Abstract
Introduction:
The effectiveness of continuing professional development as an intervention to improve health professional behavior and patient health is variable and contentious. To clarify the causal relationships underlying program outcomes and facilitate a necessary shift from outcomes-only–based approaches to outcome-based and theory-based approaches in program development and evaluation, we developed a model of mechanisms mapped to relevant outcomes.
Methods:
Mechanisms identified in a prior realist synthesis of opioid agonist therapy continuing professional development programs were iteratively tested and refined using purposive and opportunistic sampling and realist approaches against two systematic reviews of programs in analgesic prescribing and palliative care. Further testing involved practical application within programs in sustainable health care and pain management.
Results:
Ninety reports on 75 programs and practical application to multiple additional programs informed the final model consisting of five distinct mechanisms: motivation transformation, expert influence, confidence development, self-efficacy facilitation, and community of practice expansion. The mechanisms and related analysis emphasize that continuing professional development is heterogeneous, complex, and context dependent.
Discussion:
Shifting toward outcome-based and theory-based approaches facilitates further conceptual shifts at intraprogram and interprogram and interintervention levels toward more deliberate program development and evaluation, increased program complementarity and subsequent collaboration. It clarifies opportunities for intercalation of continuing professional development with other intervention sciences. The model presents a resource for practitioners, researchers, and policymakers to advance continuing professional development planning, coordination, and evaluation.
Funder
Health Canada
Institute of Musculoskeletal Health and Arthritis
Department of Family and Community Medicine, University of Toronto
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Education,General Medicine
Reference147 articles.
1. The impact of CME on physician performance and patient health outcomes: an updated synthesis of systematic reviews;Cervero;J Contin Educ Health Professions,2015
2. Evidence for continuing professional development standards for regulated health practitioners in Australia: a systematic review;Main;Hum Resour Health,2023
3. Continuing education meetings and workshops: effects on professional practice and healthcare outcomes;Forsetlund;Cochrane Database Syst Rev.,2021
4. Effectiveness of continuing medical education;Marinopoulos;Evid Rep Technol Assess (Full Rep),2007
5. Didactic CME and practice change: don't throw that baby out quite yet;Olson;Adv Health Sci Educ.,2012