The Journal of continuing education in the health professions
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J Contin Educ Health Prof · Jan 2013
ReviewDemoralization in health professional practice: development, amelioration, and implications for continuing education.
Demoralization is a feeling state of dejection, hopelessness, and a sense of personal "incompetence" that may be tied to a loss of or threat to one's own goals or values. It has an existential dimension when beliefs and values about oneself are disconfirmed. Numerous sources describe high rates of dissatisfaction and burnout in physicians and other health professionals. ⋯ These conflicts place health professionals at risk for demoralization and burnout. "Remoralization," or renewal of morale, depends on the reestablishment of the potential for fulfillment of one's values in the work environment. This depends on organizational, group, and personal efforts. Continuing education and continuing professional development programs should have a programmatic focus on the importance of a values orientation in health care and support program development aimed at recognizing, addressing, and reducing demoralization and its potential for negative health care consequences for health professionals and patients.
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J Contin Educ Health Prof · Jan 2013
The long-term impact of a performance improvement continuing medical education intervention on osteoporosis screening.
The purpose of this study is to determine whether a performance improvement continuing medical education (PI CME) initiative that utilizes quality improvement (QI) principles is effective in producing sustainable change in practice to improve the screening of patients at risk for osteoporosis. ⋯ The data indicate that PI CME utilizing QI principles can be effective in producing sustainable change in practice to improve the screening of patients at risk for osteoporosis. Further research is needed to determine the extent to which such changes can be directly attributed to this type of intervention.
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J Contin Educ Health Prof · Jan 2013
The United Kingdom's experience with and future plans for revalidation.
Assuring fitness to practice for doctors internationally is increasingly complex. In the United Kingdom, the General Medical Council (GMC) has recently launched revalidation, which has been designed to bring all doctors into a governed environment. Since December 2012, all doctors who wish to practice are required to submit and reflect on supporting documentation against a framework of best practice, Good Medical Practice. ⋯ However, it has a long and troubled history that is shaped by high-profile medical scandals and delays from the profession, the GMC, and the government. Revalidation has been complicated further by rhetoric around patient care and driving up standards but at the same time identifying poor performance. The GMC have responded by commissioning a national evaluation which is currently under development.
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J Contin Educ Health Prof · Jan 2013
ReviewSpecialty board certification in the United States: issues and evidence.
The American Board of Medical Specialties (ABMS) certification and maintenance of certification (MOC) programs strive to provide the public with guidance about a physician's competence. This study summarizes the literature on the effectiveness of these programs. ⋯ Certification boards should continuously try to improve their programs in response to feedback from stakeholders, changes in the way physicians practice, as well as the growth in the fields of measurement and technology. Keeping pace with these changes in a responsible and evidence-based way is important.
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J Contin Educ Health Prof · Jan 2013
Core competencies for shared decision making training programs: insights from an international, interdisciplinary working group.
Shared decision making is now making inroads in health care professionals' continuing education curriculum, but there is no consensus on what core competencies are required by clinicians for effectively involving patients in health-related decisions. Ready-made programs for training clinicians in shared decision making are in high demand, but existing programs vary widely in their theoretical foundations, length, and content. An international, interdisciplinary group of 25 individuals met in 2012 to discuss theoretical approaches to making health-related decisions, compare notes on existing programs, take stock of stakeholders concerns, and deliberate on core competencies. ⋯ Others argued that this would be premature as there is still no consensus on the definition of shared decision making or sufficient evidence to recommend specific competencies for implementing shared decision making. However, all participants agreed that there were 2 broad types of competencies that clinicians need for implementing shared decision making: relational competencies and risk communication competencies. Further multidisciplinary research could broaden and deepen our understanding of core competencies for shared decision making training.