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November 19, 2018 | 2:00 - 3:00 pm CT- REGISTER NOW

Title: The Role of CPD in Developing Leaders in Academic Health Care Systems


Richard I. Rothstein, MD
Joseph M. Huber Professor and Chair
Department of Medicine
Dartmouth-Hitchcock Medical Center
The Geisel School of Medicine at Dartmouth

Mary G. Turco, EdD, FSACME
Clinical Associate Professor of Medicine
Department of Medicine
Dartmouth-Hitchcock Medical Center
The Geisel School of Medicine at Dartmouth


Mila Kostic, CHCP, FACEHP
Director of Continuing Medical Education,
Perelman School of Medicine at the University of Pennsylvania
Co-Director of Interprofessional Continuing Education,
Penn Medicine

Session Overview:

Are you developing leaders for your academic health system, medical center or hospital? If so, how are you going about it? And, if not, why not? Are there challenges you face as you develop or deliver a Leadership Program? In this session, we will discuss the role of CPD professionals in developing leaders for the AHS, AMC or teaching hospital. With the chapter we authored (with Allison McHugh) in Continuing Professional Development in Medicine and Health Care: Better Education, Better Patient Outcomes titled “Learning to Lead in an Academic Health System” as pre-reading,  and a slide deck about Collective Competency theory by Lorelei Lingard and her colleagues as pre-viewing, we will discuss why it is imperative to help system leaders reflect on and train for what it takes to lead themselves, others, and healthcare teams effectively to today’s complex environments.  We will then discuss what you are doing or aspire to do, any barriers you may have encountered, and how to address them.  We will also give a short overview of the CPD Leadership Program we and Dartmouth-Hitchcock colleagues developed in 2015-16 and show examples of the institutional impact and genuine outcomes the Program is starting to generate. We hope you’ll join us.


At the end of the session, participants will be able to:

  • 1.      discuss concepts regarding leading yourself, others, and inter-professional health care teams
  • 2.      use a CPD focus to influence the design/redesign or development of a current or future Leadership Program
  • 3.      describe the elements of a Leadership program where participants are generating specific goals and outcomes that are based of their leadership  training


Turco, M., McHugh, A., Rothstein, R. (2018) Learning to Lead in an Academic Health System. In W. F. Rayburn, M. G. Turco, & D. A. Davis (Eds.), Continuing professional development in medicine and health care: better education, better outcomes (pp. 335-341). Philadelphia, PA: Wolters Kluwer.  

Lingard, L.  (PowerPoint) “Rethinking the Discourse of Competency in the Context of Teamwork” (with permission)


October 16, 2018 | 2:00 - 3:00 PM CT 

Title: Meaningful Involvement of Patients, Families and Caregivers in Continuing Professional Development

Presenter:  David Wiljer, PhD
Executive Director, Education Technology Innovation,
Associate Professor, Dept. of Psychiatry
University of Toronto

Facilitator: Curtis Olson, PhD, FSACME
Immediate Past Editor-in-Chief,
Journal of Continuing Education in the Health Professions
Assistant Professor, Department of Medicine,
Geisel School of Medicine at Dartmouth

Session Overview

Patients, families and caregivers involved in meaningful ways in better continuous professional development have the potential to improve care, resulting in the best outcomes. The focus of this discussion will be on understanding the diverse ways patients can be involved, and on exploring some particular considerations that may optimize meaningful involvement. Two key domains will be explored: 1) involving patients as partners and teachers in the continuing professional development of health professionals and in the improvement of quality, evidence-based care; and 2) improving the impact of CPD by activating patients through effective patient education.

This discussion will start from the assumption that patients and families should be involved in the lifelong learning cycle of health care professionals (HCPs).  As in the case study above, taking time to learn together with, for, and from patients and their families can enrich the clinical experience and professional growth. Working from this assumption, the discussion seeks to drive the conversation forward and ask the question, how do we meaningfully involve patients and families in the continuing professional development of health professionals to improve the quality of care that is delivered?


  1. Assess levels of involvement that contribute to meaningful involvement in health professions education
  2. Identify the potential roles of patients and service users and their families in health professional education
  3. Examine the role of patient education in developing effective health professional education


Wiljer, D. Chapter 11: Meaningful Involvement with Patients, Families and Caregivers. In: William Rayburn, MD, MBA, David Davis, MD, and Mary Turco, EdD, editor(s). Continuing Professional Development in Medicine and Healthcare. Philadelphia (United States): Wolters Kluwer; 2016. All registrants will receive a copy of the book chapter.

