Pivoting Continuing Professional Development During the COVID-19 Pandemic: A Narrative Scoping Review of Adaptations and Innovations.

Introduction: Most formal continuing professional development (CPD) opportunities were offered in person until March 2020 when the COVID-19 pandemic disrupted traditional structures of CPD offerings. The authors explored the adaptations and innovations in CPD that were strengthened or newly created during the first 16 months of the pandemic.

Methods: The objectives of the narrative review were to answer the following questions: (1) what types of adaptations to CPD innovations are described? and (2) what may shape future innovations in CPD? The following databases were searched: Medline, Embase, CINAHL, and ERIC to identify the literature published between March 2020 to July 2021.

Reimagining Physician Development and Lifelong Learning: An Ecological Framework.

Learners and leaders in medical education recognize the remarkable growth in clinically relevant information, persistent changes in the organization of health care, and the need to develop physicians able to adapt successfully to changes in their lives and practices. The success of those physicians and of those who facilitate their learning depends on a careful understanding of the psychological, social, and biological factors that influence physician development and lifelong learning. To improve research and policy, development and learning must be explored for finer understandings of physicians in relation to other beings and to the physical and social surroundings most conducive to better learning and outcomes.

Development of a Framework to Describe Functions and Practice of Community Health Workers.

There is evidence to support the effectiveness of community health workers (CHWs), as they practice in a wide range of health care settings; yet, the perceived value of CHWs suffers from a lack of uniform credentialing and from a dearth of billing and payment structures to recognize their individual work. In turn, credentialing and billing for the work of CHWs is hampered by widely variable regulation, conflicting job titles and position descriptions, and general confusion about CHW identity, sometimes complicated by service boundaries that overlap with those of other health care and social service occupations. This article presents evidence from a rapid review of the CHW literature from 2003 to 2018.

An Interprofessional Quality Improvement Training Program That Improves Educational and Quality Outcomes.

A key component of quality improvement (QI) is developing leaders who can implement QI projects collaboratively. A yearlong interprofessional, workplace-based, continuing professional development program devoted to QI trained 2 cohorts of teams (dyads or triads) to lead QI projects in their areas of work using Plan-Do-Study-Act methodology. Teams represented different specialties in both inpatient and outpatient settings.

Predictors of Emergent Emergency Department Visits and Costs in Community-Dwelling Older Adults.

Background: The number of yearly emergency department (ED) visits by older adults in the United States has been increasing.

Purpose: The objectives were to (1) describe the demographics, health-related variables, and ED visit characteristics for community-dwelling older adults using an urban, safety-net ED; (2) examine the association between demographics, health-related variables, and ED visit characteristics with emergent vs nonemergent ED visits; and (3) examine the association between demographics, health-related variables, ED visit characteristics, and ED visit costs.

Methods: A cross-sectional, retrospective analysis of administrative electronic medical record and billing information from 2010 to 2013 ED visits (n = 7805) for community-dwelling older adults (⩾65 years old) from an academic medical center in central Virginia was conducted.

Interprofessional practice in different patient care settings: A qualitative exploration.

Increasing interprofessional practice is seen as a path to improved quality, decreased cost, and enhanced patient experience. However, little is known about how context shapes interprofessional work and how interventions should be crafted to account for a specific setting of interprofessional practice. To better understand, how the work of interprofessional practice differs across patient care settings we sought to understand the social processes found in varying work contexts to better understand how care is provided.

Low-Income Senior Housing Residents' Emergency Department Use and Care Transition Problems.

Older adults may be at risk of adverse outcomes after emergency department (ED) visits due to ineffective transitions of care. Semi-structured interviews were employed to identify and categorize reasons for ED use and problems that occur during transition from the ED back to home among 14 residents of low-income senior housing. Qualitative thematic and descriptive analyses were used.

Classifying publications from the clinical and translational science award program along the translational research spectrum: a machine learning approach.

Background: Translational research is a key area of focus of the National Institutes of Health (NIH), as demonstrated by the substantial investment in the Clinical and Translational Science Award (CTSA) program. The goal of the CTSA program is to accelerate the translation of discoveries from the bench to the bedside and into communities. Different classification systems have been used to capture the spectrum of basic to clinical to population health research, with substantial differences in the number of categories and their definitions.

Dissemination of Evidence From Systematic Reviews Through Academic CME Providers: A Feasibility Study.

Introduction: Although systematic reviews represent a source of best evidence to support clinical decision-making, reviews are underutilized by clinicians. Barriers include lack of awareness, familiarity, and access. Efforts to promote utilization have focused on reaching practicing clinicians, leaving unexplored the roles of continuing medical education (CME) directors and faculty in promoting systematic review use.

The effects of power, leadership and psychological safety on resident event reporting.

Context: Although the reporting of adverse events is a necessary first step in identifying and addressing lapses in patient safety, such events are under-reported, especially by frontline providers such as resident physicians.

Objectives: This study describes and tests relationships between power distance and leader inclusiveness on psychological safety and the willingness of residents to report adverse events.

Methods: A total of 106 resident physicians from the departments of neurosurgery, orthopaedic surgery, emergency medicine, otolaryngology, neurology, obstetrics and gynaecology, paediatrics and general surgery in a mid-Atlantic teaching hospital were asked to complete a survey on psychological safety, perceived power distance, leader inclusiveness and intention to report adverse events.

Training and Assessing Interprofessional Virtual Teams Using a Web-Based Case System.

Purpose: Today, clinical care is often provided by interprofessional virtual teams-groups of practitioners who work asynchronously and use technology to communicate. Members of such teams must be competent in interprofessional practice and the use of information technology, two targets for health professions education reform. The authors created a Web-based case system to teach and assess these competencies in health professions students.

