1. Continuing Education (Participant and Provider) in the Department of Medicine Mary J. Bell, MD, MSc, FRCPC Associate Professor of Medicine Director of Continuing Education Department of Medicine, University of Toronto, Toronto, Canada

2. At the end of this presentation participants will: Analyze the Maintenance of Certification template Assess steps involved in Accredited Rounds as an attendee, presenter, and organizer. Consider continuing professional development strategies through personal learning projects, faculty development and educational research opportunities.

3. Sections of Maintenance of Certification SectionCredit/hr.Maximum 1. Accredited Group ActivitiesOneNo max 2. Other (non-accredited) ActivitiesOne100/5yr cycle 3. Self AssessmentTwoNo max 4. Structured Learning ProjectsOneNo max 5. Personal Practice ReviewTwoNo Max 6. Personal Education Development OneNo Max Report annually by Jan 31 with the Royal College at www.mainport.orgwww.mainport.org

4. Documentation of Maintenance of Certification SectionDoc. Requirements 1. Accredited Group ActivitiesAttendance Record 2. Other (non-accredited) ActivitiesNone (Gift) 3. Self AssessmentDocumented learning outcomes 4. Structured Learning ProjectsDocumented learning outcomes 5. Personal Practice ReviewDate, findings & documented learning outcomes 6. Personal Education DevelopmentTeaching Dossier or Annual Report &/or documented learning outcomes File annually with the Royal College website by Jan 31

5. What strategy is most likely to change physician performance? Formal Didactic Conferences Multi-faceted Interventions Audit and Feedback Reminders Patient Mediated Interventions Opinion Leader Training

6. Impact of Formal Continuing Medical Education Davis et al JAMA ‘99 14 studies/17 interventions 9/17 changes in practice 3/4 altered health care outcomes * Only interactive and mixed educational sessions (practice skills) can effect change in practice and on occasion health care outcomes Didactic sessions do not appear to be effective in changing physician performance

7. Changing Physician Performance (Davis et al JAMA ‘95) Study Selection-Random-controlled trials 50% or more physicians/residents Assess physician performance and/or health care outcomes (HCO) Data Synthesis 99 trials/160 interventions 101/160 improvement 70% change physician performance 48% HCO positive change

8. Educational Strategies (Davis, et al ‘95) EffectiveReminders Patient-mediated interventions Outreach visits Opinion leaders ***Multi-faceted activities Less EffectiveAudit with feedback Educational materials Little ImpactFormal conferences without enabling/ reinforcing strategies

9. Accredited Educational Activities ***Series of Events Planning committee / Needs Assessment Objectives-Circulated 25% interactive Evaluation Records *** Annual or one time events are accredited through the National Specialty Societies, or University Faculty Continuing Education Offices

10. Goals and Objectives GOAL: General statement of purpose OBJECTIVES: More precise, measurable A.Starts with “By the end of rounds participants will:” B.Use an action verb to communicate performance C.Finish with the specifics of what the learner will achieve (measure outcomes).

11. Dept of Medicine CE Evaluation Objectives, Outline Knowledge of topic Clear, Organized Stimulated Enthusiasm Appropriate level Clear visuals Effective Style 25% Interactive Good Rapport Audience Invited participation Individual items were validated to the overall evaluation of the presenter Rothman AI, Sibbald G. Evaluating Medical Rounds. The Journal of Continuing Education in the Health Professions 2001 Spring; 22(2):77-83.

12. Accredited Rounds Presentations (54,560 Forms)

13. CHE vs. Continuous Professional Development (CPD) CriteriaCHE-AccreditationCPD-Personal Learning Project FocusFacilitatorLearner LocationClassroomWorkplace ContentNeeds assessment /facilitator Situational- determined by practice /patients RelevanceVariableRelates to day to day activities Change behavior /outcomes Unlikely without enabling or reinforcing strategies Will confirm current activities, change practice or require more information

14. Structured Learning Projects Learning issue Stimulus to inquiry Learning resources used Outcome decisions Change of Practice Validates Current Practice Need more information References (or attached from search) Personal notes. MOC will likely be Linked to revalidation in Ontario

15. Faculty Continuing Education Office Course- Accreditation, Management Knowledge Translation Program Center for Faculty Development Ontario Guidelines Advisory Committee Public Education (Mini Meds School, Health News) Center for e Health and Innovation

16. Performance Assessment Domains Patient care Expertise Personal management Knowledge transfer into practice Continuous Professional Development System or environment managers Communities of Practice Hayes…Sibbald et al Medical Education Oct 2002

17. Linking Continuing Education to Graduate Education Proposed Masters Applied Public Health Science (MAPHS) Flexible Time Self Funding 5 courses- education, public health sciences, subspecialty expertise Practicum, Electives

18. Educational Research Opportunities Divisional Accredited Rounds Personal Learning Projects and their integration into Accredited Rounds Knowledge Translation Program E-Health and Distance Education Programs Pilot Project Seed Funding-Faculty and Department CE

19. At the end of this presentation participants will: Analyze the Maintenance of Certification template Assess steps involved in Accredited Rounds as an attendee, presenter, and organizer. Consider continuing professional development strategies through personal learning projects, faculty development and educational research opportunities.