Providing education for the profession: the role of the medical society

Susanna Price – Celine Carrera

Conflicts of interest

•  Educational Contract, Medtronic •  Medical Advisory Board, Abbott (MitraClip)

My Practice

Cardiologist and intensivist •  Critical care cardiology •  GUCH

Educational •  Chair: education committee ESC Acute Cardiovascular Care Association •  Member: education committee, ESC •  Member: CPC, ESC

•  Regional Adviser, Intensive Care Medicine, NW Thames •  Education & Training committee, Intensive Care Society •  Accreditation committee: British Society of Echocardiography •  Examination committee: Faculty of Intensive Care Medicine •  Examiner: European Society of Intensive Care Medicine, Faculty of

Intensive Care Medicine, Acute Cardiac Care Association, British Society of Echocardiography

Key points

•  There is a clear need for high-quality CME and CPD

•  At an individual level it is complex

•  At the level of the medical societies it is complex: one society may well not fulfil the CME/CPD needs – even if brilliant – as practice is now frequently multidisciplinary

•  Scepticism exists regarding the perceived “business” of CME/CPD – possibly unfairly

Outline

•  Background and context

•  What is currently happening?: clinician perspective

•  What is currently happening?: ESC perspective

•  Outline some of the challenges

Good Medical Practice?

i)   Good professional practice ii)  Maintaining good medical practice iii)   Relationships with patients iv)   Working with colleagues v)   Teaching and training vi)  Probity vii)  Health

‘Continuous advances in medical science mean that all doctors need to ensure they are always at the leading edge of medical practice.

‘Lifelong learning is the key to ensuring that doctors keep up to date and this

new guidance will support doctors in their efforts to achieve this and in their preparation for revalidation. We hope they will use it to reflect on how their learning and development improves the quality of care they provide for patients and for the service in which they work.’

Professor Sir Peter Rubin, Chair of the GMC

What is CPD

A continuing process, outside formal undergraduate and postgraduate training, that enables individual doctors to maintain and improve standards of medical practice through the development of knowledge, skills, attitudes and behaviour, CPD should also support specific changes in practice.

• gaining knowledge • improving patient care.

Directors of CPD Subcommittee of AoMRC

Themes CPD should address

•  Context and circumstance •  Knowledge •  Human factors/non-technical skills •  Skills and practices (clinical know-how) •  Professional values and identities •  Decision-making •  Realisation and performance •  Approaches to identifying learning needs

GMC, 2010

Relationship with fitness to practice

•  CPD, appraisal and revalidation are processes concerned with development and performance – to different degrees

•  CPD: high for D&P •  Revalidation: low for D, high for P

(primarily concerned with fitness to practice)

Bouch

My Scope of Clinical Practice

•  Intensive Care •  Critical care cardiology (Acute Cardiac Care)

•  Heart failure •  EP •  Valvular heart disease •  Cardiac surgery (including circulatory support and transplantation) •  Cardiothoracic malignancies •  Thoracic disease •  GUCH •  Coronary artery disease

•  Cardiac and non-cardiac imaging and investigations

•  Cardiac surgery: surgeons and anaesthetists, nurses and paramedical staff

What do I want/need from my societies?

•  Accessible •  Relevant •  High quality •  Not prohibitively expensive •  Flexible (content, time

availability, types of learning) •  Unbiased •  Not influenced by anything

other than evidence-base (or experience-base)

•  Reflect postgraduate learning process

•  Reflect professional learning •  Not just reflect CME, but CPD •  Not mapped to basic

certification, but to the practice of the profession and the individual

•  Relevant interaction between international/national/ certification bodies

Survey of consultant CPD attitudes

Motivation for undertaking CPD: largely positive

ü

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Attitudes towards CPD: largely positive

ü

ü

What CPD undertaken in previous year?

ü

ü

ü ü

Quality and content?

ü

ü

ü

ü

Most valuable contributors to CPD

ü

ü

ü

ü

ESC mission statement: To reduce the burden of

cardiovascular disease in Europe

EP and device therapy

Physicians

HF and transplant

Prevention

Cardiovascular Imaging

Nurses

Interventional Cardiology

GUCH

Cardiac Intensive care

Cardiology: a changing world

•  Greater integration with primary care practitioners •  Changing societal and patient expectations •  Genuine requirement for multiprofessional as well as multidisciplinary team

working

•  Very rapidly developing fields of practice •  Increasing subspecialisation

•  Greater scrutiny of independence of practice development •  Increasingly challenging financial support for education

