| 1. |
- Alsiö, Åsa, 1965, et al.
(author)
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Health Care Leaders' Perspectives on How Continuous Professional Development Can Be Promoted in a Hospital Organization
- 2022
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In: Journal of Continuing Education in the Health Professions. - 0894-1912 .- 1554-558X. ; 42:3, s. 159-163
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Journal article (peer-reviewed)abstract
- Introduction: Leaders play a central role in continuous learning processes aimed to improve health care. However, knowledge of how leaders with power and influence in hospital organizations promote the means for continuous learning in practice is scarce. This study aims to explore how key stakeholders in a hospital organization think about approaches and roles when promoting the reflective practice in small groups as means for continuous professional development in their organizations.Methods:Six key stakeholders from a regional hospital (two department directors, two ward managers, and two resident supervisors) were recruited through purposive sampling. Semi-structured interviews were conducted, and an abductive content analysis was performed.Results:In the current study, leaders stressed that cultural and structural conditions at all levels in the system were important for the practice of small-group learning. Yet, their suggested approaches referred exclusively to a limited part of the system and were directed to staff at lower hierarchical levels within their jurisdictions.Discussion:The identified gap between the suggested approaches and the claimed conditions for implementing a new strategy for continuous professional development among leaders in a health care organization illuminates difficulties in the implementation process. Providing adequate conditions at all levels of the system demands implementation approaches that include the entire hospital system. This requires that leaders first recognize their need to learn and apply a systemic perspective, and second, that they can create such learning opportunities for themselves.
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| 2. |
- Bäckryd, Emmanuel
(author)
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Nurturing the Virtues: Upholding Professionalism in the Midst of Busy Medical Practice
- 2019
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In: Journal of Continuing Education in the Health Professions. - : LIPPINCOTT WILLIAMS & WILKINS. - 0894-1912 .- 1554-558X. ; 39:1, s. 69-72
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Journal article (peer-reviewed)abstract
- Tom L. Beauchamp and James F. Childress (Bamp;C) book Principles of Biomedical Ethics is well known for its fourprinciple approach to biomedical ethics. However, the authors also emphasize the importance of the virtues of health care personnel. After a short overview of virtue ethics, the five "focal virtues" described by Bamp;C are discussed and applied to a chronic pain example. The question of how virtues are learned in the health care setting is addressed, and it is argued that virtues such as the ones defended by Bamp;C are acquired when health care personnel are socialized in an environment dedicated to the continuous upholding of practices that aim at the telos of medicine. Viewed from this perspective, professional isolation can be considered to be dangerous; the upholding of medical professionalism throughout a whole career largely presupposing the existence of a community where virtues relevant to the practice of medicine are embodied and kept alive. The concept of professional socialization is important in that respect. Finally, some potential general implications of this view for continuing professional development are proposed.
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| 3. |
- Bäckryd, Emmanuel
(author)
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"Professional Helper" or "Helping Professional?" The Patient-Physician Relationship in the Chronic Pain Setting, With Special Reference to the Current Opioid Debate
- 2016
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In: Journal of Continuing Education in the Health Professions. - : LIPPINCOTT WILLIAMS & WILKINS. - 0894-1912 .- 1554-558X. ; 36:2, s. 133-137
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Journal article (peer-reviewed)abstract
- There seems to be a strong cultural expectation among patients for effective pain relief. As a result, physicians often find themselves trying to bridge the gap between the chronic pain patients expectations and harsh biomedical reality. The typology of Emanuel and Emanuel of four models for the patient-physician relationship is used in this article as a conceptual tool to examine the possible roles of physicians in the context of chronic noncancer pain. Their typology is reconceptualized as a "pathway" along which the physician is able to walk more or less far, starting from the "information" end of the path. The other end of the pathway is "caring deliberation." I then propose that, in pain medicine today, consumerism is a powerful incentive for physicians to stay at the information end of the spectrum. Against this background, I discuss the current opioid epidemic in the United States and the need for what has been called a new medical professionalism. I conclude by challenging educators involved in pain medicine continuing professional development to not only design adequate biomedical-educational programs, but also consider issues like professionalism, personal development, critical self-reflection, and the ethics of engaging in caring deliberation with chronic pain patients.
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| 4. |
- Carlson, Elisabeth, et al.
(author)
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Critical Friends : Health Professionals' Experiences of Collegial Feedback in a Clinical Setting
- 2018
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In: Journal of Continuing Education in the Health Professions. - : Lippincott Williams & Wilkins. - 0894-1912 .- 1554-558X. ; 38:3, s. 179-183
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Journal article (peer-reviewed)abstract
- Introduction: A critical friend is a trusted person who asks provocative questions, provides data to be examined through another lens, and offers critique of a person's work as part of collegial feedback. However, empirical evidence presenting the use of collegial feedback to develop health professionals’ competence in clinical settings seems to be scarce. The aim of this study was to explore health professionals’ experiences of observing each other as critical friends in a clinical setting, as part of a continuous professional development initiative. Methods: The study was designed as a qualitative inductive study. Reflective journals written by health professionals (n=57) were analysed using thematic networks. The health professionals represented registered nurses and registered nurses with different specialist education (for example in paediatrics, mental health, intensive care and anaesthesiology), biomedical scientists, occupational therapists, physiotherapists and dental hygienists. Results: Health professionals can successfully use collegial feedback and benefit from critical friendships in clinical settings as it offers ample opportunities for reflection before, during and after the observation. A key finding was that in order to incorporate changes to professional practice, each individual needs to not only to act as a critical friend, but also experience being observed by a critical friend. Discussion: Based on the results of this study, it seems worthwhile to implement and further develop opportunities for health professionals to act as critical friends. We suggest that future research explore not only how professional competence develops over time, but also how it impacts on health related outcomes for patients.