Ferguson G, Abi-Jaoude A, Johnson A, Saikaly R, Woldemichael B, Maharaj A, Soklaridis S, Nirula L, Hasan M, Wiljer D. Collaborating with Families: Exploring Family Member and Health Care Provider Perspectives on Engaging Families Within Medical Education. Acad Psychiatry. 2018 Feb 12. doi: 10.1007/s40596-017-0878-y.

Towle A, Bainbridge L, Godolphin W, et al. Active patient involvement in the education of health professionals. Med Educ. 2010;44:64-74.


September, 2018 - REGISTER NOW

Title: Improving CPD Interventions and Strengthening the CPD Value Proposition By Developing Our Capacity for Doing Research

Curtis Olson, PhD, FSACME

Immediate Past Editor-in-Chief,
Journal of Continuing Education in the Health Professions
Assistant Professor, Department of Medicine,
Geisel School of Medicine at Dartmouth


Mila Kostic, CHCP, FACEHP,
Director of Continuing Medical Education,
Perelman School of Medicine at the University of Pennsylvania
Co-Director of Interprofessional Continuing Education,
Penn Medicine


Betsy Williams, PhD, MPH
Clinical Program Director
Professional Renewal Center


All CPD professionals confront two imperatives: delivering ever more effective educational interventions and strengthening stakeholders’ understanding of the value of CPD to our institutions and to improving patient care. Enhancing effectiveness requires better ways of detecting, measuring, and communicating the impacts of CPD interventions. Enhancing value entails providing key stakeholders with evidence showing the effectiveness of specific educational interventions and, in the academic setting, trading in the currency of the realm (ie, dissemination of our efforts through forums such as refereed journals).

Both imperatives require that we give greater attention to research in CPD.  This session present the case for developing increased research capacity in CPD and explore ways in which CPD professionals at all levels can contribute to this end.

Journal Club Questions:

  1. Why should CPD professionals at all levels learn more about educational research? 
  2. How can busy CPD professionals find ways to engage in research? 
  3. What steps can individual CPD professionals take to further develop their understanding of and ability to conduct educational research?
Articles to be Reviewed: 

Olson, C. A., & White Williams, B. (2018). Principles of effective research in continuing professional development in the health professions. In W. F. Rayburn, M. G. Turco, & D. A. Davis (Eds.), 
Continuing professional development in medicine and health care: better education, better outcomes (pp. 363-384). Philadelphia, PA: Wolters Kluwer. Access this material.

Olson, C. A. (2012). Twenty predictions for the future of CPD: implications of the shift from the update model to improving clinical practice. Journal of Continuing Education in the Health Professions, 32(3), 151-152.


June, 2018 - REGISTER NOW

Title: Comparing and Contrasting Faculty Development and Continuing Professional Development


Ivan Silver, MD, MEd, Vice-President Education, Centre for Addiction and Mental Health, University of Toronto

Karen Leslie MD MEd, Director of the Centre for Faculty Development, St. Michael’s Hospital, University of Toronto


Mila Kostic, CHCP, FACEHP, Director of Continuing Medical Education Perelman School of Medicine at the University of Pennsylvania; Co-Director of Interprofessional Continuing Education, Penn Medicine


Faculty Development and Continuing Professional Development programs have had parallel and overlapping histories and areas of focus at medical schools in the past 50 years. During the session we will first review the history of each of these education fields and then highlight their shared elements and their differences in target audience, purpose, pedagogy and scholarship. We will then examine the opportunities for these two fields to intersect and to compliment each other to foster system change and use pooled practice and teaching evaluation data to foster performance improvement and continuing professional competence. 

Journal Club Questions:

  1. Describe three key differentiating features between faculty development and continuing professional development. What are three similar features?

  2. Faculty development and continuing professional development are often in different offices at medical schools. How would you optimally align these two fields and practices for the benefit of both?

  3. What are the opportunities for these two education fields to engage in collaborative scholarship and research?

Articles to be Reviewed: 

Ng, S.L., Baker, L.R. & Leslie, K. Re-positioning faculty development as knowledge mobilization for health professions education. Perspect Med Educ 2017;6(4):273-276.

Silver I, Leslie K. Comparing and Contrasting Faculty Development and Continuing Professional Development. In: Rayburn WF, Davis D, Turco M, eds. Continuing Professional Development in Medicine and Health Care: Better Education, Better Patient Outcomes. New York: Wolters Kluwer; 2017:203-218.

