A new Institute of Medicine (IOM) report calls upon healthcare professionals to create a public-private institute to oversee the development of a new science-based multidisciplinary system of continuing education.
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An Institute of Medicine report calls for a revamp of continuing professional education that, among other things, would provide interdisciplinary training in real clinical settings.
The Josiah Macy, Jr, Foundation commissioned the IOM to assess the possibility of creating a national interprofessional institute dedicated to improving continuing education for clinicians. Such an institute had been proposed at a 2007 conference hosted by the foundation. An IOM committee conducted an extensive review of the existing system of continuing education, assessed various alternatives for improvement, and ultimately recommended the creation of an institute that would bring together public and private interests to revamp continuing clinician education. The committee's report is available online (http://www.iom.edu/Reports/2009/Redesigning-Continuing-Education-in-the-Health-Professions.aspx).
At a briefing in December, Chair Gail L. Warden, MHA, professor of health management and policy at the University of Michigan School of Public Health in Detroit, said the committee found major flaws in the conduct, financing, regulation, and evaluation of clinician continuing education programs.
Among the most pressing concerns the committee identified was the potential for conflict of interest when makers of drugs or devices fund education for the practitioners who decide whether to use these products. Warden noted that in 2007, commercial entities contributed $1.5 billion to such education programs. The committee's report, he said, took a hard line on the need to prevent marketing messages from being integrated into clinical education programs. Other problems the committee identified included a focus on meeting general credit requirements rather than on the training needs of the individual; a lack of scientific information on what types of training are effective; and fragmented oversight of continuing education, in which each profession, specialty, or state has its own requirements.
To address such problems, the committee recommended that the United States shift toward a model of continuing professional development that allows health professionals to develop curricula that fit their specific needs and work settings.
To oversee this shift, the committee proposes the creation of a public-private institute with leadership from various health disciplines. This institute would create a research agenda for continuing professional development and work with credentialing organizations to develop standards that align with research findings. The institute also would work with stakeholders to establish conflict-of-interest policies and to identify appropriate funding sources for continuing education.
One of the tasks of the new institute should be to find ways to target education programs to help improve the quality of care and boost patient safety. “All of us felt that health professional development, quality patient care, and system performance are inextricably linked,” said David C. Leach, MD, former executive director of the Accreditation Council for Graduate Medical Education.
The institute should promote the use of health information systems to encourage interactive professional development based on the needs of individual practitioners, Warden said.
Noting that most care is delivered by interdisciplinary teams, Leach also emphasized the importance of cross-profession development programs.
“We're really all in this together,” he said.
Additionally, Leach said such programs need to evaluate not only whether professionals learned the materials, but also whether they are applying them in practice—as he phrased it, “Can I do it, and do I do it?”
Catherine DeAngelis, MD, MPH, editor in chief of JAMA and professor at Johns Hopkins University School of Medicine, in Baltimore, also served on the committee. DeAngelis, who trained in medicine, nursing, and public health, noted that she has witnessed the undue influence of for-profit companies on physician education. This new approach, she said, would have a transformational effect on health care.
“I believe this health team approach is long overdue,” she said. “Health professionals, and especially patients, will benefit greatly.”
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