Journal of Continuing Education in the Health Professions最新文献

{"title":"Family Physician Quality Improvement Plans: A Realist Inquiry Into What Works, for Whom, Under What Circumstances.","authors":"Marguerite Roy,&nbsp;Jocelyn Lockyer,&nbsp;Claire Touchie","doi":"10.1097/CEH.0000000000000454","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000454","url":null,"abstract":"<p><strong>Introduction: </strong>Evaluation of quality improvement programs shows variable impact on physician performance often neglecting to examine how implementation varies across contexts and mechanisms that affect uptake. Realist evaluation enables the generation, refinement, and testing theories of change by unpacking what works for whom under what circumstances and why. This study used realist methods to explore relationships between outcomes, mechanisms (resources and reasoning), and context factors of a national multisource feedback (MSF) program.</p><p><strong>Methods: </strong>Linked data for 50 physicians were examined to determine relationships between action plan completion status (outcomes), MSF ratings, MSF comments and prescribing data (resource mechanisms), a report summarizing the conversation between a facilitator and physician (reasoning mechanism), and practice risk factors (context). Working backward from outcomes enabled exploration of similarities and differences in mechanisms and context.</p><p><strong>Results: </strong>The derived model showed that the completion status of plans was influenced by interaction of resource and reasoning mechanisms with context mediating the relationships. Two patterns were emerged. Physicians who implemented all their plans within six months received feedback with consistent messaging, reviewed data ahead of facilitation, coconstructed plan(s) with the facilitator, and had fewer risks to competence (dyscompetence). Physicians who were unable to implement any plans had data with fewer repeated messages and did not incorporate these into plans, had difficult plans, or needed to involve others and were physician-led, and were at higher risk for dyscompetence.</p><p><strong>Discussion: </strong>Evaluation of quality improvement initiatives should examine program outcomes taking into consideration the interplay of resources, reasoning, and risk factors for dyscompetence.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 3","pages":"155-163"},"PeriodicalIF":1.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10292514","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":"Exploring the Great Divide: Comparing Professional Development Satisfaction and Opportunities of Program Coordinators at Academic Medical Centers and Community-Based Programs.","authors":"Lauren Anderson,&nbsp;Kathleen Rowland,&nbsp;Megham Twiss,&nbsp;Jory Eaton,&nbsp;Mackenzie Krueger,&nbsp;Katherine Wright","doi":"10.1097/CEH.0000000000000430","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000430","url":null,"abstract":"<p><strong>Introduction: </strong>Program coordinators (PCs) need to maintain flexibility and evolve professionally with rapid changes in accreditation, specialty requirements, and policies. The Accreditation Council for Graduate Medical Education recommends professional development for PCs. This mixed-methods study explored professional development opportunities and current practices of PCs at community and academic programs.</p><p><strong>Methods: </strong>A survey was administered to the Chicago Area Medical Education Group members to elicit attitudes and opinions regarding professional development availability.</p><p><strong>Results: </strong>A total of 109 participants (eligible = 178) completed surveys. 97.2% (n = 105, N = 108) of respondents indicated that development is necessary for being a great coordinator. PCs at community-based programs report lower attendance at national conferences and less satisfaction with professional development opportunities than their academic-based institution counterparts. 28.5% of the community-based coordinators are dissatisfied with opportunities compared with 7% of the academic-based coordinators. 37.7% of the community coordinators (compared with 2.9% academic) report a lack of development activities by their program or graduate medical education. Only half of the PCs report discussing professional development with their program director. However, institutional supports were regarded as facilitators to satisfaction.</p><p><strong>Conclusions: </strong>Despite recommendations for regular professional development, this study finds only half of the PCs regularly discuss professional development and finds disparities in opportunities between those in community versus academic settings.