Davis DA, Rayburn WF, Smith GA. Continuing Professional Development for Faculty: An Elephant in the House of Academic Medicine or the Key to Future Success? Acad Med. 2017;92(8):1078-1081.


May, 2018 - REGISTER NOW

Title: The Practice and Improvement Gaps in Medical Practice and Medical Education: Insights from Implementation Science.

Presenters: Gary A. Smith, Ph.D., Assistant Dean for Faculty Development in Education, University of New Mexico School of Medicine

Facilitator Curtis Olson, PhD, Immediate Past Editor-in-Chief, Journal of Continuing Education in the Health Professions

Assistant Professor, Geisel School of Medicine at Dartmouth

Within academic medical centers, clinician educators grow and improve practice along combined professional trajectories as physicians and educators.  CME and faculty development programs focus separately on these roles, have different traditions and approaches, but are both charged with continuing professional development responsibilities.  Both of these CPD programs also share the paradox of unacceptably low rates of transfer of disseminated research to practice (the practice gap) and from practice to expected outcomes (the improvement gap).

The session will use the lens of implementation science to inquire about roles of faculty development and CME programs, separately and potentially together, to enhance medical and teaching practice along with learner and patient outcomes.

Journal Club Questions:

1. How are faculty development and CME programs similar and different?  How could each benefit from one another?

2. What are the challenges that form the practice and improvement gaps?

3. How are CPD programs – both faculty development in teaching and CME in medical practice – positioned to close these gaps?  And, if not, what changes are necessary?

Articles to be Reviewed: 

Davis DA, Rayburn WF, Smith GA. Continuing professional development for faculty: An elephant in the house of academic medicine or the key to future success? Academic Medicine. 2017; 92(8):1078-1081.

Smith GA, Stark AM. Enhancing continuing professional development with insights from implementation science. In: Rayburn WF, Davis D, Turco M, eds. Continuing Professional Development in Medicine and Health Care: Better Education, Better Patient Outcomes. New York: Wolters Kluwer; 2017:305-322.


April, 2018 - Register Now

Title: Implications of UME and GME Outcomes-based Reform Efforts for CPD

Presenters & Facilitators: Eric S. Holmboe, MD, MACP, FRCP and Mila Kostic, CHCP, FACEHP

Background: Outcomes-based approaches to undergraduate (UME) and graduate medical education (GME) using competencies, milestones and entrustable professional activities (EPAs) are increasingly being implemented globally. 

A critical assumption (or necessary foundational state) of outcomes-based approaches using competency frameworks is that the teachers (i.e. interprofessional healthcare educators) and institutions are highly competent in the clinical areas they teach and provide care. This has major implications for efforts in continuous professional development (CPD) as a large body of research shows this condition is not always met within training institutions. 

This session will explore current issues in implementing competencies using milestones and EPAs as part of the educational continuum.

Questions to be addressed in the discussion include:

  • Role of competencies, milestones and EPAs to meet public and health system needs
  • Impact of institutional performance on educational and clinical care outcomes
  • Essential competencies needed by interprofessional educators
  • Co-learning and co-production as potential approaches to enhance CPD in quality improvement and patient safety
  • What exactly is competency-based CPD? Is it really anything new?

Eric has selected the following recent articles to stimulate discussion on this topic.

Articles to be Reviewed

Batalden P, Davidoff F. What is “quality improvement” and how can it transform healthcare? Qual Saf Healthc. 2007;16(1):2–3.

Campbell C, Silver I, Sherbino J, Cate O Ten, Holmboe ES. Competency-based continuing professional development. Med Teach. 2010;32(8):657–62. 

Wong BM, Holmboe ES. Transforming the Academic Faculty Perspective in Graduate Medical Education to Better Align Educational and Clinical Outcomes. Acad Med. 2016;91(4):473-9.

Additional reference: 

Wong BM and Holmboe ES. Reforming UME and GME by Implementing Competencies to Meet Public and Health System Needs. In Continuing Professional Development in Medicine and Health Care. William Rayburn MD, MBA, David A. Davis MD, Mary G. Turco EdD, Editors. LWW. 2017.


March, 2018

Title: Are conventional learning theories sufficient to guide multi-site complex educational interventions?

