of Medicine (IOM), has spurred debate about how best to ensure the continuing competence of health professionals. As discussed in Chapter 1, the IOM report Health Professions Education: A Bridge to Quality (2003) details five core competencies deemed necessary for all health professionals: patient-centered care, interdisciplinary team-based care, evidence-based practice, quality improvement strategies, and the use of health informatics. These competencies are intended to help provide a more safe, effective, patient-centered, efficient, timely, and equitable health care system (IOM, 2001). For example, advances in the areas of evidence-based practice and quality improvement require the ability to integrate clinical knowledge with professional practice. Connecting these processes through evidence-based health professional education has the potential to revolutionize the health care system (Berwick, 2004; Cooke et al., 2006).

The components of CE—the CE research system, regulatory and quasi-regulatory bodies, and financing entities—are currently ill-equipped to support these core competencies consistently. For example, as this chapter later details, effective CE incorporates feedback and interaction, yet 76 percent of continuing medical education (CME) instruction hours are delivered through lectures and conferences (ACCME, 2008) that typically limit interactive exchange (Forsetlund et al., 2009). Various professions, however, have begun to use different methods of CE, including methods that better take into account the clinical practice setting (Kues et al., 2009; MacIntosh-Murray et al., 2006).

Research on CE methods and theories behind adult learning, education, sociology, psychology, organizational change, systems engineering, and knowledge translation have provided an initial evidence base for how CE and continuing professional development should be provided. Additionally, previous works have offered theoretical frameworks for conceptualizing CE and guiding its provision (Davis and Fox, 1994; Fox et al., 1989).

This chapter presents summary data on the ways in which CE is typically provided. The chapter discusses the most common methods of providing CE; details findings on the effectiveness of CE in general, as well as the effectiveness of specific CE methods; discusses theories that support what is known about how adults learn; and describes the attributes of successful CE methods and how theory can be applied to improve these methods.



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