The last session of the workshop gave participants a chance to reflect on the previous day and a half of discussions, to identify gaps, and to think about how they could use what they learned to move forward, individually and collaboratively. To spur conversation, a panel of three participants—Lucy Savitz, Simon Kitto, and Jody Frost—each took a few minutes to share their thoughts with the other participants.
CPD FOR KEEPING PACE WITH A CHANGING ENVIRONMENT
Lucy Savitz, Intermountain Healthcare
Savitz started by acknowledging the major changes that are happening in health care as well as the “velocity of data” that are being promulgated in the worlds of education, clinical care, and research. She said that providers cannot keep pace with this dynamic environment and that high-value continuing professional development (CPD) is an excellent model for helping providers stay up to date and deliver the highest-quality care. In addition to the shift from continuing education’s (CE’s) didactic, top-down approach to CPD’s interactive, holistic approach, there is also a shift toward learning health care systems, where education and research are embedded into the delivery system, said Savitz. Using a learning health care system model creates an iterative ecosystem in which learning and service delivery can inform each other, and where professionals can learn on the job rather than in an atmosphere that is disconnected from the workplace. Savitz noted that while professional development in the workplace is often
focused on the individual, “we need to think about how . . . to educate teams of people so we can meet mission critical elements.” She added that while it is sometimes difficult to measure specific outcomes for a team-focused approach, this approach can add value for the delivery system through improved collaboration and coordination.
Savitz recalled the earlier discussion about workforce well-being (see Chapter 5), and said that “caregiver experience” should be added to the value proposition for a business plan. She noted that when health professionals feel competent it can lead to increased workforce well-being and, in turn, decreased turnover and improved recruitment and retention. In addition to these benefits, Savitz said that high-value CPD that takes caregiver experience into account can help decrease the “individual learning burden” that professionals face. In Savitz’s experience, professionals are overwhelmed by the expectation that they maintain their professional development in their free time. Savitz said that more research is needed to build the evidence base regarding CPD and the caregiver experience.
Finally, Savitz encouraged participants to think outside of the traditional cost-benefit analysis when making decisions about CPD. She noted that while this type of analysis is beneficial for “comparing competing opportunities to invest in training,” investing entities should also look for opportunities to “lift all boats” to reach a higher level of practice that meets the mission of the organization.
CPD FOR TRANSMITTING VALUES AND NORMS ACROSS GENERATIONS AND COHORTS
Simon Kitto, University of Ottawa
As a sociologist, Kitto said that “all [he] looks at is nonmonetized values in health care and health care education,” but that these are often seen as “thin bargaining chips in building a business case.” While it is difficult to assign value in economic terms to nonmonetized values, these values are essential to the maintenance and growth of the professional identities of individuals and organizations that, in effect, serve to bind or unbind people to collaborative activities in CPD. He elaborated that he views CPD not just as an instrumental way to “pick up skills or knowledge” but as a way to transmit values and norms across generations and cohorts. The business case for CPD should consider not only monetized outcomes and costs but also the educational value for the participants and how this education benefits providers, the system, and patients. He noted that while bundled interventions—which might include educational, clinical, and systems components—are essential for improving care, it is important to maintain and champion the unique contribution of education as a mechanism for instill-
ing the value and behaviors of high-value CPD into health care organizations and professions.
A REVIEW OF THE WORKSHOP
Jody Frost, National Academies of Practice
Jody Frost, representing the National Academies of Practice, reviewed the workshop sessions and noted the “quality presentations and very knowledgeable presenters.” Frost expressed her appreciation for the global perspective brought by the participants from outside the United States. Noting their wonderful ideas and “solutions that are not U.S.-centric,” she said that it “broadens our thinking when you get other people who bring different points of view and give us new ways of looking at things and new innovations.” She applauded how the workshop allowed participants to see CPD through the lenses of different stakeholders and to discuss a more comprehensive and holistic view of CPD. In particular, Frost gave the panel on accreditation and credentialing (see Chapter 5) “top honors” because it was thought provoking, innovative, and “questioned long-standing assumptions about how we measure CE.” Regarding the case study discussions (see Chapter 6), Frost noted that working through these examples—and seeing the variety of stakeholders involved in these cases—made it clear that “the decisions we make are not as simple as we think.” Finally, Frost drew an analogy between high-value CPD and the workshop itself, noting that both require an investment of time and money and that both should result in measurable outcomes. She encouraged the forum to “practice what you preach” and build a business case for its workshops.
“We too often drive into the future using only our rearview mirror.”
Cervero asked workshop participants to think about the words that Frost used in reflecting on the workshop: “So what, and now what?” He said that workshop participants need to have a sense of urgency about using their leadership in order to facilitate the shift toward high-value CPD. Cervero asked participants to take 10 minutes and talk with one another about “one actionable item that you plan to take forward from this workshop,” adding that participants were there not only to learn, but also to be the spark that could ignite action. After these table discussions, individual participants returned with the following ideas for moving high-value CPD forward:
- Disseminate the great ideas heard at the workshop to members at national meetings.
- Work on translating day-to-day interprofessional teamwork into CPD.
- Study maintenance of certification requirements for different professions and how these requirements affect other providers in the interprofessional network.
- Integrate ideas from the workshop into a 10-year initiative that is being developed.
- Meet the needs of CPD participants by ensuring an environment of psychological safety in which participants feel safe speaking up and taking risks.
Cervero thanked the workshop participants for their high-quality discussions and their excellent ideas for next steps. Noting the many connections that were made over the last day and a half, Cervero called on participants to continue these discussions, and adjourned the workshop.