Presenters & Facilitators: Jocelyn Lockyer, PhD and Mila Kostic, CHCP, FACEHP

"Without theories, people might view research findings as disorganized collections of data, because researchers and practitioners would have no overarching frameworks to which data could be linked.” (Schunk, 2016, p11) 

Theories provide frameworks for interpreting environmental observation and serve as bridges between research and education. They enable research findings to be organized and systematically linked to theories and they reflect environmental phenomena and generate new research through hypotheses. 

During this session, the presenter will lead us in the review of CPD learning theories and interventions for better patient outcomes. 

Together we will determine how the lessons learned in this study can apply to our work in CPD.

Article to be Reviewed

Semrau KEA, Hirschhorn LR, Marx Delaney M, Singh VP, Saurastri R, Sharma N, Tuller DE, Firestone R, Lipsitz S, Dhingra-Kumar N, Kodkany BS, Kumar V, Gawande AA; BetterBirth Trial Group. Outcomes of a Coaching-Based WHO Safe Childbirth Checklist Program in India. N Engl J Med. 2017 Dec 14;377(24):2313-2324. 

Click here to access this article.

Atul Gawande TED Talk: 

June, 2016

Title: Professional Identity Formation: Role of CPD

Presenters & Facilitators: Barbara Barnes, MD and Mila Kostic, CHCP, FACEHP

There has been considerable recent literature on the topic of professional identify formation, particularly for students and residents. This issue is also extremely relevant to practicing health professionals, particularly as they experience career transitions and confront a changing healthcare environment. In this session we will be discussing the topic based on one primary and several other articles as well as a recent interview with Dr. Fred Hafferty. We will explore how this concept relates to CPD and how attendees can address professional identity formation in their CPD programs. Participants may find it useful to read the articles ahead of the session and consider how the views expressed may inform their own thinking and practice related to the topic.

Article to be Reviewed

Hafferty, FW, Alternative Framings, Countervailing Visions: Locating the "P" in Professional Identity Formation, Academic Medicine 2016:91:2:171-174

Interview with the Author


Additional Suggested Readings

Cruess, RL, Amending Miller's Pyramid to Include Professional Identity Formation, Academic Medicine 2016:91:2:180-185

May 27, 2016

Title: Learning from each other, building collective minds, and other behaviors exhibited by highly effective clinical teams: Implications for CPD

Presenter: John Parboosingh, MB FRCSC

Facilitators: Curt Olson, PhD

Journal articles in support of this premise will be reviewed at the Journal Club.

Participants will be invited to discuss the statement that “conversations between networked professionals are essential components of the learning process (Pedagogy) and should receive more attention in CME/CPD sessions.

Articles to be Reviewed

Suchman, A. Organizations as machines, organizations as conversations: Two core metaphors and their consequences. Med Care 2011;49: S43–S48

Link to article alternate link

Jordan ME, Lanham HJ, Crabtree BF, et al. The role of conversation in health care interventions: Enabling sensemaking and learning. Implement Sci. 2009:4:1-15.

Link to article

Additional Suggested Readings

Gabbay J, le May A. Evidence based guidelines or collectively constructed “mindlines”? Ethnographic study of knowledge management in primary care. BMJ. 2004;29(7473):1013-1018.

Hess, D et al: Enhancing engagement in practice improvement: A conceptual framework .Journal of Continuing Education in the Health Professions. 2015; 35(1): 71–79.

Abbey N. Developing 21st Century Teaching and Learning: Dialogic Literacy. Johns Hopkins School of Education.2008.


Margolis A, Parboosingh J. Networked Learning and Network Science: Potential Applications to Health Professionals' Continuing Education and Development. Journal of Continuing Education in the Health Professions: Summer 2015 - Volume 35 - Issue 3 - p 211–219.

April 27, 2016

Title: Preparation for future learning as a missing competency in health professions education

Presenter: Don Moore, PhD

Facilitators: Mila Kostic, CHCP, FACEHP


The authors state that the evidence suggests that clinicians may not be learning effectively from all facets of their practices. They have not been prepared for future learning. Preparation for future learning is understood to be the capacity to learn new information, to use resources effectively, and to invent new strategies for learning and problem-solving, supporting the use of adaptive expertise in novel circumstances.

