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The Best Technology for Professional Learning - Chris Graf
- 1. The best technology for professional learning Chris Graf, Editorial Director Wiley, Health Sciences, Melbourne 1 March 2012
- 2. wileyprolearning.wordpress.com #pdmelb
- 4. Agenda • Solving problems: Users, regulators • USA, Canada • Australia: Where next? • My opinion: The best tech for pro learning – Community – Connected – Clever • What’s your opinion?
- 5. Put users at the centre A not very systematic review: What users report as barriers to completing continuing professional development
- 6. • Halkett GKB et al. Continuing professional development: Western Australian radiographersʼ opinions and attitudes. The Radiographer Volume 58 (2) 2011:19-24. http://www.minnisjournals.com.au/articles/sholer%20radiographer%20june%202011.pdf • An investigation into the participation and attitudes of dental technicians in Wales towards continuing professional development. Iola H. Ellis. Vital 7, 29 - 33 (2010) Published online: 26 November 2010. doi:10.1038/vital1285. http://www.nature.com/vital/journal/v7/n5/full/vital1285.html • Northwestern University Feinberg School of Medicine (FSM) Educational Professional Development Needs Assessment http://educationinmedicine.northwestern.edu/academy/projects/needs-assessment.html • T.C. Brown, Martin McCracken, (2009). Building a bridge of understanding: How barriers to training participation become barriers to training transfer. Journal of European Industrial Training, Vol. 33 Iss: 6, pp.492 – 512 http://www.emeraldinsight.com/journals.htm?articleid=1805761&show=html • Citation: Hundley VA, Tucker JS, van Teijlingen E, Kiger A, Ireland JC, Harris F, Farmer J, Caldow JL, Bryers H. Midwives' competence: is it affected by working in a rural location? Rural and Remote Health 7: 764. (Online) 2007. www.rrh.org.au/articles/showarticleeuro.asp?ArticleID=764 • Fiona French, Jane Andrew, Morag Awramenko, Helen Coutts, Linda Leighton-Beck, Jill Mollison, Gillian Needham, Anthony Scott, Kim Walker, (2005) General practitioner non-principals benefit from flexible working, Journal of Health Organization and Management, Vol. 19 Iss: 1, pp.5 – 15 http://www.emeraldinsight.com/journals.htm?articleid=1463385&show=html • Shifting the Curve: Building a Stronger Future for Texas Children http://earlylearningtexas.org/umbraco/plenary
- 7. • Halkett GKB et al. Continuing professional development: Western Australian radiographersʼ opinions and attitudes. The Radiographer Volume 58 (2) 2011:19-24. http://www.minnisjournals.com.au/articles/sholer%20radiographer%20june%202011.pdf • An investigation into the participation and attitudes of dental technicians in Wales towards continuing professional development. Iola H. Ellis. Vital 7, 29 - 33 (2010) Published online: 26 November 2010. doi:10.1038/vital1285. http://www.nature.com/vital/journal/v7/n5/full/vital1285.html • Northwestern University Feinberg School of Medicine (FSM) Educational Professional Development Needs Assessment http://educationinmedicine.northwestern.edu/academy/projects/needs-assessment.html • T.C. Brown, Martin McCracken, (2009). Building a bridge of understanding: How barriers to training participation become barriers to training transfer. Journal of European Industrial Training, Vol. 33 Iss: 6, pp.492 – 512 http://www.emeraldinsight.com/journals.htm?articleid=1805761&show=html • Citation: Hundley VA, Tucker JS, van Teijlingen E, Kiger A, Ireland JC, Harris F, Farmer J, Caldow JL, Bryers H. Midwives' competence: is it affected by working in a rural location? Rural and Remote Health 7: 764. (Online) 2007. http://www.rrh.org.au/articles/showarticleeuro.asp?ArticleID=764 • Fiona French, Jane Andrew, Morag Awramenko, Helen Coutts, Linda Leighton-Beck, Jill Mollison, Gillian Needham, Anthony Scott, Kim Walker, (2005) General practitioner non-principals benefit from flexible working, Journal of Health Organization and Management, Vol. 19 Iss: 1, pp.5 – 15 http://www.emeraldinsight.com/journals.htm?articleid=1463385&show=html • Shifting the Curve: Building a Stronger Future for Texas Children http://earlylearningtexas.org/umbraco/plenary
- 14. Proposition • Culture: We can change • Money: We can find • Time: We need to make
- 15. Will technology provide as good a learning experience as trad methods?