•  Locally •  Nationally •  Internationally •  Within and outside the profession

• Congresses  &  Educa/onal  Courses  • Industry-­‐sponsored  satellite  symposia  • Trade  exhibi/ons  • Unrestricted  educa/onal  grants  • Distance  learning  • Clinical  Prac/ce  Guidelines  • Registries  and  post-­‐marke/ng  surveillance  

Aims of ESCeL: Lino Goncalves

•  Can you please describe what is the ESC eLearning platform? •  Will allow specialist trainees across Europe, and other countries to go

through their training programme and to acquire not only the knowledge but also the practical and professional skills that they will need in the future as sub-specialists

•  Can you please tell us what are the main aims of this

platform and their importance? •  To harmonise the training of the sub-specialties across Europe in order to

allow, as per the EU Directive, the free movement of doctors

ESCeL

Knowledge •  Authors identified to lead for each chapter for textbook to provide

materials for ESCeL •  78 courses (with submodules) •  Theoretical knowledge & formative MCQs •  Mandatory and advanced educational materials •  Tracking facility •  Facility available to all involved in ACC (multiprofessional,

multidisciplinary)

Skills •  Logbook building tool (linked to revised curriculum, 2014) •  Potential for DOPS and other evaluation

Professionalism •  Ability to build CV •  Potential to track CPD •  Inclusion of 360 facility

Current status and ongoing developments: ESC

How does the ESC plan & target educational programmes for its membership?

•  Following ESC Curricula •  E-learning: ACCA learning programme on ESCeL is being developed following

the ACCA curriculum, likewise the EAPCI learning programme on ESCeL •  Textbooks: curriculum-based

•  Guidelines-based education •  Guidelines into Practice Tracks in congress and congress 365 •  Focus sessions •  Webinars - bringing most clinically relevant aspects of guidelines to HCPs

•  Case-based and interactive approach •  ESC Webinars programme •  ESC Clinical Case Portal •  Cases in cross-fire sessions – new and interactive •  Meet the experts sessions – new and interactive

Outcomes hoped for?

•  Increasing knowledge, changing clinical practice, improving patient outcomes

How are these catered for in the planning of education? •  Moving toward developing needs assessment as a means to structure

and consolidate its educational offerings •  Currently: mainly cover knowledge gaps •  Some educational initiatives (hands on and focus sessions) cover skills,

changing clinical practice. •  2014 will see the first such experience.

How are surveys used in driving education programmes?

•  Presently results from Euro Heart Survey are only used to feed into the process of guidelines updates

•  With the introduction of needs assessment, the link with surveys will be

reinforced to drive education programme decisions, depending on the gaps identified

Challenges and successes?

•  Challenges •  Technology •  E-learning format •  New way to contribute for ESC KOLs and contributors (different from

preparing content for in-person meetings, slide sets, etc ...) •  Structuring relevant content (moving away from slide resources)

•  Successes: •  E-learning •  Availability of content on demand •  Added-value by having KOLs selecting and transforming/ repurposing

content to give higher educational value to members

Challenges – individual cardiologist

•  Mapping CPD to relevant bodies for licencing •  Staying current in all areas of practice •  Knowing the quality of educational offerings •  Clarity in understanding potential for bias and when it

exists •  Identifying the educational materials that are available •  Finding time to access the materials •  Ensuring balanced CPD – and that one doesn’t rest in one’s

comfort zone

How do I stay current in all areas?

•  Multi-disciplinary working: member of ESC, BCS, BSE, ICS, ESICM, RCP, EACTA, SCCM, EACVI, HFA, ISACCD, RCP, RSM, etc) •  All provide variable CMD/CPD/educational resources •  Mapping to different areas of practice challenging and not uniform

•  Need to map to certification process/curriculum for revalidation? •  Need to stay current in all areas?

•  Who keeps records? •  How are records kept? •  Where should I submit them?

•  How do I know that what I am doing is worthwhile, balanced and relevant?

•  Finding time to do this within working life a challenge – I just want to be a good doctor

Scepticism…?

Scepticism…?

BMJ, 2003

Key points

•  There is a clear need for high-quality CME and CPD

•  At an individual level it is complex

•  At the level of the medical societies it is complex: one society may well not fulfil the CME/CPD needs – even if brilliant – as practice is now frequently multidisciplinary

•  Scepticism exists regarding the perceived “business” of CME/CPD – possibly unfairly

Eric Hoffer

1902-1983

“In times of change learners inherit the earth, while the learned find themselves beautifully equipped to deal with a world that no longer exists”

Thank you