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Class 1, 20.09.2010Atatürk University Medical Faculty

Continuous Professional Continuous Professional DevelopmentDevelopment

Zekeriya Aktürk, Prof. Dr.zekeriya.akturk@gmail.com http://aile.atauni.edu.tr

I've learned that in medicine nothing is "never" and it's certainly never "always."

/ 272 Stephen Sullivan. Knowledge and the Half-Life of Truth. http://www.medhunters.com/articles/knowledgeAndTheHalfLifeOfTruth.html

Example of outdated knowledge

• Infectious hepatitis – now hepatitis A

• Serum hepatitis – now hepatitis B

• Non A non B hepatitis – now hepatitis C

• Diabetes was checked formerly by urine ketones instead of blood glucose

• Alcohol bad for the liver but good for the heart?

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• 50 years ago radical mastectomy and radiotherapy – Now lumpectomy

• HRT was used to protect the heart – now considered harmful

• Flu vaccine under age 5 was routinely recommended in the past

• Chest x-ray to scean for lung cancer

• …

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Aim – Objectives• At the end of this lecture the participants are

expected to have information about continuous professional development and its importance for medical doctors.

• Objectives– differentiate CME and CPD– define board recertification– discuss the half life of medical knowledge– explain the CPD cycle

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Definition

• Continuing Professional Development (CPD) or Continuing Professional Education (CPE) is the means by which members of professional associations maintain, improve and broaden their knowledge and skills and develop the personal qualities required in their professional lives.

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CPD for medical professionals

• CPD consists of any educational activity which helps to maintain, develop or increase knowledge, problem-solving, technical skills or professional performance standards all with the goal that physicians can provide better health care.

• CPD includes 'formal' activities, e.g. courses, conferences and workshops, as well as self-directed activities such as preceptorship and directed reading. / 277

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What is the half life of medical knowledge?

• any new information we may gather has a half-life of 5 years.

• Lifelong learning is important, but no more important than clinical judgement, common sense and a critical evaluation of new information.

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Emanuel E. "A half-life of 5 years" Can Med Assoc J 112:572, 1975

A. J. MACGREGOR. Half-life of medical knowledge. CMA JOURNAL/MAY 17, 1975/VOL. 112 1165

In 2000

• 285 of 474 conclusions (60%) were still considered to be true,

• 91 (19%) were considered to be obsolete,

• and 98 (21%) were considered to be false.

/ 2710Poynard T, Munteanu M, Ratziu V, Benhamou Y, Di Martino V, Taieb J, Opolon P. Truth Survival in Clinical Research: An Evidence-Based Requiem? Annals of Internal Medicine 2002;136(12):888-895

One study:

• The half-life of truth was 45 years.

• the rate of loss of truth is 0.75% per year

/ 2711Platell C, Hall JC. Half-life of truth in surgical literature Lancet 1997; 350:1752

CPD in European countries

/ 2712Cathy Peck, Martha McCall, Belinda McLaren, Tai Rotem. Continuing medical education and continuing professional

development: international comparisons. BMJ VOLUME 320 12 FEBRUARY 2000

The CPD Cycle

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Sources of Professional Knowledge

• Textbooks• Medical literature (journals)• Short term courses• Long term trainings (Masters, PhD…)• Educational meetings (Conferences, panels..)• Information from the media• Exchange of experience with colleagues• Reviving personal experience• Collecting experience out of school• Learning on own initiative

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Measurement Scale for Planning

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Measurement Scale for Action

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International Federation of Accountants. International Accounting Education Standards Board. Approaches to ContinuingProfessional Development (CPD) Measurement 2008.

http://web.ifac.org/media/publications/c/approaches-to-continuing-pr/approaches-to-continuing-pr.pdf

CPD Log

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Barriers towards attending educational activities

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http://www.aare.edu.au/07pap/sid07623.pdf

Board Exams

• The Turkish Association of Family Physicians has finished preparations for board exams.

• Announcements are done through their web page and applications being collected

/ 2719http://www.tahud.org.tr/hakkimizda/yeterlilik-kurulu/tahud-board-sinavi/49

ABFM

• Founded in February 1969

• Certification candidates must have satisfactorily completed three years of training in a Family Medicine residency program

• Currently certificates are valid for a seven-year period

/ 2720https://www.theabfm.org/

Canada

• The Federation of Medical Regulatory Authorities of Canada has stated that all licensed physicians in Canada must participate in a recognized revalidation process in which they demonstrate their commitment to continued competent performance.

• The revalidation process came into effect January 1, 2010, and consists of mandatory compliance with continuing professional development (CPD) requirements.

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CME credits: TAHUD

• The aim of Turkish Board of Family Physicians – CPD (TAH-SMG) credits system:– To support scientific improvements of family

physicians by encouraging participation to high quality educational activities.

/ 2722http://www.tahud.org.tr/hakkimizda/yeterlilik-kurulu/surekli-mesleki-gelisim/48

Turkish Union of Medical Doctors CME-CPD Credits

• Group 1– Educational activities demanding full time participation:

Conferences, symposia…

– Courses: Aiming to improve professional level

– Activities related with peer rewieved journals: Yearly subscription, completing tests, quizzes etc.

– Educational activities with audiovisual materials: material sources have to be mentioned and evaluation at the end should be done.

– Other activities: publications, book writing, presenting, teaching, master, PhD…

/ 2723http://www.ttb.org.tr/index.php/ttb/kredilendirme

• Group 2– Activities of trainers not mentioned in Group 1

(journal clubs, audit mettings, mortality meetings..)

– Distance learning activities– CME/CPD activities not mentioned in Group 1

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Benefits of CPD

• Build confidence and credibility

• Earn more

• Achieve your career goals

• Cope positively with change

• Be more productive and efficient

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How CPD benefits the organisation

• Helps maximise staff potential by linking learning to actions and theory to practice.

• Helps set SMART (specific, measurable, achievable, realistic and time-bound) objectives

• Promotes staff development.

• Helps give a positive image/brand to organisations.

• …

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Summary

• What is the difference between CME and CPD?

• What do you understand from professional board organizations and recertification?

• What is the approximate half life of medical knowledge?

• Can you explain the CPD cycle?

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