In a previous article, the authors further state that the CE community has relied on the adult education model of the “self-regulating learner” which they consider to be flawed. In that article, they review the assumptions that underlie the idea of the “self-regulating learner” in CE and why these assumptions are faulty. Rather than trying to link the “faulty” self-regulating learner model to formal CE activities their recommendation is that (1) the CE community should recognize that adaptive expertise is needed in practice settings to address novel challenges and (2) focus on practice-embedded learning activities that would require that clinicians be “prepared for future learning”. They review the instructional conditions that they suggest promote preparation for future learning.

They conclude with suggestions for moving forward.

Journal Club Questions:

1. What is preparation for future learning?

2. How are students prepared for future learning?

3. What is the role of the basic sciences in preparing students for future learning?

4. How can what the authors propose be used in CPD learning activities?

5. Is there any part of the article that you have concerns about?

Recommended Reading

Mylopoulos M, et al, Preparation for future learning: a missing competency in health professions education? Medical Education 2016; 50: 115–123.

Link to full text article

February 24, 2016

Title: INQUIRY-TERMS- LEARNING- PERFORMANCE: Mutually Beneficial Exchanges

Presenter: Alan Knox, PhD, EED, University of Wisconsin

Facilitators: Curtis Olson, PhD, University of Wisconsin
Mila Kostic, University of Pennsylvania


The SACME VJC on Wednesday, February 24 is about use of terminology to connect scholarly inquiry and professional learning activities. The recent JCEHP supplement on terminology, and a current International Compendium, illustrate ways to enhance mutually beneficial exchanges between scholarly inquiry and effective professional learning activities. This VLC session will be moderated by Alan Knox, who three years ago became an emeritus professor of education at the University of Wisconsin, and continues his long association with the UW School of Medicine and Public Health, Office of Continuing Professional Development. His recent book is Improving Professional Learning (2016) Stylus Publishing.


Preparation for the February 24 VJC session includes the following overview, and reading several related statements. Proposed discussion questions are provided.

Words Matter! A distinctive feature of the Society for Academic Continuing Medical Education (SACME), among professional associations generally, is the centrality of mutually beneficial exchanges that occurred between scholarly practitioners and scholars of practice. For generations, SACME members, along with contributors, consulting editors, and readers of the Journal of Continuing Education in the Health Professions (JCEHP) have used their experience from various specialties in the helping professions. This abundance of experience and vision is especially apparent, at a time when there is a World Congress on Continuing Professional Development.

The Fall 2015 JCEHP supplement based on the Terminology Project, includes an editorial1 which is the main reading in preparation for the February 24, 2016 VJC session. A related reading is the editorial’s reference 8, on research to practice, based on a thematic analysis of earlier articles reported in JCEHP,2, regarding interrelated concepts and words for effective communication in the field.

The recent launch by practitioners and scholars of an International Compendium of Adult and Continuing Education (ICACE) provides both an opportunity and a resource of potential interest to VJC participants. An e- edition of the Compendium will provide a resource that builds on the pioneering terminology project, which focused on terminology related to four important types of professional learning activities. However, the Compendium will include more than 100 brief articles and related concepts, envisioned in the 2006 JCEHP article on systemic connections, that reflect the broad scope of major relationships entailed in effective professional learning and quality improvement.

This opportunity will occur because during 2016, proposals to author an article are being received from able practitioners and scholars from various countries and types of continuing education organizations. For interested VJC participants, a link is provided to the Compendium website, and to the presentation to launch the Compendium at a recent international conference general session.

During our hour-long February 25 VJC session, we will discuss ways in which each of us can guide mutually beneficial exchanges among people engaged in inquiry (educational research and evaluation) and practitioners, focus on enhanced professional learning and performance. As suggested in the recent JCEHP editorial, the effectiveness of professional learning and quality improvement sessions reflects a combination of personal and situational influences. Similar influences contribute to excellent professional performance. Clear understanding of terms for important concepts can facilitate exchanges among practitioners and scholars.

Discussion Questions

1. How important is it, in your University professional development program, to strengthen connections between scholarship and practice by people who help conduct professional learning activities for members of the health professions?

2. When conducting your professional development programs, how would you characterize typical relationships between scholarship and practice?

3. How difficult is use of terminology regarding communication among people in various specialties?

4. How does increased inter-professional education affect conducting professional learning activities and enhancing professional performance and benefits for patients?


1. Knox AB. Reflections on Terminology in the Continuing Education of Health Professionals. Journal of Continuing Education in the Health Professions. 2015;35:S43-S44.