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| 5. |
- Esmaily, Hamideh M., et al.
(author)
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Can Rational Prescribing Be Improved by an Outcome-Based Educational Approach? : A Randomized Trial Completed in Iran
- 2010
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In: Journal of Continuing Education in the Health Professions. - : Ovid Technologies (Wolters Kluwer Health). - 0894-1912 .- 1554-558X. ; 30:1, s. 11-18
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Journal article (peer-reviewed)abstract
- Introduction: An outcome-based education approach has been proposed to develop more effective continuing medical education (CME) programs. We have used this approach in developing an outcome-based educational intervention for general physicians working in primary care (GPs) and evaluated its effectiveness compared with a concurrent CME program in the field of rational prescribing. Methods: A cluster randomized controlled design was used. All 159 GPs working in 6 cities, in 2 regions in East Azerbaijan province in Iran, were invited to participate. The cities were matched and randomly divided into an intervention arm, for an outcome-based education on rational prescribing, and a control arm for a traditional CME program on the same topic. GPs' prescribing behavior was assessed 9 months before, and 3 months after the CME programs. Results: In total, 112 GPs participated. The GPs in the intervention arm significantly reduced the total number of prescribed drugs and the number of injections per prescription. The GPs in the intervention arm also increased their compliance with specific requirements for a correct prescription, such as explanation of specific time and manner of intake and precautions necessary when using drugs, with significant intervention effects of 13, 36, and 42 percentage units, respectively. Compared with the control arm, there was no significant improvement when prescribing antibiotics and anti-inflammatory agents. Discussion: Rational prescribing improved in some of the important outcome-based indicators, but several indicators were still suboptimal. The introduction of an outcome-based approach in CME seems promising when creating programs to improve GPs' prescribing behavior.
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| 6. |
- Hadadgar, Arash, et al.
(author)
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A Theory-Based Study of Factors Explaining General Practitioners' Intention to Use and Participation in Electronic Continuing Medical Education
- 2016
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In: Journal of Continuing Education in the Health Professions. - : Lippincott Williams & Wilkins. - 0894-1912 .- 1554-558X. ; 36:4, s. 290-294
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Journal article (peer-reviewed)abstract
- Introduction: Electronic modes of continuing medical education (eCME) can provide an appropriate and scalable way of updating the knowledge and skills of general practitioners (GPs). To optimize the adoption of eCME and develop efficient and cost-effective eCME programs, factors explaining GPs' intention to use eCME must first be elucidated. Methods: Using the Theory of Planned Behavior as a framework, we developed a questionnaire and administered it to GPs in seven CME seminars in Isfahan, Iran, in 2014. Three domains of GPs' intention to use eCME were measured: attitudes, perceived behavioral control, and subjective norms. We used linear and logistic regression to identify the main predictors of intention and behavior. Results: GPs who had high score in perceived behavioral control and a more positive attitude toward e-learning had a higher intention to adopt it for CME. In contrast, subjective norms (eg, social pressures to use eCME) were not a predictor. Attitude toward usefulness of eCME was the main predictor of being an actual eCME user. Discussion: Perceived behavioral control and attitude constitute the main predictors of the intention to use eCME. Establishing discussions forums and strengthening organizational support for eCME through an increased awareness among clinical superiors and CME managers would be expected to increase GPs' intention to use eCME.
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| 7. |
- Hopwood, Nick, et al.
(author)
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Three Principles Informing Simulation-Based Continuing Education to Promote Effective Interprofessional Collaboration: Reorganizing, Reframing, and Recontextualizing
- 2020
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In: Journal of Continuing Education in the Health Professions. - : LIPPINCOTT WILLIAMS & WILKINS. - 0894-1912 .- 1554-558X. ; 40:2, s. 81-88
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Journal article (peer-reviewed)abstract
- Introduction: Shoulder dystocia is a complex birth emergency where patient outcomes remain a concern. This article investigates the detailed processes of simulation-based continuing education in a hospital where evidence over 10 years demonstrates improvements in practitioner knowledge, enacted practices, and maternal and child outcomes. Methods: Data were collected by video recording teams participating in a shoulder dystocia simulation and debrief. Analysis combined grounded thematic development with purposive coding of enactments of a relevant protocol (the ALSO HELPERR). Results: Three themes were identified (three Rs) that capture how effective interprofessional collaboration is promoted through collectively oriented reflection: Reorganizing roles and responsibilities between team members; Reframing the problem of shoulder dystocia from individuals correctly following a protocol, to a team of professionals who need to attune to, respond to, and support one another; and Recontextualizing by collectively "commingling" theoretical knowledge with practical experience to reflect on actions and judgements. Discussion: The three Rs are relevant to diverse clinical settings and address gaps in knowledge relating to the process of interprofessional simulation. Together, they constitute a set of principles to inform the design and conduct of continuing education for interprofessional practice through simulation.