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"139-142"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10255137","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":"Professional Coaching as a Continuing Professional Development Intervention to Address the Physician Distress Epidemic.","authors":"Sylvain Boet,&nbsp;Cole Etherington,&nbsp;Cecile Andreas,&nbsp;Manon Denis-LeBlanc","doi":"10.1097/CEH.0000000000000450","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000450","url":null,"abstract":"<p><strong>Abstract: </strong>Physician distress and burnout are reaching epidemic proportions, threatening physicians' capacities to develop and maintain competencies in the face of the increasingly demanding and complex realities of medical practice in today's world. In this article, we suggest that coaching should be considered both a continuing professional development intervention as well as an integral part of a balanced and proactive solution to physician distress and burnout. Unlike other interventions, coaching is intended to help individuals gain clarity in their life, rather than to treat a mental health condition or to provide advice, support, guidance, or knowledge/skills. Certified coaches are trained to help individuals discover solutions to complex problems and facilitate decision-making about what is needed to build and maintain capacity and take action. Across many sectors, coaching has been shown to enhance performance and reduce vulnerability to distress and burnout, but it has yet to be systematically implemented in medicine. By empowering physicians to discover and implement solutions to challenges, regain control over their lives, and act according to their own values, coaching can position physicians to become leaders and advocates for system-level change, while simultaneously prioritizing their own well-being.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"126-132"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10256766","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":"Systematic Review of the Effectiveness of Allied Health Clinical Education Programs.","authors":"Cristie Windfeld-Lund, Rodney Sturt, Carol Pham, Natasha A Lannin, Marnie Graco","doi":"10.1097/CEH.0000000000000477","DOIUrl":"10.1097/CEH.0000000000000477","url":null,"abstract":"<p><strong>Introduction: </strong>Continuing allied health professional (AHP) clinical education is essential to ensure high-quality patient care; however, the effectiveness of current education programs is unclear. This review aimed to determine whether AHP education programs improve the knowledge of AHPs, change their clinical practice behavior, and/or improve patient-related clinical outcome and to identify important components of these programs.</p><p><strong>Methods: </strong>Four electronic databases were searched. Controlled clinical trials investigating the effectiveness of clinical education programs were included. Education programs were diverse, varying in design, delivery mode, and intensity. Only therapy-specific AHPs were included. Effectiveness was determined by differences in group outcomes in the domains of AHP knowledge, AHP clinical practice behavior, and patient-related clinical outcomes.</p><p><strong>Results: </strong>Forty-four studies were identified, of which 26 included physiotherapists only. Most control groups were waitlist, passive dissemination of information, or usual care, limiting comparisons between programs. Changes in AHP knowledge was investigated in 20 trials, with 13 showing an improvement. Thirty studies investigated changes in AHP clinical practice behavior, with half demonstrating a difference between groups. Seventeen studies investigated a patient-related clinical outcome, with five finding a difference between groups. Where improvements in outcomes were demonstrated, programs tended to incorporate self-selection and cater to the learner's contextual needs.</p><p><strong>Discussion: </strong>AHP knowledge is effectively improved through targeted education programs. To change AHP behavior and patient outcomes, it seems important to incorporate self-selection for the program and consider the learner's individual needs and contexts through mentoring, outreach visits, reflection, and incorporating patient participation in the learning.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"109-116"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10282073","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":"When Illness and Loss Hit Close to Home-Do Health Care Providers Learn How to Cope?","authors":"Alex Lee,&nbsp;Bonnie Niu,&nbsp;Fady Balaa,&nbsp;Nada Gawad","doi":"10.1097/CEH.0000000000000462","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000462","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 85% of newly qualified physicians report loss or illness in themselves or a loved one. These experiences can intensify feelings of grief in the professional setting, but the range of formal training that addresses personal illness or loss is unknown. This study aimed to explore interventions that teach health care providers and trainees about personal illness experience.</p><p><strong>Methods: </strong>A scoping review was conducted by searching three bibliographic databases using the terms \"illness,\" \"personal,\" \"education,\" and synonyms. Article screening was performed in duplicate to identify studies that described an intervention that included teaching or learning on personal experiences with illness or loss for health care providers and trainees.</p><p><strong>Results: </strong>The search yielded 4168 studies, of which 13 were included. Education most often targeted medical students (54%), resident or attending physicians (31%), and nurses (31%). Other participants included social workers and psychologists. Personal illness was most frequently taught for reflection in the context of palliative care curricula (54%). Only two studies' primary purpose was to teach about coping with grief related to personal experiences. No studies within the scope of our defined methodology described training on how to support colleagues or trainees facing personal illness or loss. Reported outcomes included improved coping skills, decreased stress, and better ability to support bereaving patients.