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Diane purcille practice inquiry v7

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Diane purcille practice inquiry v7

  1. 1. FAMILY MEDICINEPHYSICIANSFACULTY TRAINING:Practice Inquiry Modelfor Continuing MedicalEducationCopyright The Permanente Medical Group, Inc. 2013Start
  2. 2. Click Next to continue.Introduction: Course ObjectivesAt the end of this module, learners will be able to:• Describe the benefits of holding a practice inquirycolleague group in their facility• Identify the key components of the PI model andapply that model to a clinical problem• Identify strategies to engage group members toparticipate in sessions• Describe strategies for documentation to be incompliance with CME requirements
  3. 3. Click Next to continue.Help:What to do if you get stuck• Click on in the upper right corner to return to the list of modules.• To review the previous section of content click .• To advance to the next section of content click .If you have any other questions about this program, please email Diane Purcilleat diane.m.purcille@kp.org
  4. 4. Module 1: Introduction to Practice Inquiry• Clinical practice uncertainty• What is Practice Inquiry?• Facilitator Role• Benefits of Practice InquiryModule 2: Applying the Practice Inquiry Model• Practice Inquiry Matrix Inputs• Facilitation strategies• PracticeModule 3: CME review• Clinical practice change• Documentation RequirementsMenu
  5. 5. Click next tocontinueNextClinical practice uncertainty
  6. 6. What is practice inquiry?Click Next to continue.a small-group, collaborativelearning method …designed to assist physicians inbetter managing patient-basedclinical uncertaintyGroups meet weekly, bi-weekly, or monthly for one hour.
  7. 7. What is practice inquiry?Click Next to continue.un  cer  tain  ty noun1 state of doubt or not being sure2 perception of not knowing what to doThe goal is to exploreideas to addressdilemmas andfacilitate reflection onpractice……not tell doctors how to do their work.• diagnostic• doctor – patient relationship• patient care management• ethicalexamples in clinical areas
  8. 8. Clarifying the dilemmaExplorationAnalysisClosingWhat happens during a practice inquiry session?Click the boxes to learn more. Click Next to continue.Opening
  9. 9. Click each role to learn more. Then click Next to continue.Practice Inquiry Model: What is the faculty’s role in Practice Inquiry?Facilitating a practice inquiry session requires several skills. Click on the images below tolearn more.What is it like to be a facilitator in practice inquiry?
  10. 10. Individual• The presenter walks away with ideas about how they can approachtheir dilemma.• All colleagues have the opportunity to reflect on their own practicesand experiences.• All colleagues can learn new ways to address their own problematicsituations.Group• Discussion can reveal variations in practices or systems issues thatneed to be addressed.• The group has opportunity to share strategies and best practices.• Group can identify practice changes they would like to implement toincrease efficiencies and quality.What are the benefits to practice inquiry?Click Next to continue.
  11. 11. DisorientingdilemmasAnalysis &ProblemsolvingReflection /DiscussionStrategies &ApproachesSummary: Reflection QuestionsTake a few moments to reflect on the following questions:• What are the barriers to dealing with clinical uncertainty in your practice?• How would you describe the purpose of practice inquiry sessions to others?• What is the benefit to facilitated discussion around uncertainty?
  12. 12. Module 2: Applying the Practice Inquiry Model• Practice Inquiry Matrix Inputs• Facilitation strategies• Practice
  13. 13. - Clinical experience- Resources andevidence basedrecommendations- Next steps- Feedback process ofthe groupDilemma?Patient Context?Physician Context?Clinical Experience?Evidence?Clarify AgreementPatient andphysicianRelationshipChart MatrixMatrixTool for Practice Inquiry facilitationClick on next page to learn more about the chart matrix
  14. 14. Click Start to begin the activity.Amy Pratt, MDGroup FacilitatorRoberta Chan, MDCase presenterWelcome to the Practice Inquiry Session!Listen to the case presentation. Try to identify strategies the facilitator isusing to coach the group.Click Start to begin.StartFacilitation strategies: Guiding through questionsGeorge Wilcox, MDGroup Participant
  15. 15. Strategies for Facilitators – Sample questionsTo read through the example facilitator questions for each of the 7 input areas, click on the box.