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| 8. |
- Stevenson, Katherine, et al.
(author)
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From Theory to Practice : The Enacted Curriculum of a Successful Master's Program in Quality Improvement and Leadership
- 2023
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In: Journal of Continuing Education in the Health Professions. - : Lippincott Williams & Wilkins. - 0894-1912 .- 1554-558X. ; 43:4, s. 234-240
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Blended learning has taken on new prominence in the fields of higher and continuing education, especially as programs have shifted in response to teaching in a global pandemic. The faculty at the Jönköping Academy's Masters in Quality Improvement and Leadership program has been offering a blended learning curriculum, based on four core design principles, since 2009. We studied key features of the enacted curriculum to understand conditions that can support an effective blended learning model. METHODS: We used a case study approach underpinned by interactive research. Document analysis, a focus group, individual interviews, and stimulated recall interviews were used for data collection. Themes were identified through qualitative content analysis and data reduction, data display, and conclusion drawing. RESULTS: We grouped data into six emergent themes that clarify the enacted curriculum of an established Master's program: focusing on a common purpose, developing technical and relational knowledge and skills, linking theory and practice in the workplace, leveraging collaboration for mutual benefit, concentrating on leadership and coaching, and applying a blended and interprofessional learning model. CONCLUSION: Educators faced with increased demands to be flexible and to offer opportunities for distance education can learn from this case example of effective teaching of quality improvement and leadership in a blended format.
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| 9. |
- Tamas, Eva, et al.
(author)
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Closing the Gap : Experienced Simulation Educators' Role and Impact on Everyday Health care
- 2019
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In: Journal of Continuing Education in the Health Professions. - : Lippincott Williams & Wilkins. - 0894-1912 .- 1554-558X. ; 39:1, s. 36-41
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Trained simulation educators (SEs) usually work both at simulation centers and in everyday health care, and thus, they possess dual expertise. Experienced SEs are known to grow confident with their expanding experience, but evidence is scarce about how this affects their development as clinical professionals. The aim of this study was to explore how experienced SEs describe their role within the context of everyday health care.METHODS: An explorative descriptive study including 14 semistructured interviews and 27 questionnaires was conducted with 41 experienced SEs. An inductive thematic analysis was used to identify and analyze patterns describing SEs' perceptions of the influence of their educational work on everyday health care.RESULTS: The SEs' descriptions of their encounters during everyday clinical work, which were affected by the fact that they had experience of facilitating simulation training, were gathered into three main themes with three of their own subthemes: education (educational needs, routines/guidelines, and being a resource), nontechnical skills (communication, feedback, and leadership/coworkership), and clinical proficiency (situational insight, role model, and confidence in clinical practice). The insights gained and actions taken as clinical professionals are all intended to be implemented with the ultimate aim of safe patient care.DISCUSSION: All the aspects of the SEs' work are perceived to be successfully translated into clinical practice and can be summarized by the main themes of education, nontechnical skills, and clinical proficiency as delineated by this study. These themes are demonstrated at the individual, team, and organizational levels through increased competence and confidence.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
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| 10. |
- Vallo Hult, Helena, 1976-, et al.
(author)
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Digitalization and Physician Learning : Individual Practice, Organizational Context, and Social Norm
- 2020
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In: Journal of Continuing Education in the Health Professions. - : Wolters Kluwer. - 0894-1912 .- 1554-558X. ; 40:4, s. 220-227
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Journal article (peer-reviewed)abstract
- INTRODUCTION: The emerging context of online platforms and digitally engaged patients demands new competencies of health care professionals. Although information and communication technologies (ICTs) can strengthen continuous professional development (CPD) and learning at work, more research is needed on ICT for experiential and collegial learning.METHODS: The study builds on prior qualitative research to identify issues and comprises a quantitative assessment of ICT usage for learning in health care. A survey was administered to Swedish physicians participating in a CPD program as part of specialist medical training. Conclusions focused specifically on learning dimensions are drawn from correlation analyses complemented with multiple regression.RESULTS: The findings show that physicians' actual use of ICT is related to perceived performance, social influence, and organizational context. Social norm was the most important variable for measured general usage, whereas performance expectancy (perceived usefulness of ICT) was important for ICT usage for learning. The degree of individual digitalization affects performance and, in turn, actual use.DISCUSSION: The study highlights the need to incorporate ICT effectively into CPD and clinical work. Besides formal training and support for specific systems, there is a need to understand the usefulness of digitalization integrated into practice. Moving beyond instrumentalist views of technology, the model in this study includes contextualized dimensions of ICT and learning in health care. Findings confirm that medical communities are influencers of use, which suggests that an emphasis on collegial expectations for digital collaboration will enhance practitioner adaptation.
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