time constraints continued to be the greatest barrier to preventive counseling. Physicians who indicated they often or always provide vape prevention information during a visit increased from 9 to 50 percent. Average resources provided increased from 1 to 94 per month.</p><p><strong>Discussion: </strong>Tailored provider-training and resources increased physician knowledge of and confidence with the topic of vaping as well as the frequency of screening and preventive guidance provided to teens and their families.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"9-15"},"PeriodicalIF":1.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Naloxone Reach Through Innovative Training Strategies at an Academic Medical Center in Arkansas.","authors":"Leah Tobey-Moore, Adrian J Williams, Meghan Breckling","doi":"10.1097/CEH.0000000000000633","DOIUrl":"10.1097/CEH.0000000000000633","url":null,"abstract":"<p><strong>Abstract: </strong>The Arkansas Naloxone Education and Training (ANET) program, based at the University of Arkansas for Medical Sciences, was developed to address the urgent need for opioid-overdose prevention across the state. Funded by the Substance Abuse and Mental Health Administration (SAMHSA), ANET uses a train-the-trainer model to equip health care professionals with the knowledge and tools necessary to deliver naloxone education in their local settings. In its first year, the program launched a three-module curriculum, accredited for continuing education, of health care professionals and delivered using an academic detailing teaching strategy, prioritized recruitment from counties through a needs assessment including the highest rates of opioids dispensed and of overdose deaths, and implemented a comprehensive evaluation plan that is grounded in an evidence-based framework that facilitates continuous evaluation and improvement (ie, RE-AIM framework-Reach, Effectiveness, Adoption, Implementation, and Maintenance). Knowledge and attitudes were assessed before and after health care professionals completed the training program. All trainers received technical support and outreach materials. The program also fostered strategic statewide partnerships to support recruitment, implementation, and community engagement. ANET is embedded within an academic medical center and aligned with continuing professional development infrastructure, offering a replicable model for community-centered overdose prevention. Lessons learned during the program's implementation underscore its potential to inform future design, delivery, and sustainability of similar interventions.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"56-62"},"PeriodicalIF":1.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145821979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Together From Uncertainty: An Evaluation of Practice Inquiry Groups in a Nationwide Primary Care Practice.","authors":"Gurpreet Dhaliwal, John Penner, Meg Scott, Lucia S Sommers","doi":"10.1097/CEH.0000000000000610","DOIUrl":"10.1097/CEH.0000000000000610","url":null,"abstract":"<p><p>Practice inquiry (PI) is a structured method of discussion that helps primary care clinicians explore uncertainty and learn from challenging cases. An understanding of what aspect of PI primary care clinicians value could guide leaders who are contemplating implementation of collaborative discussion formats in their clinical systems. We administered a survey examining clinicians' perceptions of PI in a large nationwide membership-based primary care service. Two hundred ninety-six surveys (61%, N = 296/482) were received from participants and 69 surveys (75%, N = 69/92) were received from facilitators. Most respondents (>70% across five queries) felt that PI led to enhancement of knowledge and management skills and helped them become more comfortable managing uncertainty. Colleagues in PI groups provided validation and reassurance, valuable health system information, and insights into reasoning and patient-clinician relationships. Participants and facilitators outlined ways PI sessions could be improved (eg, case follow-up) and how the organization could support PI sessions (eg, enhanced facilitator training). This is the first program evaluation of PI in a large, community primary care setting. Future directions include examining what group-level characteristics mediate PI efficacy and how clinicians and patients fare after PI discussions. Such insights could inform enhancements to the group facilitation process.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"67-70"},"PeriodicalIF":1.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Educators Professional Development Utilizing Clinical Educators Milestones-Qualitative Thematic Analysis.","authors":"Lewis Goulder, Paul Jinks, Selma Omer","doi":"10.1097/CEH.0000000000000598","DOIUrl":"10.1097/CEH.0000000000000598","url":null,"abstract":"<p><strong>Introduction: </strong>Medical educators often face challenges in planning and prioritizing professional development due to a lack of structured guidance. The Clinician Educator Milestones (CEMs) were introduced to address this gap, providing a roadmap for educators' growth and development. This study explores the effectiveness of CEMs as a tool for self-assessment and goal setting in medical education.</p><p><strong>Methods: </strong>Participants in a medical education course at our University undertook self-assessment using CEMs and used this to develop educational development plans. Interviews were conducted to gather feedback and insights. The data were transcribed and analyzed thematically.</p><p><strong>Results: </strong>Participants reported that CEMs supported effective goal setting, identifying development needs and recognizing support required. Thematic analysis revealed themes on the use of CEMs related to developing a clear vision for professional development, identifying new perspectives, relating theory to practice, reflecting on their own understanding and capabilities, and recognizing educational role models.</p><p><strong>Discussion: </strong>The structured approach facilitated by CEMs aligns with the principles of Self-Determination Theory, empowering educators to take control of their development, enhance competence, and foster a sense of belonging within the medical education community. This research supports the efficacy of using CEMs to promote educators' growth and well-being.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"63-66"},"PeriodicalIF":1.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Theory to Practice: Evaluating the Integration of Adult Learning Theory in Continuing Medical Education Activities.","authors":"Adrienne R Madhavpeddi, Jessica L Walter, Jordan R Wells, Megan Jehn","doi":"10.1097/CEH.0000000000000636","DOIUrl":"10.1097/CEH.0000000000000636","url":null,"abstract":"<p><strong>Abstract: </strong>The underpinnings of adult learning theory are foundational to continuing medical education (CME). Several widely studied learning theories are relevant to medical providers including deliberate practice, situated learning theory and community of practice, social cognitive theory and self-determination, adaptive expertise, and experiential learning theory. The Accreditation Council for Continuing Medical Education recognizes 11 types of CME activities each integrating these learning theories to some degree. Provider preferences are shaped by accessibility, cost, flexibility, and opportunities for networking leaving many balancing the convenience of online programs with the value of in-person interactions. The degree to which learning theories are integrated within CME activities is widely understudied despite their interwoven relationship and association to provider preferences. This analysis aims to (1) evaluate the degree various CME models integrate learning theory; (2) identify theory-led strengths and limitations of CME models; and (3) extrapolate themes for CME planners to strengthen theory integration. The three most common types of CME activities are enduring material (ie, web-based courses, web-based courses with simulation), live courses (ie, conferences, webinars, simulations), and regular scheduled series (ie, Project Extension for Community Healthcare Outcomes, speaker series). Integration of learning theory across 7 CME models was evaluated through a content analysis using a trichotomous classification system (fully integrated, partially integrated, or no integration). Results varied, with Project Extension for Community Healthcare Outcomes and live simulations having the highest degree of theory integration. A thematic analysis identified five themes for improving theory integration including feedback mechanisms, structured self-reflection, adaptability to promote autonomy, repeat exposure to complex skills, and practice of humility.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":" ","pages":"38-43"},"PeriodicalIF":1.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}