Commitment to change and assessment of confidence: tools to inform the design and evaluation of interprofessional education.

Introduction: This study examines use of the commitment-to-change model (CTC) and explores the role of confidence in evaluating change associated with participation in an interprofessional education (IPE) symposium. Participants included students, faculty, and practitioners in the health professions.

Methods: Satisfaction with the symposium and levels of commitment and confidence in implementing a change were assessed with a post-questionnaire and a follow-up questionnaire distributed 60 days later.

An exploratory study of an assessment tool derived from the competencies of the interprofessional education collaborative.

Linking the outcomes from interprofessional education to improvements in patient care has been hampered by educational assessments that primarily measure the short-term benefits of specific curricular interventions. Competencies, recently published by the Interprofessional Education Collaborative (IPEC), elaborate overarching goals for interprofessional education by specifying desired outcomes for graduating health professions students. The competencies define a transition point between the prescribed and structured educational experience of a professional degree program and the more self-directed, patient-oriented learning associated with professional practice.

Evaluation and the NIH clinical and translational science awards: a "top ten" list.

Since 2006, a total of 61 Clinical and Translational Science Institutes (CTSAs) have been funded by the National Institutes of Health (NIH), with the aim of reducing translation time from a bench discovery to when it impacts patients. This special issue of Evaluation & the Health Professions focuses on evaluation within and across the large, complex system of the CTSA Program of NIH. Through insights gained by reading the articles in this special edition and the experience of the authors, a "top ten" list of lessons learned and insights gained is presented.

Are researcher development interventions, alone or in any combination, effective in improving researcher behavior? A systematic review.

Academic institutions funded by the Clinical and Translational Science Awards (CTSA) Program of the National Institutes of Health were challenged recently by the Institute of Medicine to expand traditional mentoring of graduate and postdoctoral scholars to include training and continuing education for faculty, professional staff, and community partners. A systematic review was conducted to determine whether researcher development interventions, alone or in any combination, are effective in improving researcher behavior. PubMed, CINAHL, and Education Research Complete databases and select journals were searched for relevant articles published from January 2000 through October 2012.

The effects of expanding primary care access for the uninsured: implications for the health care workforce under health reform.

The Patient Protection and Affordable Care Act seeks to improve health equity in the United States by expanding Medicaid coverage for adults who are uninsured and/or socioeconomically disadvantaged; however, when millions more become eligible for Medicaid in 2014, the health care workforce and care delivery systems will be inadequate to meet the care needs of the U.S. population.

Applying organizational science to health care: a framework for collaborative practice.

Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration.

Improving quality in systems of care: solving complicated challenges with simulation-based continuing professional development.

The delivery of quality health care depends on the successful interactions of practitioners, teams, and systems of care comprising culture. Designing educational programs to improve these interactions is a major goal of continuing professional development, and one approach for educational planners to effect desired changes is simulation-based education. Because simulation-based education affords an opportunity for educators to train health care professionals in environments that resemble clinical practice, this instructional method allows planners to integrate overarching priorities for improvement in health care practice with the training goals of individuals.

Patient safety attitudes and behaviors of graduating medical students.

As North American medical schools reformulate curricula in response to public calls for better patient safety, surprisingly little research is available to explain and improve the translation of medical students' knowledge and attitudes into desirable patient safety behaviors in the clinical setting. A total of 139 fourth-year medical students at Virginia Commonwealth University, School of Medicine, 96% of the 2010 graduating class, completed the Attitudes toward Patient Safety Questionnaire and a self-report of safety behaviors. The students were exposed to informal discussions of patient safety concepts but received no formal patient safety curriculum.

Measuring medical students' orientation toward lifelong learning: a psychometric evaluation.

Background: The principle of lifelong learning is pervasive in regulations governing medical education and medical practice; yet, tools to measure lifelong learning are lagging in development. This study evaluates the Jefferson Scale of Physician Lifelong Learning (JeffSPLL) adapted for administration to medical students.

Method: The Jefferson Scale of Physician Lifelong Learning-Medical Students (JeffSPLL-MS) was administered to 732 medical students in four classes.

Resources and studies are required to build knowledge on assessment, service, and health care.

The quality of continuing education in the health professions depends in part upon the success of educators in determining what clinicians need to know to improve practice. Studies are required to build knowledge of assessment, service, and the economies of health care education. All those interested in better systems of education and care must assure the availability of resources adequate to fulfill their primary obligations to improving practice.

Institute of Medicine recommends a continuing professional development institute for U.S. health professions.

A workforce of knowledgeable professionals is critical to the discovery and application of best health care practices; yet, today in the United States, the professional health workforce is not consistently prepared to provide safe, high-quality health care, even as the nation spends more per capita on health care than any other country. The Institute of Medicine recently recommended creation of a continuing professional development institute (CPDI) supported as a public-private initiative. The CPDI would coordinate and guide efforts that align: (a) content and knowledge among health professions; (b) regulation across states and national continuing professional development (CPD) providers; and (c) the financing of CPD, not only for improving professional performance and patient outcomes, but also for strengthening the scientific basis for the practice of CPD.

It is time to study the costs and benefits of regulating continuing medical education in the United States.

There is a dual system of continuing medical education (CME) accreditation in the United States, with developmental milestones dating back four decades. The Accreditation Council for Continuing Medical Education (ACCME) approves national providers of CME. State medical societies (SMS) approve intrastate providers.

Continuing medical education costs and benefits: lessons for competing in a changing health care economy.

Current approaches to evaluation in continuing medical education (CME) feature results defined as changes in participation, satisfaction, knowledge, behavior, and patient outcomes. Few studies link costs and effectiveness of CME to improved quality of care. As continuing education programs compete for scarce resources, cost-inclusive evaluation offers strategies to measure change and to determine value for resources spent.