2. MacIntosh-Murray A, Perrier L, Davis D. Research to practice in The Journal of Continuing Education in the Health Professions: A thematic analysis of volumes 1 through 24. J Cont Educ Health Prof. 2006;26(3):230-243.

October 2, 2015

Title: What are the implications of implementation science for medical education?

Presenters: David Price, MD, FAAFP, FACEHP
ABMS Research and Education Foundation
Barbara Barnes, MD, MS
University of Pittsburgh School of Medicine

Facilitator: Mila Kostic, University of Pennsylvania


What are the implications of implementation science for medical education? Price, David; Barnes, Barbara

Med Educ Online 2015, 20: 27003 

Additional Reading Materials:

May be posted shortly.

June 3, 2015


Active Engagement in Professional Improvement

Presenter: Dr. Alan Knox, University of Wisconsin

Facilitator: Curt Olson, PhD

This session will explore why and how to engage health professionals in continuing education and quality improvement activities that enhance performance. The recent article to read beforehand is:

Hess, Reed, Turko, Parboosingh, Bernstein “enhancing provider engagement in practice improvement” Journal of Continuing Education in the Health Professions,35(1):71-79,2015.

Click to access article

Our session may encourage you to try some additional engagement strategies, such as: peer interactions, appreciative inquiry, use of technology, and evaluation feedback.

In preparation for the session, read the article,  review  the following discussion questions, select some that you want to discuss, and share your comments.

1. What is the contribution of structured/facilitated dialogue to guide enhanced learning and improved practice?

2. How is praxis between concepts and performance important to enhanced teamwork and engagement?

3. How central is the affective domain (feelings, emotions, motives, commitment) to the JCEHP article conceptual framework and procedures?

4. Why is individualized, informal and self-directed learning important for engagement ?

5. How might appreciative inquiry based on shared stories contribute to guidelines that enhance improvement?

6. Why is trust and a supportive context important for practice improvement?

7. What types of learning and improvement activities warrant greater use?

8. What are some effective ways to estimate participant readiness to engage in performance improvement activities?

April 27, 2015


Critical Thinking Strategies

Presenter: Annette Donawa, PhD, Johns Hopkins University

Facilitator: Mila Kostic, University of Pennsylvania

Learning Objectives:
- Review and discuss the Elder & Paul Elements of Thought critical thinking model.
- Discuss critical thinking strategies. - Review the State, Elaborate, Explicate, and Illustrate (SEEI) model.

- Discuss how this framework can be applied and integrated into CME.


Critical thinking as a citizenship competence: teaching strategies, Geert ten Dam, Monique Volman
Learning and Instruction 14 (2004) 359–379

Additional Resources:

Collaborative Learning Enhances Critical Thinking

Defining Critical Thinking

Our Concept and definition of Critical Thinking

Professional Development Model – Colleges and Universities that Foster Critical Thinking

Role of Socratic Questioning in Thinking, Teaching, and Learning

Becoming a Critic of your own thinking

March 6, 2015


Effectiveness of CME 

Presenter: Don Moore, PhD

Facilitator: Curt Olson, PhD

Background: Ever since George Miller’s “Continuing Education for What?” in the 1960s, there have been concerns that CME does not work. Sibley’s report in the early 1980s1 reinforced those concerns. In many ways, these concerns have prevented the field from reaching its full potential, even though since 1977, there have been several meta-analyses that demonstrated that CME is effective, but under certain circumstances. Now, under the auspices of the Accreditation Council for CME, Cervero and Gaines have developed a synthesis of the meta-analyses and have produced a more positive picture of CME effectiveness.

It would be helpful for you to read the report “Effectiveness of CME: Updated synthesis of systematic reviews”, July 2014.

After a short summary of the report, we will examine these questions:
1. Are systematic reviews and meta-analysis the right methodologies to examine the issue of effectiveness?
2. Did the report (or the methodologies) leave something out?
3. What do the findings mean for the day-to-day practice of CME?
4. Do we really know what conclusion #3 (“more interactive, more methods, multiple exposures”) means?
5. When Cervero and Gaines say “it will be important to incorporate the insights from the scientific study of CME effectiveness” (the last phrase in the report), what do they mean?
6. Do you agree with “reforming CME is less a knowledge problem than a political problem of changing the systems of which CME is an important constituent element”?

1. Sibley JC, Sackett DL, Neufeld V, Gerrard B, Rudnick KV, Fraser W. A randomized controlled trial of continuing medical education. N.Engl.J.Med. 1982;306:511-515.