  16. 16. Facilitator strategiesLet’s check out tips from the experts about facilitating practice inquiry groups. As youread, think about the following questions:• Which strategies do you already use?• Which strategies are new to you?• How is facilitating practice inquiry different from facilitating other session activities?Dr GreenDr PrattDr Bell
  17. 17. Dr Ralls is struggling getting her group to contribute to casediscussions. What should she do to get the group to add to theconversation?Click on the strategy you would recommend.Go around the room callingon members of the groupuntil someone sharessomethingNow it’s your turn to practiceDon’t say anything, justwait for a group memberto speak.Tell the group she isstumped by this too and askthe group for suggestions onhow they approach similarsituations.
  18. 18. Module 3: CME review• Clinical practice change• Documentation Requirements
  19. 19. Hi. I’m Dr Fair. I’m one of the new facultymembers for the Practice Inquiry sessions.Can you help me figure out what I need todo to get CME for my session?
  20. 20. Sure, I’m glad to. What is yourquestion?
  21. 21. I’m looking at the application andits asking about gaps, and practicechanges and outcomes. What isthat about?
  22. 22. CME is supposed to support physiciandevelopment, so to do that we need to createactivities that are addressing what is neededby the physician audience.Gaps are the difference between where thelearner is now and where we want them to be.So what is needed to bridge that gap?Is it a change in knowledge, competence, orperformance? It can be any of these!The desired outcome is what you want thelearner to be able to do after participating.
  23. 23. Oh, I see. So the activity has to linkto performance somehow? Isn’t itenough to try to understandsomething new?
  24. 24. Understanding is part of the learningprocess, but that isnt the end goal. For activitiesto be considered for CME they need to gofurther. CME has to be designed to changepractice in specific ways to address identifiedproblem areas.
  25. 25. I have an idea. What if I ask myfriend from medical school topresent about an innovative wayto treat cancer? She is a worldrenowned expert and her ideaswould definitely improve ourperformance. And it would begreat to hear about all the newtechnology that’s out there thatwe don’t have yet!
  26. 26. The best way to gauge it wouldbe to ask:How will participating in theactivity address the needs of thelearner? What will they be ableto do differently or better as aresult of participating in theactivity?Even though that topic iseducational, if they can’t applythe information then how will itimprove their practice?
  27. 27. Hmm. Ok. Well the great thing about practiceinquiry is that its all about issues seen inpractice. You’ve been a lot of help – thanks!
  28. 28. CME Activity SummaryCME accredited activities must be designed to enhance and improveperformance of physicians in order to improve the quality of care.Activities must go beyond general updates or “interesting” facts.Activities must demonstrate that they will address specific professionalpracticeActivities must be designed to change physician knowledge,competence or performance or patient care outcomes.
  29. 29. In order to have the practice inquiry sessions eligible to be considered forCME, facilitators must manage the application process and complete the followingadministrative steps:Contact the Richmond CMEcoordinator to request an addendumto the East Bay CME activityapplication for the RSS: Practice Inquiry- 20131Request and submit an annualfaculty disclosure form with theaddendum to the Richmond CMEcoordinator2At your first session, have allparticipants complete an annualdisclosure form.3 At each session, have allparticipants sign in on theattendance sheet.4Document session outcomes byphotographing the matrix orcreating a summary of discussionpoints and ideas generated.5
  30. 30. Multiple Choice QuestionAccreditation GuidelinesPractice Inquiry sessions will be eligible for CME credit. To bein compliance with CME accreditation guidelines, thelearning events should be designed to do what?Inform physicians about interesting or rare clinicalproblems they may see in practice.Help physicians be aware of changes or advances inclinical treatments.Change physician behaviors or practices based onevidence based recommendations.Allow physicians to share opinions on how to bestaddress clinical issues.Click a response. Then click Next to continue .Assessing and documenting outcomes: CME Knowledge Check