- 16. Institute of Medicine • Well-designed e-learning courses can be as good as or better than traditional learning methods Redesigning Continuing Education in the Health Professions Committee on Planning a Continuing Health Professional Education Institute Institute of Medicine http://www.nap.edu/catalog.php?record_id=12704
- 17. Institute of Medicine • Electronic data collection • Simulation • Population data • Mentoring • Social networking Redesigning Continuing Education in the Health Professions Committee on Planning a Continuing Health Professional Education Institute Institute of Medicine http://www.nap.edu/catalog.php?record_id=12704
- 18. Redesigning Continuing Education in the Health Professions Committee on Planning a Continuing Health Professional Education Institute; Institute of Medicine http://www.nap.edu/catalog.php?record_id=12704
- 19. Practice metrics Learning Practice intervention standards Performance gaps
- 20. USA Healthcare reform Electronic Records, Prescribing The Third Wave
- 21. US healthcare is under pressure Thanks for the slides, • Center stage in healthcare reform: – Quality measurement – Performance measurement Medicare / Insurers Providers / Systems Patients / Employers
- 22. Meanwhile… Thanks for the slides, The First Wave The Second Wave CME 2.0…The Third Wave “Bums in Seats” “Learning Outcomes” “Convergence with Quality” Extreme Forces in Support of Quality, Safety & Value are Forging the Continuous Learning Health System & need for Continuous •Focus on Learning Performance Improvement Outcomes •Dinner Meetings •MOC, MOL & OPPE •Welcome to •Value Based Purchasing •Online CME Maintenance of •Comparative Effectiveness Certification •Medicare Advantage Stars •Satellite Symposia •Physician & Hospital Compare •Welcome to cyclical •National Priorities Partnership •Journal Articles Performance •Care Coordination Improvement-CME •ACO and P4P •REMS and more… 2000 2004 2010 2013 2015 Note: Waves 1 and 2 persist but at reduced levels
- 23. Canada
- 24. CanMEDS, Royal College Physicians and Surgeons of Canada http://www.royalcollege.ca/public/resources/aboutcanmeds Image from http://qualitysafety.bmj.com/content/19/Suppl_2/i34.full
- 25. Australia
- 27. Surgical Audit and Peer Review, a Guide by the Royal Australasian College of Surgeons http://www.surgeons.org/media/310877/surgical_audit_peer_review.pdf
- 28. Supporting Physicians’ Professionalism and Performance (SPPP), Royal Australasian College of Physicians http://www.racp.edu.au/page/sppp
- 29. The best technology for professional learning would be… In my opinion
- 30. For the community • Made for professional learning • Learning management tools
- 31. Connected a Data Data Data Data Data Data Data Da
- 32. Clever • Content management, course development • Delivery platform – customizable for distinct audiences – sufficiently robust, future-proof • Audience management • Compliant with regulations
- 34. Activities
- 35. Curricilums
- 36. Practice metrics Social Learning Practice intervention standards Performance Adaptive gaps
- 37. What’s your opinion? Chris Graf, Editorial Director +61 3 9274 3142 cgraf@wiley.com
Editor's Notes
- These designers made a really nice looking pressure gauge But they clearly have no firearms domain knowledge My domain is medical journal publishingLast 6 months realised that just one third of the company Iwork for is a journal publishing company – the remaining two third could easily be described as a learning company.This presentation is about what I’ve learned in those 6 monthsThe best tech for professional learning… Depends on the environment, the domainDomain knowledge – this is mostly about healthcare– It may apply elsewhere – but be warned!So start with discussion about the environmentUsersRegulators: USACanadaAustralia
- Workflow analysis – find people’s problems by watching what they doUser Centred Design – built products that fit around how users behaveMethodsGoogle images search“barrier continuing professional development”Not limited to healthcare
- The results I found in that search
- What follows is what these papers reported as barriers to completing CPDie Problems that need to be solved from users’ perspectives
- Published in 2011Radiographers, WA192 questionnaires were returned. A response rate of 64%
- Published 2010Dental technicians, WalesSent to all (n = 258). Response rate was 83 (32.1%)Four of the responses were incomplete, leaving 79 for analysis.27.8% stated that they find it difficult to keep up-to-date with gaining CPD hours The barriers affecting them keeping up-to-date are shown
- Conducted summer 2011, individuals involved in teaching at the Feinberg School of Medicine,Chicago, 288 people responded
- Published 2009, Canadian employees, mostly from the broader public sector, 137 responses
- Published 2007, Midwives, rural (R), urban (U) Scotland, 82 midwives remote and rural areas,107 midwives urban hospitals
- Proposition: Culture – we can change; regulations may have got there first and required changeMoney – we can find (can we?)Time – we need to make … that’s where tech comes inBut will tech provide as good learning experience as traditional?
