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Redesigning Continuing Education in the Health Professions
TRAINING, EDUCATION, ANDPROFESSIONAL DEVELOPMENT
Lifelong learning is the notion that learning occurs along a continuum, from elementary and secondary education to undergraduate and graduate education, lasting through the end of one’s career. There are several stages of learning, including training, education, and professional development. These terms are used somewhat interchangeably, but clear distinctions should be made due to their varying abilities to both promote and confine learning. Training often refers to the standardization of a process to yield similar results. Education refers to the process by which people learn to apply solutions to problems and adapt to new situations. Professional development transcends both concepts and includes areas such as self-directed learning, systems changes, and quality improvement; it teaches people not only how to apply solutions but also how to focus on actual performance and how to identify problems.
Within this schematic, continuing education is largely teacher-driven, focuses on clinical education, and predominantly builds on education theory. CE often is associated with didactic learning methods, such as lectures and seminars, which take place in auditoriums and classrooms. In theory, the purpose of continuing education is to update and reinforce knowledge, which should ultimately result in better patient care. But in practice, there often are conflicting ideas about the purpose of CE. Some health professionals see CE as a means to attain credits for the licensure and credentialing they need to practice their occupations. Employers often view CE as a way to keep staff up to date and to improve quality. Many regulators believe the purpose of CE is to maintain competence and improve quality.
In recent years, a broader concept, called continuing professional development (CPD), has been emerging that incorporates CE as one modality while adding other important features. CPD is learner-driven, allowing learning to be tailored to individual needs. CPD uses a broader variety of learning methods and builds on a broader set of theories than CE. CPD methods include self-directed learning and organizational and systems factors; and it focuses on both clinical content and other practice-related content, such as communications and business. Although CPD is a relatively new term to some U.S. health professionals, the term is used widely in Canada, New Zealand, and the European Union, including the United Kingdom (see Appendix C). CPD encompasses more diverse learning formats than those in CE (e.g., clinical reminders and academic detailing, where practitioners learn about drug prescribing from noncommercial sources) (Davis et al., 2003), and takes place in more