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Overcoming Barriers to Change In CME: What Has the Pandemic Taught Us About Our Big Assumptions?
Thursday, January 27, 2022, 3:00 - 4:00 PM CT

Despite recurring calls for reform and extensive literature on best practices, the field of CME/CPD has been slow to change. Lack of change despite stated intentions suggests this is what Heifetz calls an “adaptive challenge,” one requiring a change not in skillset, but in mindset.

Together we will address this adaptive challenge through the “Immunity to Change” (ITC) framework by education psychologists Kegan and Lahey. This process yields a map of the complex network of competing commitments and underlying assumptions that form the immunity to change. We will explore one possible map of the collective “immune system” of CME practitioners that generates powerful insights into our barriers to change: seemingly unresolvable tensions between learner autonomy and learning needs, feasibility and impact, innovation and acceptance, and more—all based in paralyzing “big assumptions.”

Map in hand, change in mindset then comes from implementing tests of these assumptions’ validity. We will use the ITC framework to integrate our individual experiences as CME leaders during the COVID-19 pandemic—an unanticipated but highly impactful test—into system-wide insights for positive change.

Miya Bernson-Leung, MD, EdM
Program Director, Child Neurology Residency Training Program
Department of Neurology, Harvard Medical School
Course Director, Michael J. Bresnan Child Neurology Course
Associate Medical Director, Continuing Medical Education
Boston Children's Hospital

Host & Facilitator
Mila Kostic, CHCP, FACEHP
Strategic Advisor, Center for Continuing Medical Education
Stanford University School of Medicine

Primary References and Pre-Work

  1. Bowe CM, Lahey L, Armstrong E, Kegan R. Questioning the ‘big assumptions’. Part I: addressing personal contradictions that impede professional development. Medical Education. 2003;37(8):715-722. doi:10.1046/j.1365-2923.2003.01579.x

  2. After reading Bowe et al 2003, please review the example ITC map (handout)

  3. Price DW, Campbell CM. Rapid Retooling, Acquiring New Skills, and Competencies in the Pandemic Era: Implications and Expectations for Physician Continuing Professional Development. J Contin Educ Health Prof. Spring 2020;40(2):74-75. doi:10.1097/CEH.0000000000000297

  4. Kawczak S, Fernandez A, Frampton B, et al. Observations from Transforming a Continuing Education programme in the COVID-19 Era and Preparing for the Future. Journal of European CME. 2021;10(1)doi:10.1080/21614083.2021.1964315

Additional Optional References

  1. Kegan R, Lahey LL. The real reason people won't change. Harvard Business Review. 2001;79(10):85.

  2. Bowe CM, Lahey L, Kegan R, Armstrong E. Questioning the ‘big assumptions’. Part II: recognizing organizational contradictions that impede institutional change. Medical Education. 2003;37(8):723-733. doi:10.1046/j.1365-2923.2003.01580.x

  3. Rowland P, Tavares W, Lowe M, et al. Rapid Knowledge Mobilization and Continuing Professional Development: Educational Responses to COVID-19. J Contin Educ Health Prof. Apr 2 2021;doi:10.1097/CEH.0000000000000348

  4. Sklar D, Yilmaz Y, Chan TM. What the COVID-19 Pandemic Can Teach Health Professionals About Continuing Professional Development. Acad Med. Oct 1 2021;96(10):1379-1382. doi:10.1097/ACM.0000000000004245

Questions for Pre-VJC Reflection and Discussion

  1. What are your observations about and reactions to the example ITC map? Are there pieces of it that stand out to you as particularly striking or true to your experience prior to the pandemic? Are there pieces missing?

  2. What longstanding Big Assumptions about CME has the pandemic revealed, and perhaps called into question, in your office/institution?

  3. What examples do you have of innovations or practice changes during the last two years, perhaps in response to the “questions and opportunities to explore” outlined by Price and Campbell? What do these experiences tell you about your/our Big Assumptions?

Previous Sessions

17 Dec 2021Embracing Liminal Learning Spaces
19 Nov 2021 EDI & Leadership: Why and How
28 Oct 2021 Implementation Science Models for Aligning Health Professions Education with Health System Needs
30 Sept 2021 CPD and Complexity: Learning in Healthcare Systems
17 Dec 2020 Considering the Future of CME/CPD Post Pandemic: Never Let a Good Crisis Go to Waste
24 Sept 2020 Safer Opioid Prescribing Education: The Effect of Mandatory Education on CME Outcomes
23 July 2020 Effective Online Learning by Design – Preparing for Life Post-Pandemic
18 June 2020 Assessing Meaningful Outcomes in Program Evaluation of Online Learning
16 Apr 2020 Reimagining Medical Meetings after the COVID-19 Pandemic
26 Mar 2020 CPD Community Response to a Global Pandemic
12 Feb 2020 20/20 Vision: I Can See PD Clearly Now! What's your plan to make that same-old every-year program more attractive, more effective, more patient-centered?
23 Jan 2020
MOOCs - A Disruptive Innovation in CME

12 Dec 2019 Achieving Practice Change through Outcomes Based CPD
20 Nov 2019 Advances in Simulation-Based Continuing Professional Development and Training
30 Aug 2019 Providing Quality Peer Reviews – and Learning Along the Way
29 Jul 2019 Posters and Oral Presentations: Skills and Best Practices for Submitting Your Scholarly Work as Abstracts
26 Jun 2019 Surveying the Landscape: What We’re Learning About the Changing World of Professional Development
30 May 2019 Collaborating Interprofessionally for Team-Based Care
22 Apr 2019 A Long View of Lifelong Learning and CPD/CME
28 Mar 2019 Online Information Resources for Point of Care (POC) Learning
20 Feb 2019 Articulating the Value of Continuing Medical Education/Continuing Professional Development
30 Jan 2019 Improving Communication Skills of Health Care Providers
04 Dec 2018 Continuing Professional Development in the Clinical Learning Environment
19 Nov 2018 Role of CPD in Developing Leaders in Academic Health Care Systems
16 Oct 2018 Meaningful Involvement of Patients, Families and Caregivers in Continuing Professional Development
07 Sep 2018 Improving CPD Interventions and Strengthening the CPD Value Proposition
04 Jun 2018 Comparing and Contrasting Faculty Development and Continuing Professional Development
15 May 2018 The Practice and Improvement Gaps in Medical Practice and Medical Education
05 Apr 2018 Implications of UME and GME Outcomes-based Reform Efforts for CPD
07 Mar 2018 Are conventional learning theories sufficient to guide multi-site complex educational interventions?

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