</p><p><strong>Discussion: </strong>Specific training on personal illness experience is limited, with gaps in continuity of learning, particularly for continuing medical education. Future curricula can equip providers with coping strategies while enabling improved resilience and patient care.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"117-125"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870162","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":"Achieving and Sustaining Change Through Capacity Building Train-the-Trainer Health Initiatives in Low- and Middle-Income Countries: A Systematic Review.","authors":"Bobbi Snowden,&nbsp;Shaon Lahiri,&nbsp;Rebecca Dutton,&nbsp;Lindsay Morton","doi":"10.1097/CEH.0000000000000458","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000458","url":null,"abstract":"<p><strong>Introduction: </strong>Given the anticipated health challenges, forecasted deficiencies in the global health workforce, and steady demands to work through resource constraints, effective and efficient training approaches to build capacity are direly needed. Although train-the-trainer (T3) is not a new approach, there has been considerable interest in using it to develop and sustain capacity, particularly in low- and middle-income countries. This systematic review aimed to better understand the factors to achieve and sustain change across multiple countries and levels through T3 approaches.</p><p><strong>Methods: </strong>A literature search was conducted of six scholarly, peer-reviewed, and gray literature databases. Data were extracted for the study method, design, characteristics, and implicit or explicit factors related to maximizing the likelihood of achieving and sustaining change. An existing conceptual framework for T3 interventions in global health guided the thematic analysis. The framework consisted of five factors pertinent to capacity building T3 initiatives: Talent, Resources, Alignment, Implementation, and Nurture and Development.</p><p><strong>Results: </strong>Twenty-two studies met the inclusion criteria. The T3 training spanned all geographical regions, but interventions were most prevalent in sub-Saharan Africa (46%). Nearly all studies (68%) quantitatively examined change at the individual level (95%), but some studies also explored change at the organizational (77%) and institutional (23%) levels. Implementation and Nurture/Development were the two most salient factors in achieving and sustaining change. The greatest hindrances involved Resources and Context , an additional theme that the data identified.</p><p><strong>Discussion: </strong>The findings and recommendations from this first systematic review exploring antecedents influencing change through health-related T3 interventions can inform training and capacity-building investments, improve existing T3 initiatives, and steer planning for future approaches.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"96-103"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876397","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":"Recommendations for Publishing Innovation Reports in JCEHP.","authors":"Douglas Archibald","doi":"10.1097/CEH.0000000000000515","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000515","url":null,"abstract":"","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"73-76"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9883026","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":"Evaluation of an Academic Detailing Program to Improve Blood Pressure Measurement and Hypertension Treatment in Urban Community Health Centers.","authors":"Michael Holliday,&nbsp;Alexandra Burnett,&nbsp;Molly Leavitt,&nbsp;Jackie Knapke,&nbsp;Daniel Hargraves,&nbsp;Harini Pallerla","doi":"10.1097/CEH.0000000000000468","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000468","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is estimated at a prevalence of 30 to 50% in the United States. Only 54% of patients with hypertension have their condition adequately controlled. This study aimed to use academic detailing (AD) to improve practice team knowledge and confidence in blood pressure (BP) management, specifically in low-income, underresourced patient populations.</p><p><strong>Methods: </strong>AD was developed for five practices that care for high percentages of Medicaid-eligible patients. A needs assessment was administered to each site's practice champion to determine high-yield AD sessions for their team. Presession and postsession evaluations were completed by practice team members.</p><p><strong>Results: </strong>Fifty providers and eight staff member participants completed evaluations over nine sessions for two AD topics at four practice sites. Statistical significance was found for several items within sessions including accurately choosing cuff sizes and identifying barriers to home BP monitoring.</p><p><strong>Discussion: </strong>AD is a potentially financially efficient model to improve knowledge and confidence in hypertension care at the practice level. Tailoring session content to specific needs of a practice site, along with an identified practice champion, facilitated implementation of the program. This replicable model is one way to deliver evidence-based information to those who serve Medicaid-eligible patients.