How we Pay the BillsAOCOPM OMECO

Jeffrey J. LeBoeuf, CAEExecutive Director American Osteopathic College of

Occupational and Preventive Medicine (AOCOPM)

PO Box 3043Tulsa, OK 74101800-558-8686918-561-1431 (fax)jeffrey@aocopm.org

Jeffrey J. LeBoeuf, CAEExecutive Director Osteopathic Medical Education

Consortium of OklahomaRoom 325, CHS1111 West 17th StreetTulsa, OK 74107918-561-1414918-561-1431(fax)jeffrey.leboeuf@okstate.edu

Design a learning plan to achieve measurable outcomesDiscuss dynamics of adult learning and re-evaluate teaching methods commonly utilized for CMEIdentify ways to improve the needs assessment process to effect practice change

Pedagogy vs AndragogyPedagogy is the study of teaching children (teacher-directed)Andragogy is the study of teaching adults (learner-directed) is problem-centered rather than content-centered. permits and encourages active participation. encourages past experiences. is collaborative between instructor-student and

student-student. is based on planning between the teacher and the

learner. is based on an evaluation agreement. prompts redesign and new learning activities based on

evaluation. incorporates experiential activities.

Theyre Not Just Big Kids: Motivating Adult Learners , Dr. Karen Jarrett Thoms

Problem solvers (detectives)Works and learns as part of a teamHas a panel of experts to call uponAssembles dataExperiential learnersDialogues with patientsSelf-directed, autonomousAuditory, visual, tactile, and participatory

Sustained attention is the level of attention that produces the consistent results on a task over time. Most healthy teenagers and adults are unable to sustain attention on one thing for more than about 20 minutes at a time, although they can choose repeatedly to re-focus on the same thing. This ability to renew attention permits people to "pay attention" to things that last for more than a few minutes, such as long movies.

Dianne Dukette; David Cornish (2009). The Essential 20: Twenty Components of an Excellent Health Care Team. RoseDog Books. pp. 7273. ISBN 1-4349-9555-0.

Ensures that CME provided matches: Job Task Analysis of Targeted Learners Competency Deficiencies of Learners Health Deficiencies of Patient PopulationEnhances the extent to which your CME is Evidence-BasedAvoids CME which is too narrowly focused or repetitive

Credentialing Board Information Job task analysis Table of Specificity 3 year rolling aggregated examination

reports03-2010 CME Needs Assessment Source Data MemoState and National Health StatisticsThe Medical Letter (for Drug Class Comprehensiveness)Surveys of membership and previous attendeesCDC and State Health Departments (for timely topics; e.g. disasters, epidemiological outbreaks, bio-terrorism)CME Programming Committee Journal Club ReportRecent Historical CME OfferingsPopular Literature & Media e g Web MD

Avoid Outdated Sources or Studies that do not hold up to scientific rigorBe careful about allowing Drug Reps and Professional Speakers to influence your needs assessment. Needs Assessment Topics Topics Needs AssessmentGet an early commitment from your Committee to treat the needs assessment with respect and importance.Needs Assessment should also identify optimal learning modality and duration.

Specialty College

CME ProviderDevelops training standards for GME programs

Credentialing Board

Develops and administers credentialing examsConducts Job Task Analysis and Table of SpecificityCan provide aggregated test performance data

Add OCC requirementsConsideration of job task analysisTraining on performance evaluation and improvementRisk managementPre- and Post- tests?Curriculum based

LevelLevel OutcomeOutcome DefinitionDefinition

11 ParticipationParticipation AttendanceAttendance

22 SatisfactionSatisfaction ParticipantsatisfactionParticipantsatisfaction

33 LearningLearning ChangesinKSAChangesinKSA

44 PerformancePerformance ChangeinpracticeperformanceChangeinpracticeperformance

55 PatientHealthPatientHealth ChangeinpatienthealthstatusChangeinpatienthealthstatus

66 PopulationHealthPopulationHealth ChangeinpopulationhealthstatusChangeinpopulationhealthstatus

Moore, DE. A framework for outcomes evaluation in the continuing professional development of physicians. In Davis, et al. eds. The Continuing Professional Development of Physicians. Chicago, Ill: AMA Press; 2003

Mock disasters/outbreaksPatient actorsPanel discussionsCritique SessionsSimulators/TechnologyAudience Feedback DevicesLearning labsSmall group learningProblem-based learning

Break up one-hour lectures (Every 15-20 minutes) Questions and answers Poll the audience Show a clip Tell a storyTransform your PowerPoint presentations Pictures are better than words Video vignettes drive home key points Motion and colors are goodTransform your handouts Bullet-point pearls are better than copies of slides

Physicians, like most humans, are creatures of habitChange produces anxietyWe will remain in a broken business model due to a reluctance to change.

Physicians (and CME committees) should be encouraged to develop a change plan, similar to a care planInvolve the team in identifying the problems, not just the symptomsIdentify measurable outcomesRe-evaluate and redesign

Physicians will change if they learn a new skill or technique or acquire new equipment that enhances revenue

Its obvious to them that the change will help their patientsThey are convinced that its a smart business moveThey have assurance and support and mentorship regarding the changesThey are reinforced with measurable results

Performance Measure(s)

Needs Assessment

PerformanceData

Learning Objectives

Improvement Interventions

Content Delivery

Performance DataOutcomes/Eval

Demonstrate performance improvement in knowledge and skillsCompare scores to national benchmarks and standards of care based on evidenceExamples: Testing modules on specialty clinical

knowledge, skills, procedures Skills testing lab

What if we knew exactly what our physicians need to know to be competent?What if we truly gauged learning gaps of our participants?What if our faculty was taught, and applied, the best principles of androgogy?What if our CME was fast-paced, moving, and included innovative modalities?

What if we could guarantee non-boredom?What if we pre- and post-tested our participants?What if we re-post-tested in six months?What if linked our efforts to OCC practice assessment to effect clinical improvements?