Recommended Readings: 

• Accreditation Council for CME Publishes Two Reports
Addressing Important Issues in CME click to access

February 4, 2015


What determines how we practice? Insights from the Asch study

Presenter: Robert Englander, MD, Senior Director for Competency-based Learning and Assessment, Association of American Medical Colleges

Facilitator: Curt Olson, PhD

Background: A fundamental assumption of continuing education of health professionals is that clinical performance is educationally sensitive. That is, it can be improved through activities aimed at changing practice. However, studies by David Asch, MD, MBA and colleagues at the University of Pennsylvania suggest that a powerful predictor of how a physician practices is where he or she received residency training.

Questions to be addressed in the discussion include:
1. How can we make sense out of the findings of the Asch study? What hypotheses might account for them?
2. What questions does this study raise regarding physician performance?
3. What other factors are thought/known to influence how physicians practice?
4. What is the evidence that these other factors are influential?

Dr. Englander has selected the following recent articles to stimulate discussion on this topic.

Recommended Readings: (links coming soon)

• D.A. Asch, S. Nicholson, S. Srinivas, J. Herrin, A.J. Epstein. Evaluating obstetrical residency programs using patient outcomes. Journal of the American Medical Association, September 23/30, 2009, vol. 302, pp. 1277-83

• D.A. Asch, A. Epstein, S. Nicholson. Evaluating medical training programs by the quality of care delivered by their alumni. Journal of the American Medical Association, September 5, 2007, vol. 298, pp. 1049-51.

January 8, 2015


"Flipping" the Classroom Approach in Medical Education

Presenter: William Rayburn, MD, MBA, University of New Mexico

Facilitator: Barbara Barnes, MD, University of Pittsburgh

Background: The flipped classroom describes an educational approach that reverses the traditional lecture and homework elements of a course. For those considering whether to flip their own classroom, a valuable question to ask is: “Do I use the time I spend in front of my students to best effect?” If the answer is “no,” then a transition to the flipped classroom, or adoption of at least some of its features, could represent a simple and practical way of reinvigorating teaching and learning.


1. Describe the format of “flipping” the classroom.
2. Understand an ongoing project to illustrate tips about “flipping” a lecture.
3. Discuss implications of this approach with CME/CE/CPD.

Recommended Readings:


Moffet J. Twelve tips for “flipping” the classroom. Medical Teacher 2014, 1-6, (early online). [Link requested - will post soon]


McLaughlin JE, Roth MT, Glatt DM, et al. The Flipped Classroom: a course redesign to foster learning and engagement in a health professions school. Acad Med 2014; 89: 236-43. Link to article.

Leung JM, Jin Y, Yung AL. Short review of the flipped classroom approach. Medical Education 2014; 48: 1127. Link to article.

July 31, 2014

Title: Basics of Evaluation Science as Applied to Health Professions Education

Presenter: Thomas J. Van Hoof, MD, EdD, Associate Professor, University of Connecticut Schools of Nursing & Medicine

Description: The purpose of this session is to outline some basic principles and concepts of evaluation science that are critical to health professions education, including formative and summative evaluation and process and outcome evaluation. Through reflection and pre-reading, participants will be prepared to discuss some challenges that they face in planning and implementing educational activities and quality improvement programs and to consider how evaluation can be helpful to improving and to judging such efforts..

Reflective Questions (prior to reading): 

1. What is the distinction between formative evaluation and summative evaluation?
2. What is the difference between “assessment” and “evaluation”?
3. What are different ways in which one can use formative evaluation to plan and implement a program?
4. Why is a process evaluation critical to a summative evaluation?
5. Is evaluation always necessary and why is stakeholder perspective so important to evaluation efforts?

Recommended Readings (prior to session but after reflection): 

1. Weiss CH. “Purposes of Evaluation” (Chapter 2, pp. 10-23) in Evaluation. (2nd Ed.). 1998. Upper Saddle River, NJ: Prentice Hall. Download not available. Please check with your institution's library for access. 

2. Stetler CB, Legro MW, Wallace CM, et al. (2006). The role of formative evaluation in implementation research and the QUERI experience. Journal of General Internal Medicine, 21, S1-8. Download PDF file.

3. Moore DE, Green JS, Gallis HA. (2009). Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities. Journal of Continuing Education in the Health Professions, 29,1, 1-15. Download PDF file.

