the public trusts health professionals to provide care that is safe, efficient, effective, timely, patient-centered, and equitable.

The health professions covered by this report are those listed by the Bureau of Labor Statistics as “healthcare practitioner and technical occupations” with baccalaureate or higher degrees (see Appendix B). Examples of included professions are physicians, physician assistants, dentists, dieticians, nurses, and speech-language pathologists. These health professionals undergo extensive formal education, followed by what has become known in the United States as continuing education (CE). CE lasts the duration of a health professional’s career and is therefore the model of learning that spans the longest period. It serves two functions: maintenance of current practice and translation of knowledge into practice.

Educating professionals about new theories and evidence of what does and does not work, and under what circumstances, is one part of promoting the provision of better health care. Because individual learning styles differ greatly, innovative learning methods are developed to help health professionals maintain their competencies. Over time, learning methods have evolved from a focus on professionals’ attendance at and satisfaction with a limited set of educational activities to a focus on demonstrably changing professional practice and improving patient outcomes. Better learning methods need to be developed continuously, as creating appropriate methods, processes, and contexts is imperative for professionals to provide the highest quality care possible. Health professionals also need to provide feedback to themselves and the system about what actually works in specific practice settings, as the common wisdom of what “should be” practiced continuously evolves. What is considered to be the best knowledge one day may later be found to be inadequate. Health professionals’ abilities to identify these instances and adapt is critical. With the development of the Internet and Web 2.0, the world of information has expanded at exponential rates—so much so that the breadth of information for which health professionals used to be responsible is now beyond the capacity of any one professional.

On average, it now takes 14-17 years for new evidence to be broadly implemented (Balas and Boren, 2000). Shortening this period is key to advancing the provision of evidence-based care, and will require the existence of a well-trained health professional workforce that continually updates its knowledge.



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