Tag Archives: JCEHP

Give me Moore

Ten years ago, the Journal of Continuing Education in the Health Professions published Achieving Desired Results and Improved Outcomes: Integrating Planning and Assessment Throughout Learning Activities, which quickly became known as the “Moore’s outcomes paper” (sorry, Green and Gallis). While applauded for several years, it has now become vogue to wave aside as an antiquated interpretation of physician learning outcomes.

Why a paper primarily focused on the design and implementation of educational interventions for clinicians was ever considered bedrock for outcome assessment, escapes me. Then again, maybe I shouldn’t be surprised that the learning objectives of a passive, print intervention would be so poorly translated to its target audience.

So what were Moore, Green and Gallis trying to communicate? Specifically…the central point of this article is that before outcomes can be measured, educational planning focused on the outcomes must occur so that these outcomes can be expected to happen (JCEHP 2009; 29: p. 5). To be fair, they do use the word “outcomes” a lot in that sentence, but the key terms are clearly “educational planning”. Overall, this was meant to be an instructional guide for planning continuing medical education (CME) – not an outcomes paper. Here are the key points:

  1. There may be five stages of physician learning
  2. If there are such stages, designing CME using the predisposing-enabling-reinforcement framework may be a good idea
  3. The seven level outcomes framework may help CME providers apply the predisposing-enabling-reinforcement framework
  4. Formative assessment is really important and can be incorporated in the predisposing-enabling-reinforcement framework

Noting a pattern here? Whole lotta chatter about the predisposing-enabling-reinforcement framework.  As far as outcomes, the “Moore’s model” is a simple amalgam of frameworks – I suspect that neither Moore nor Green nor Gallis really care which framework you use, as long as it also incorporates…let’s all say it together now…the predisposing-enabling-reinforcement framework!

While I recognize that many a fine point has been made in criticism of the Moore’s outcomes framework as an independent entity (ie, outside of the context of the article in which it was published), my concern is that we’re tossing the baby with the bathwater for those newly initiated into the field of CME. Everyone in the practice of CME should read this paper. The insights neatly tucked into 15 pages may not instantly transform a CME providers’ practice, but they will at least help tune their attention to the evidence-based barriers and facilitators to transferring clinical education to practice.

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Filed under CME, Formative assessment, JCEHP, Methodology, Outcomes, Predisposing-enabling-reinforcement, Summative assessment

The dark side of SurveyMonkey

I love SurveyMonkey…survey creation, distribution and data collection is a snap with this service (and it’s super cheap).  What could possibly be bad about making surveys so accessible to everyone?  Oh, yeah…it’s probably making surveys so accessible to everyone.  Surveys used to represent a significant time and financial investment (e.g., postage, envelop stuffing, data entry).  Now all you need is a list of emails.  Without previous barriers, the decision to survey can come a little too quickly.

Admittedly, I’ve done more than one survey too many surveys simply because it was easy…rather than necessary.  Now I’m afraid that all this ease is actually making surveying harder than ever.  There are only so many physicians, and if we’re all bombing their inboxes with survey invitations, what’s the difference between us and cheap Viagra spam?

In his recent JCEHP Editorial, Dr. Olson eloquently describes this concern:

“…a survey population is a commons, a resource that is shared by a community, and like other commons such as ocean fisheries or antibiotics, it can be degraded by overuse” (p. 94)

Dr. Olson goes on to detail five ways in which we most typically misuse this common resource – which are much easier to address than climate change.  I highly recommend reading this editorial.   Afterward, continue to “reduce, reuse, recycle” and add: resist.

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Filed under Best practices, CME, JCEHP, Needs Assessment, Survey

Defining Educational Methods

Although I’ve described CME activities as both “interactive” and “multi-faceted”, I’m not really sure what these things are.  I haven’t been able to find any clear definition of either (which is a big limitation of meta-analysis of CME outcomes).  For example, what is the minimum criteria to satisfy “interactive”?  Is it simply the addition of an audience response system?  Or what about “multi-facetedness” (that’s a mouthful)…would a live activity be considered “multi-faceted” once re-purposed into an enduring material?  I don’t know.  But I do have an idea about how we might start to clarify these terms, which a colleague and I address in the latest JCEHP.

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Filed under CME, Interactive CME, JCEHP, Multi-faceted