- IOM of the National AcademiesPublished 2010Well-designed e-learning courses can be as good as or better than traditional learning methods for individual practitioners, as measured by learner satisfaction, knowledge retention, and even skills acquisition
- Electronic data collection help clinicians analyze practice patterns, identify performance gapsSimulationCase scenarios High fidelity mannequins Computer modelling of a population of patients (infectious disease management or hospital patient flow)Population data -- health professionals get health outcomes of patients they treatedElectronic health records Personal health recordsOnline mentoring at the point of care (clinician learns from the consultant) can be used to enhance learningSocial networking:Twitter and FacebookProfessionals communicate, collaborate, share with each other and public Promise of social networking cannot be ignored, should be embraced
- The IOM stated ambition:Close research–practice gapsfor healthcare professionals and continuing education professionals
- My simpler version of that (which you’ll see again later)That’s ‘user’ problems identified, and strong arguments thatTechnology can provide as good or better learning experiencesBut political and regulatory pressure also shapes things
- Thanks for the slides Simone Karp at CE CityValue Based PurchasingMedicare Rating: 33 measures hailing from 5 different rating systems, ties federal reimbursement rates for insurance carriers administering Medicare Advantage products to performanceHealth Insurance Quality Improvement NetworksProvider EngagementAccountable Care Organisations: ties provider reimbursements to quality metrics and reductions in the total cost Medicare Hospital VBP‘Never’ EventsNever events are inexcusable outcomes in a health care setting. The initial list of 28 events was compiled by the National Quality Forum of the United Statespay for performance, Pay-for-reporting (Electronic Prescribing Incentive Program, Physician Quality Reporting Initiative/System)‘Meaningful’ Use of Electronic health records, incentivisedLicensure (MOL), Certification (MOC), Credentialing (OPPE Ongoing Professional Practice Evaluation)TransparencyPatient Impact on Payment (Surveys)Patient Impact on Quality & Cost (Adherence, Education, etc)Patient Participation in CareREMS Risk Evaluation and Mitigation Strategy
- A little further north
- early 1990s The Royal College: competency-based framework (rather than a knowledge-based framework)CanMEDSSeven roles that lead to optimal health and health care outcomes: medical expert (central role), communicator, collaborator, manager, health advocate, scholar and professional.The model has been adapted around the world in the health profession and other professions.
