ing and evaluated whether the institute or another alternative was preferable. The committee focused on five alternatives:

  1. Maintaining the status quo;

  2. Developing a program within an existing government agency;

  3. Forming a coalition of stakeholders;

  4. Creating a new, private structure of professional societies; and

  5. Developing a new, public-private structure.

The committee compared the ability of each alternative to achieve change in the following areas: research agenda, regulation, financing, conflict of interest, and interprofessional care (see Table 4-1). The committee also considered the long-term costs of the various alternatives.

Alternative 1:
Maintaining the Status Quo

Maintaining the status quo would leave CE researchers, providers, funders, regulators, and other stakeholders to address problems facing CE on their own. Some important research topics, such as team-based learning and workplace learning, require a degree of collaboration that is difficult or impossible to achieve under the status quo. Research on the amounts and types of learning to best improve practitioner performance is also needed and currently is not identified as a responsibility of any one particular group or organization.

The fact that regulatory responsibilities for CE vary across jurisdictions and professions will impede necessary collaboration as well. Although some organizations are beginning to explore ways to work together, it remains clear that no central vision or force guides change and stakeholders have no incentive to move away from the status quo.

The inconsistency of financing across professions also limits the stability of CE in both the short and long terms. Under the status quo, financing does not support interprofessional learning, point of care learning, and other cross-cutting areas of learning. Moreover, although some policies have been developed recently, CE activities are not free from conflicted sources of funding. There is no mechanism to ensure that continued learning is free from conflicts of interest.

In addition, the status quo has limited capacity to promote widespread interprofessional learning opportunities. Some efforts exist in



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