IOM Report: National Institute Could Improve Continuing Education System for Health Professionals

By News Staff
Posted: 12/23/2009, 11:10 a.m.

According to a new report from the Institute of Medicine, or IOM, there are a number of deficiencies with the current continuing education, or CE, system for health professionals in the United States. The report is calling for the creation of a national, interprofessional CE institute to achieve a new vision of continuing professional development for health professionals, with the goal of improving patient care and health care delivery.

The report, Redesigning Continuing Education in the Health Professions, calls out five messages regarding the current system of continuing education for health professionals -- including those in medicine, nursing and pharmacy. According to the report,

there are major flaws in the way CE currently is conducted, financed, regulated and evaluated;
the science behind CE for health professionals is fragmented and underdeveloped;
continuing education efforts need to bring health professionals from various disciplines together in tailored learning environments;
a new vision of professional development for health care professionals is needed to replace the current culture; and
establishing a national, interprofessional public-private institute to foster improvements in CE may help improve the overall system.

The report notes that although some CE programs focus on the goals above, overall, the U.S. approach to CE has a number of flaws. For example, notes the report, health professionals and their employers tend to focus on meeting regulatory requirements rather than identifying personal knowledge gaps.

In addition, many current approaches to CE use didactic learning methods, such as lectures and seminars; traditional settings, such as auditoriums and classrooms; frequently mandated intervals; and teacher-driven content that may or may not be relevant to the clinical setting.

The report also notes that although scientific literature offers guidance about general principles for CE, it offers little specific information about how to best support learning, and CE providers often cannot determine the effectiveness of their methods.

In medicine, for example, says the report, pharmaceutical and medical device companies have taken a lead role in financing the provision of and research on CE, raising questions about conflicts of interest.

"Such commercial funding has raised and continues to raise concerns about conflicts of interest and whether some companies are using CE to influence health professionals so as to increase market share," the report says.

According to AAFP President Lori Heim, M.D., of Vass, N.C., the AAFP currently is looking at the 184-page report. "The AAFP has a long history of providing excellent quality CE to its members," said Heim. In addition, she noted, "There are a number of ways in which the Academy already is looking to the future, and many programs that have been initiated to improve the overall quality of our CE product to meet the ongoing needs of our members. The AAFP has been a leader in looking at models of learning and incorporating learning at the point of care."

The report suggests that the federal government work with stakeholders to develop a public-private institute -- called the Continuing Professional Development Institute, or CPDI -- that would be devoted to continuing professional development and fostering the delivery of high-quality health care. The report makes a number of specific recommendations:

that the secretary of HHS commission a planning committee to develop the CPDI that would coordinate and guide efforts to align approaches in such areas as content and knowledge of continuing professional development among health professions;
that the planning committee design an institute that creates a new scientific foundation for continuing professional development;
that the CPDI work with stakeholders to develop national standards for regulation of continuing professional development;
that the CPDI analyze the sources and adequacy of funding for continuing professional development;
that the CPDI identify, recognize and foster models of continuing professional development that build knowledge about interprofessional team learning and collaboration; and
that the CPDI report annually to the public and to private stakeholders and hold a national symposium on the performance and progress of professional development and its role in enhancing quality of care and patient safety.