- Similar political environmentlegislation Tech – HER, MyCPD
- Performance linked Professional Development AtRACSSurgical audit and peer reviewMEDICAL EXPERTISETECHNICAL EXPERTISECLINICAL DECISION MAKINGWith CPD from RACSCOMMUNICATIONCOLLABORATIONMANAGEMENT and LEADERSHIPHEALTH ADVOCACYSCHOLAR and TEACHERPROFESSIONALISM
- RACP Supporting Physicians' Professionalism and Performance (SPPP)Help Fellows and trainees reflect on practice, performance Identify areas of strength + opportunities for learning,Structure based on Surgical Competence and Performance Guide from RACS9 areas of focus – professional qualities CompetenciesLEAP framework -- Learning, Education And ProfessionalismRANZ College of Obstetrics and Gynaecology Clinical Expertise, Risk Management, Professional Values and ResponsibilitiesStrands subdivided into ten ‘Components’ of professionalismThree levels of professional development activity: Level 1 – skills and knowledge Level 2 – Change facilitating Level 3 – Change evaluatedCanMEDS
- SoUSERS at the centreWe think tech can provide good solutionsThe world has provided some excellent toolsWhat makes best tech?
- Developed expressly for professional learning (different from higher education)Focus less on instructor, and instructor–student interactionFocus more on storage, retrieval, and delivery of relevant content(see Mark Levings poster)Learning management tools end-user to track progress store/retrieve certificates/recordsSelf-assessment functionalityincorporating adaptive learning capabilities;Connects learning activity (online, or offline) with e-portfolio or record (egMyCPD)Perhaps with performance record ?AND maybe with practice metrics?Adaptive learningAdaptive learning is an educational method which uses computers as interactive teaching devices. Computers adapt the presentation of educational material according to students' weaknesses, as indicated by their responses to questions. The motivation is to allow electronic education to incorporate the value of the interactivity afforded to a student by an actual human teacher or tutor. The technology encompasses aspects derived from various fields of study including computer science, education, and psychologyhttp://en.wikipedia.org/wiki/Adaptive_learning
- For Colleges, Societies, Associations, Regulators, Employers like hospitals… health systemsCollect and share dataReal -time upload to third-party data-gathering organizations (e.g., MyCPD); Real-time reporting tools, and the ability to enable administrative privileges to third-party partners and clients, allowing them to pull standard and customizable reports on participation, success rates, user data, etc.; andQuality/Performance Improvement (QI/PI) management programs (which are of particular relevance to US physicians currently), providing applications for healthcare organizations to design and execute their own QI/PI initiatives and document results;
- For creators and providersContent, course management: Plan develop administer -- collaborativelyDELIVERY PLATFORMActivity delivery and portal administration, Rapid, customized learning environments for different professions, specialties, and societies or organizations. Content delivery in all existing formats (text, image, video, and audio)Automated or a manual/automated mix of content tagging and indexing, utilizing emerging integration technology standards.Use, re-use, deliver, re-deliver -- efficientAudience managementdemographic information storage and retrieval, simplifying engagement/marketing activitiesCompliance management tools (regulatory), virtual back-office (needs assessment, measure outcomes, record transparency, and capture compliance data)
- Continuation of clever! Sophisticated, robust, highly capable technology at the back end; Great people with strong editorial skillsJoin learning activities with performance record ?AND with practice metrics?PlanningCollaborative project management across organisationsActivity developmentFaculty managementResource centreLearning objective database (linked with outcomes measures)Needs assessment database; Assessment designer, details, retrieval indexActivity deliveryConvenient for community; Saves them timeContent that covers technical, professional skills Ability to link with performance improvement (adaptive) now or in the futureProcess activities Outcome reporting by activity, provider, faculty, level of outcomeImport data for offline activitiesBy participant, activity, print/send awardsOutcome driven future needs assessmentReportingData feeds, automated
- CPD activities
- Learning programmes … Maintenance of Certification and Re-certification-readyDesigned to look and feel like an extension of YOUR websiteLearning and Performance Improvement Activities can be Linked to the Recognition Tracking /ePortfolio systemePortolio and Recognition Tracking System to track and manage Certification and Maintenance of Certification process for their Fellows/ DiplomatesLink to CQI modules for Continuous Quality Improvement from the Recognition system to fulfill the requirement
- Ready for the next stage… PERFORMANCE IMPROVEMENT CME PI-CMESophisticated, capable technology to do that… and a great team to work itSocial learning: Peer comparison; peer networksAdaptive learning: Continuous feedback loopsTriple Aim – to improve healthcare COST; OUTCOME; SATISFACTION3Cs… Community, Connected, Clever