European CME/CPD

The Transformative Learner
By Helena Prior Filipe, MD, MMEd

This column aims to generate a conversation on how continuing education and practice development is currently viewed and developed around the world, especially through the lens of the educator. We will acknowledge a variety of experiences and systems of continuing professional development (CPD) to support healthcare professionals’ (HCP) lifelong learning.

In the medical education continuum, CPD is the longest and most heterogeneous educational stage spanning diverse educational systems, regulation and organizational structures. CPD embraces an intricate and complex network of stakeholders with unique perspectives and interests to ultimately converge to the best patients’ outcomes and community well-being. Accreditation systems should effectively operationalize CPD best practices and meet the need to create and conduct learning experiences with educational and clinical impact. Cultural differences and available resources to address regional healthcare teams and population healthcare needs has generated a global variety of CPD approaches. Substantive equivalency on a set of core accreditation standards was drawn to respond to the growing mobility of HCP and patients, demographic change, high societal expectations and medical knowledge and technology progression. (1)

Continuing education, classically delivered in bursts has leapt from the conference hall into the professionals’ daily flow of work to meet the professionals continuing emerging learning needs, manage the huge amount of ever newer medical information, stay current and provide quality care. The concept of continuing learning environments has evolved to encompass personal, social, physical and virtual spaces and organizational components. (2) Focusing the best patients’ outcomes and community health, HCP and teams can actively create their continuing learning environments and may involve technology as a partner. Individuals and teams co-work as members of a community of practice by sharing common practice and mutual goals, engage in seeking, sharing and developing knowledge for professional growth. Successful communities of practice provide their members a safe place to develop peer to peer conversations, reflect on practice dilemmas and offer opportunities for higher levels of learning and transformative action. These communities may blossom in the workplace and benefit from a virtual support.

The new learner should be capable and self-efficacious to creatively apply previous experiences and competence in novel situations. Master adaptive learners engage in self-regulated learning, develop critical thinking and lead a reflective practice. (3) Self-determined learners learn how to develop transformative action practicing meaningful reflection. They can find an interesting ally in the semantic web, that pushes customized educational resources to create their personal learning environments. (4) Although technology can scaffold learning at a global reach, meaningful learning outcomes derive form the combination of several factors as implementation, context, and learner characteristics interacting with technology (5)

As the CPD discipline has excitingly been evolving, uniquely propelled by the global pandemic, CPD educators are challenged to evolve their roles and responsibilities with a growing mindset in a rapid changing landscape. We wonder about educators’ needs to master adaptative leadership and mentoring, artificial intelligence, data mining, evidence informed medicine literacy and technology based learning formats (microlearning, simulation and virtual reality…); to merge continuing education with quality improvement and patient involvement embedded in daily work…; how organizations will assume leadership in effectively supporting clinical practice and medical education merge and nurture a continuing learning environment culture at the workplace; how organizations will endorse a collegial, experiential, and reflective lifelong learning with participatory community representation (6) to promote quality of care; how CPD systems’ diversity will globally reach an effective mutual agreement allowing for a reliable evaluation of systems, programs and workforce and advance robust research in CPD.

We hope these few thoughts will trigger an enjoyable collective dialogue on furthering leadership in CPD and inspire innovative educational strategies by reviewing evidence and experience to advance CPD research and scholarship.

Acknowledgements to:

John Parboosingh for the opportunities to always learn from our interaction and good conversations.  AMEE CPD committee, especially to Amy Wolfe, for her leadership liaising the AMEE CPD SIG and the AMEE CPD Committee. 

Helena Prior Filipe, MD, MMEd, is a consultant in the College of Ophthalmology of the Portuguese Medical Association International Council of Ophthalmology, University of Lisbon, Portugal.

References

1. McMahon, G. T., Aboulsoud, S., Gordon, J., McKenna, M., Meuser, J., Staz, M., & Campbell, C. M. (2016). Evolving Alignment in International Continuing Professional Development Accreditation. Journal of Continuing Education in the Health Professions, 36, S22–S26. doi:10.1097/ceh.0000000000000075 
2. Gruppen LD, Irby DM, Durning SJ, Maggio LA. Conceptualizing Learning Environments in the Health Professions. Acad Med. 2019;94(7):969-974. doi:10.1097/ACM.0000000000002702
3. Cutrer, W. B., Miller, B., Pusic, M. V., Mejicano, G., Mangrulkar, R. S., Gruppen, L. D., … Moore, D. E. (2017). Fostering the Development of Master Adaptive Learners. Academic Medicine, 92(1), 70–75. doi:10.1097/acm.0000000000001323 
4. Blaschke, L. M. (2012). Heutagogy and lifelong learning: A review of heutagogical practice and selfdetermined learning. The International Review of Research in Open and Distance Learning, 13(1), 56-61. Retrieved from http://www.irrodl.org/index.php/irrodl/article/view/1076/2087
5. Means, B., Bakia, M., & Murphy, R. (2014). Learning online: What research tells us about whether, when and how. ISBN 9780415630290. Routledge
6. Frankford DM, Patterson MA, Konrad TR. Transforming practice organizations to foster lifelong learning and commitment to medical professionalism. Acad Med. 2000;75(7):708-717. doi:10.1097/00001888-200007000-00012