  31. 31. Multiple Choice QuestionAccreditation GuidelinesPractice Inquiry sessions will be eligible for CME credit. To bein compliance with CME accreditation guidelines, thelearning events should be designed to do what?Inform physicians about interesting or rare clinicalproblems they may see in practice.Help physicians be aware of changes or advances inclinical treatments.Change physician behaviors or practices based onevidence based recommendations.Allow physicians to share opinions on how to bestaddress clinical issues.Click a response. Then click Next to continue .Incorrect.Learning events may address lesscommon clinical issues but thepurpose is not solely to inform.Accreditation guidelines requirethat we create learning events thatare needs based and aimed atchanging physician practice.Assessing and documenting outcomes: CME Knowledge Check
  32. 32. Multiple Choice QuestionAccreditation GuidelinesPractice Inquiry sessions will be eligible for CME credit. To bein compliance with CME accreditation guidelines, thelearning events should be designed to do what?Inform physicians about interesting or rare clinicalproblems they may see in practice.Help physicians be aware of changes or advances inclinical treatments.Change physician behaviors or practices based onevidence based recommendations.Allow physicians to share opinions on how to bestaddress clinical issues.Click a response. Then click Next to continue .Incorrect.The purpose of learning events isnot solely to inform of changes oradvances in clinical treatments.Accreditation guidelines requirethat we create learning events thatare needs based and aimed atchanging physician practice.Assessing and documenting outcomes: CME Knowledge Check
  33. 33. Multiple Choice QuestionAccreditation GuidelinesPractice Inquiry sessions will be eligible for CME credit. To bein compliance with CME accreditation guidelines, thelearning events should be designed to do what?Inform physicians about interesting or rare clinicalproblems they may see in practice.Help physicians be aware of changes or advances inclinical treatments.Change physician behaviors or practices based onevidence based recommendations.Allow physicians to share opinions on how to bestaddress clinical issues.Click a response. Then click Next to continue .Correct!Accreditation guidelines requirethat we create learning events thatare needs based and aimed atchanging physician practice.Assessing and documenting outcomes: CME Knowledge Check
  34. 34. Multiple Choice QuestionAccreditation GuidelinesPractice Inquiry sessions will be eligible for CME credit. To bein compliance with CME accreditation guidelines, thelearning events should be designed to do what?Inform physicians about interesting or rare clinicalproblems they may see in practice.Help physicians be aware of changes or advances inclinical treatments.Change physician behaviors or practices based onevidence based recommendations.Allow physicians to share opinions on how to bestaddress clinical issues.Click a response. Then click Next to continue .Incorrect.Learning events will allow fordiscussion of experience and bestpractices, but accreditationguidelines require that we createlearning events that are needsbased and aimed at changingphysician practice.Assessing and documenting outcomes: CME Knowledge Check
  35. 35. Dilemma?Patient Context?Physician Context?Clinical Experience?Evidence?Clarify AgreementPatient andphysicianRelationshipDocumentation GuidelinesTrue or FalseTo fulfill the requirements and stay CMEcompliant, facilitators must document outcomesby photographing the inputs captured on thepractice inquiry matrix.TrueFalse
  36. 36. Dilemma?Patient Context?Physician Context?Clinical Experience?Evidence?Clarify AgreementPatient andphysicianRelationshipDocumentation GuidelinesThis is not correct.To be compliant you must documentoutcomes.That can be done in many ways which couldinclude also summarizing findings throughnotes or through post-­­session questionnaire.True or FalseTo fulfill the requirements and stay CMEcompliant, facilitators must document outcomesby photographing the inputs captured on thepractice inquiry matrix.TrueFalse
  37. 37. Dilemma?Patient Context?Physician Context?Clinical Experience?Evidence?Clarify AgreementPatient andphysicianRelationshipDocumentation GuidelinesYou are correct.To be compliant you must documentoutcomes. This can be done in many ways,including photographing the matrix, creatingsummary notes, or through post-sessionquestionnaires.True or FalseTo fulfill the requirements and stay CMEcompliant, facilitators must document outcomesby photographing the inputs captured on thepractice inquiry matrix.TrueFalse
  38. 38. Want to learn more?Visit TPMGPhysicianEd.org for more informationabout clinical education around theregion, including practice inquiry groups in the EastBay.To sign up for future facilitator training, contactDiane M. Purcille.

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