Suggested Readings:

1. Morrison J. (2003). ABC of learning and teaching in medicine: evaluation. BMJ, 326, 385-387.

2. Wilkes M, Bligh J. (1999). Evaluating educational interventions. BMJ, 318, 1269-1272.

3. Kirkpatrick DL, Kirkpatrick JD. Chapters 3-8 (pp. 21-74) in Evaluating Training Programs: The Four Levels. (3rd Ed.). 2006. San Francisco, CA: Berrett-Koehler.

4. Brookfield SD. “Evaluating Learning and Its Facilitation” (Chapter 11, pp. 261-282) in Understanding and Facilitating Adult Learning. 1986. San Francisco, CA: Jossey-Bass.

May 29, 2014 

Topic for Discussion:
Self-Other Agreement in Multisource Feedback: Are Physicians Really So Bad at Self-Assessment (and Does it Matter)?

Presenter: Curtis Olson, PhD

Facilitator: Barbara Barnes, MD

Background: It is often stated that physicians are not good at self-assessment, and indeed there is a substantial body of evidence that supports this assertion. Multisource feedback is one strategy for addressing this problem and it has been the object of many studies. The present study examines the level of agreement between physician self-assessments and those of their colleagues and patients and explores factors that might influence the degree of agreement. Discussion of this study will raise some important questions about the global assertion that physicians can’t self-assess and suggest future lines of inquiry to enhance our understanding of this important topic.

Questions to be addressed in the discussion include:

  • What is self-assessment and what types of self-assessments are expected of physicians?
  • Why do the authors think self-other agreement in assessments is important?
  • What type of self-assessment was examined in this study?
  • To what extent were the self-assessments of physicians who took part in this study congruent with those of colleagues and patients?
  • What assumptions do the authors make about the relationship between self-other agreement and clinical performance?
  • What does this study contribute to the literature on physician self-assessment and self-other agreement?
  • What is the evidence on the relationship between self-other agreement and performance?
  • What implications might this study have for using MSF?  For using self-assessments generally?

Curt has selected the following recent articles to stimulate discussion on this topic.

Articles for Review in Support of the Discussion:

  • Roberts, M. J., Campbell, J. L., Richards, S. H., & Wright, C. (2013). Self-other agreement in multisource feedback: the influence of doctor and rater group characteristics. J Contin Educ Health Prof, 33(1), 14-23. doi: 10.1002/chp.2116 - read/download article
  • Eva, K. W., & Regehr, G. (2008). "I'll never play professional football" and other fallacies of self-assessment. J Contin Educ Health Prof, 28(1), 14-19. doi: 10.1002/chp.150 - read/download article

Additional readings for those who want to explore the topic further can be found in Roberts et al.’s excellent reference list.

  • Atwater, L. E., Ostroff, C., Yammarino, F. J., & Fleenor, J. W. (1998). Self-other agreement: does it really matter? Personnel Psychology, 51, 577-598.

April 24, 2014 

Topic for Discussion:
Assessment of Outcomes of Simulation Education/training Associated with Team Training and Competencies Beyond Clinical Skills Training 

Presenter: Barbara Barnes, MD
Facilitator: Curtis Olson, PhD

Background: There is increased interest in using simulation for training of healthcare professionals to function in new models of care and to address competencies beyond medical knowledge and clinical care. An AAMC study in 2011 demonstrated that 90% of medical schools used simulation to educate on communication skills and 90% to assess these skills.   For teaching hospitals, this was 92% and 49% respectively. However, despite these findings there has not been a rigorous assessment of the relationship between performance in the simulated and actual environments. Barbara has selected the following recent articles to stimulate discussion on this topic.

Articles for Review in Support of the Discussion: 

1. Curtis JR, et al. Effect of communication skills training for residents and nurse practitioners on quality of communication with patients with serious illness: a randomized trial. JAMA, 2013 December 4; 310(21):2271-81. doi: 10.1001/jama.2013.282081 - read/download article

2. Yardley, S., W Irvine, A. and Lefroy, J. (2013), Minding the gap between communication skills simulation and authentic experience. Medical Education, 47: 495–510.doi: 10.1111/medu.12146 - read/download article

Additional background for this topic comes from JCEHP Volume 32, Issue 4 which contains a number of interesting articles that address simulation specifically in the CE context.  The article by Rosen et al provides a review of the literature on simulations that take place in the workplace (in situ).  The second article by Curtis et al discusses the issue of fidelity in simulation and provides an interesting and sometimes counterintuitive perspective.

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