• In many cases, there is no relationship among the key regulatory components of state licensure, certification, credentialing, and accreditation. Current regulatory processes generally exist as separate systems, leading to inconsistency, duplication, and confusion over what is needed to enhance learning. There is also little consensus about how effectively the regulatory processes are functioning.

  • Licensing requirements are inconsistent across states and professions. The differences among state requirements do not have a scientific basis and thus reflect uncertainty about what amounts and types of CE are necessary, and in what contexts CE should be provided, for professionals to both maintain their competence and improve their practice.

  • CE lacks an established research agenda and is supported by a disrupted financing system, making accreditation more difficult.

  • CE currently lacks a patient-based focus, as quality and patient safety are not often well integrated into CE processes.

  • There is little recognition of the need for a multidisciplinary approach to CE. Since health care requires collaboration among professionals, providing interprofessional education holds the most promise for better aligning learning with practice needs.

In sum, the current approach to CE has serious flaws. There are major gaps in research, regulation, and financing, and the components of CE are managed by different stakeholders operating in isolation. What is fundamentally needed is a coordinated vision of what an effective continuing professional development (CPD) system for health professions should entail—and the leadership to fulfill such a vision.

Many of the components of a comprehensive, broad-based CPD system are spelled out in previous chapters. This chapter will focus on ways to implement such a system.


In considering the establishment of an institute such as the one proposed in the committee’s statement of task, the committee identified alternative means of improving health professions learn-

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