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"e13-e17"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9870654","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":"Barriers and Facilitators to Knowledge Brokering Activities: Perspectives from Knowledge Brokers Working in Canadian Rehabilitation Settings.","authors":"Dina Gaid,&nbsp;Sara Ahmed,&nbsp;Aliki Thomas,&nbsp;André Bussières","doi":"10.1097/CEH.0000000000000475","DOIUrl":"https://doi.org/10.1097/CEH.0000000000000475","url":null,"abstract":"<p><strong>Introduction: </strong>Knowledge translation experts advocate for employing knowledge brokers (KBs) to promote the uptake of research evidence in health care settings. Yet, no previous research has identified potential barriers for KBs to promote the uptake of research evidence in rehabilitation settings. This study aimed to identify the barriers and facilitators for KBs in Canadian rehabilitation settings as perceived by individuals serving as KBs.</p><p><strong>Methods: </strong>Qualitative study using semistructured telephone interviews with individuals performing KB activities in rehabilitation settings across Canada. The interview topic guide was informed by the Consolidated Framework for Implementation Research (CFIR) and consisted of 20 questions covering three domains (characteristics of individuals, inner setting, and outer settings). We conducted qualitative descriptive analysis combining deductive coding guided by the CFIR.</p><p><strong>Results: </strong>Characteristics of individuals included having communication skills, clinical experience, research skills, and interpersonal features, in addition to being confident and motivated and receiving training. The inner setting domain included having constant networking with stakeholders and being aware of stakeholders' needs, in addition to resources availability, leadership engagement, knowledge accessibility, prioritizing brokering activities, and monitoring KBs' performance. Finally, the outer setting domain showed that KBs need to be connected to a community of practice to promote information exchange and avoid work duplications.</p><p><strong>Discussion: </strong>Factors likely to hinder or promote the optimal use of KBs within Canadian rehabilitation settings include skill sets and networking abilities; organizational culture, resources, and leadership engagement; and the need for specific training for KBs and for evaluation tools to monitor their performance.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"87-95"},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876975","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":"Building Interprofessional Collaborative Practices Through a Support Program for Patients With Type 2 Diabetes in Primary Care.","authors":"Noura Bawab, Joanna Moullin, Sébastien Jotterand, Christophe Rossier, Marie-Paule Schneider, Clémence Perraudin","doi":"10.1097/CEH.0000000000000466","DOIUrl":"10.1097/CEH.0000000000000466","url":null,"abstract":"<p><strong>Introduction: </strong>The building of interprofessional collaborative practices throughout the implementation process of a patient support program (Siscare) in primary care for patients with type 2 diabetes was assessed. Siscare included regular patient-pharmacist motivational-based interviews; medication adherence, patient-reported, and clinical outcomes monitoring; and physician-pharmacist interactions.</p><p><strong>Method: </strong>This investigation was a prospective, multicenter, observational, mixed-methods cohort study. Interprofessionality was operationalized through four progressive levels of interrelationship practices between the health care professionals. The target number of patients per pharmacy was 10 among 20 pharmacies.</p><p><strong>Results: </strong>The project started with the recognition of Siscare by stakeholders, the creation of an interprofessional steering committee, and the adoption of Siscare by 41 pharmacies among 47 pharmacies in April 2016. Nineteen pharmacies presented Siscare at 43 meetings attended by 115 physicians. Twenty-seven pharmacies included 212 patients; however, no physician prescribed Siscare. Collaboration primarily occurred through the unidirectional transmission of information from the pharmacist to the physician (level 1: 70% of pharmacists transmitted interview reports to physicians), bidirectional exchange of information sometimes occurred (level 2: 42% received physician responses), and concerted measures of treatment objectives took place occasionally (level 3). Twenty-nine of 33 physicians surveyed were in favor of this collaboration.</p><p><strong>Discussion: </strong>Despite multiple implementation strategies, physician resistance and lack of motivation to participate exists, but Siscare was well received by pharmacists, patients, and physicians. Barriers to collaborative practice (financial and IT) need to be further explored. Interprofessional collaboration is a clear need to improve type 2 diabetes adherence and outcomes.</p>","PeriodicalId":50218,"journal":{"name":"Journal of Continuing Education in the Health Professions","volume":"43 2","pages":"77-86"},"PeriodicalIF":1.6,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b1/db/ceh-43-77.PMC10219666.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238462","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}