I've learned that in medicine nothing is "never"
and it's certainly never "always"
/ 27 2
Stephen Sullivan. Knowledge and the Half-Life of Truth. http://www.medhunters.com/articles/knowledgeAndTheHalfLifeOfTruth.html
Infectious hepatitis – now hepatitis A Serum hepatitis – now hepatitis B Non A non B hepatitis – now hepatitis C Diabetes was checked formerly by urine
ketones instead of blood glucose
/ 27 3
Example of outdated knowledge
50 years ago radical mastectomy and radiotherapy – Now lumpectomy
HRT was used to protect the heart – now considered harmful
Flu vaccine under age 5 was routinely recommended in the past
…
/ 27 4
At the end of this lecture you are expected to have information about continuous professional development and its importance for medical doctors.
Objectives◦ define CME & CPD◦ discuss the half life of medical knowledge◦ explain the CPD cycle◦ Discuss the methods of keeping updated.
/ 27 5
Aim – Objectives
The American Medical Association (AMA) defines CME as educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that health professionals use to provide services for patients, the public, or the profession.
Johns Hopkins University, 2007
Continuing Medical Education (CME):
“Continuing professional development (CPD), in comparison to CME, is a broader concept, refers to the continuing development of the multi-faceted competencies inherent in medical practice, covering wider domains of professionalism needed for high quality professional performance.” (WFME, 2003)
Peck et al (2000) indicated that there is no sharp division between CME and CPD.
Continuing Professional development (CPD):
Other researchers assumed that Continuing medical education is seen as representing a more teacher based didactic style whereas continuing professional development implies a more learner centered and self directed approach of learning. (Peter &roger, 1999)
CME & CPD:
CME was initiated by the American Academy of General Practice, which has required CME for membership since 1947.
In 1971 New Mexico became the first state to require CME credit for relicense.
Recently the Saudi Commission for Health Specialties (SCHS) required CME for registration of all health professionals working in Saudi Arabia to ensure high quality professional performance.
History:
CPD consists of any educational activity which helps to maintain, develop or increase knowledge, problem-solving, technical skills or professional performance standards all with the goal that physicians can provide better health care.
CPD includes 'formal' activities, e.g. courses, conferences and workshops, as well as self-directed activities such as preceptorship and directed reading.
/ 27 10
CPD for medical professionals
CPD allows doctors to demonstrate that they are maintaining their skills in their practice.
It also allows doctors to develop professionally and to learn from more informal experiences.
Importance of CPD
any new information we may gather has a half-life of 5 years.
Lifelong learning is important, but no more important than clinical judgement, common sense and a critical evaluation of new information.
/ 27 13
What is the half life of medical knowledge?
Emanuel E. "A half-life of 5 years" Can Med Assoc J 112:572, 1975
A. J. MACGREGOR. Half-life of medical knowledge. CMA JOURNAL/MAY 17, 1975/VOL. 112 1165
Textbooks Medical literature (journals) Short term courses Long term trainings (Masters, PhD…) Educational meetings (Conferences,
panels..) Information from the media Exchange of experience with colleagues Reviving personal experience Collecting experience out of school Learning on own initiative
Sources of Professional Knowledge
'You must keep your knowledge and skills up to date throughout your working life. In particular, you should take part regularly in educational activities which maintain and further develop your competence and performance.'
The ultimate purpose of CPD is to contribute to high-quality patient care. As a result, CPD should take into account the needs and wishes of patients.
Purpose of CPD:
Individual doctors need to keep themselves up to date in all areas of Good Medical Practice. These are: ◦ good professional practice;◦ maintaining good medical practice;◦ relationships with patients;◦ working with colleagues;◦ teaching and training;◦ probity and health.
Build confidence and credibility Achieve your career goals Cope positively with change Be more productive and efficient
/ 27 19
Benefits of CPD:
Helps maximize staff potential by linking learning to actions and theory to practice.
Helps set SMART (specific, measurable, achievable, realistic and time-bound) objectives
Promotes staff development. helps give a positive image/brand to
organizations. …
/ 27 20
How CPD benefits the organization
The Perceived Effectiveness Of Continuing Medical Education Among Health Professionals In Two Of The Main Hospitals in Riyadh City, Saudi Arabia.By Amal Al Otaibi
Study:
61%10%
28%
1%
Purpose of attending CME programs
Training & edu-cationPatient care Registration SCHSother
0
20
40
60
80
72 62 64 59 59 55 4076 51 51 49 56 60 47
Comparison of Perceived Benefits - Saudi vs Non-Saudi
Saudi Non-Saudi
% Agree
Gain
new k
nowle
dge
Gain
new ski
lls
Impr
ove
prof
ession
al p
erfo
rman
ce
Stim
ulat
ed to
lear
n m
ore
abou
t top
ics
Stim
ulat
ed to
lear
n ab
out r
ecen
t dev
elop
men
ts
Wor
th th
e tim
e
Wor
th th
e m
oney
0
20
40
60
80
100
120
94 87 97 71 81 81 6164 43 40 46 46 46 34
Comparison of Perceived Benefits - Physician vs. Non-Physician
Physician Non-Physician
% Agree
P=0.002
P<0.001
P<0.001
P=0.02
P=0.001 P=0.001
P=0.01
Doctors are responsible for keeping themselves up to date in all areas of their practice.
What doctors learn at medical school and during postgraduate training needs to be updated throughout their careers to reflect changes in practice.
Doctors should think carefully about all their learning experiences to help them provide the highest quality patient care.
Take home message