This document provides an overview of a webinar on employing adult education principles to tackle performance improvement challenges. It includes an introduction, objectives, information on the presenter's experience and models used in performance improvement continuing medical education. It also discusses various learning theories including behaviorism, humanism, social cognitive theory, and theories of motivation that can inform the practice of performance improvement CME. Key points covered include using evidence-based adult learning principles, addressing barriers to participation, and incorporating humanist, behavioral and social cognitive approaches.
Presentation from 'Enhancing the student experience' workshop at the CDE’s Research and Innovation in Distance Education and eLearning conference, held at Senate House London on 1 November 2013. Conducted by Ormond Simpson (HE consultant, Visiting CDE Fellow). Audio of the session and more details can be found at www.cde.london.ac.uk.
This talk is being delivered on June 19th 2012 as part of CBI's 3rd Annual Social Media Regulations and Compliance Conference in Arlington, Virginia: http://www.cbinet.com/brochures/PC12028_brochure.pdf
Presentation from 'Enhancing the student experience' workshop at the CDE’s Research and Innovation in Distance Education and eLearning conference, held at Senate House London on 1 November 2013. Conducted by Ormond Simpson (HE consultant, Visiting CDE Fellow). Audio of the session and more details can be found at www.cde.london.ac.uk.
This talk is being delivered on June 19th 2012 as part of CBI's 3rd Annual Social Media Regulations and Compliance Conference in Arlington, Virginia: http://www.cbinet.com/brochures/PC12028_brochure.pdf
Presentation: Health Reform in Massachusettsmasscare
This is a slideshow presentation that looks at the outcomes of the 2006 Massachusetts health reform law. These are major findings related to insurance coverage, access to care, costs, emergency room use, and other select outcomes from the more comprehensive report by Mass-Care and Massachusetts PNHP: "Massachusetts Health Reform in Practice, and the Future of National Health Reform."
Mobile Health: Pamf engagement mobile health stanford 2011 05-16 albertschan
How PAMF has achieved significant patient engagement with My Health Online. Over 72% of the active adult patients at PAMF use My Health Online, our implementation of Epic's MyChart.
Kharfen: DC HIV Public-Private Partnershipshealthhiv
Michael Kharfen
Bureau Chief, Partnerships, Capacity Building, Community Outreach
DC Department of Health
HIV/AIDS, Hepatitis, STD and TB Administration
AcademyHealth President and CEO Lisa Simpson's presentation for the Richard and Janet Southby Distinguished Lecutreship in Comparative Health Policy at the George Washington University Hospital on April 24, 2012
Brian Prestwich, MD
Assistant Professor of Family Medicine
Keck School of Medicine of the University of Southern California
Thursday, February 23, 2012
How Wise Investments in Research can Save Lives and Reduce Health Care CostsAcademyHealth
Dr. Peter Pronovost of the Johns Hopkins University presented this material at AcademyHealth's 2012 Hill briefing entitled "Health and the Deficit: Using Health Services Research to Reduce Costs and Improve Quality."
Returns to Public Investments in ECEC Oslo, Norway Implementing Policies for ...EduSkills OECD
Why invest in ECEC?
First 5 years lay foundations for language, academic abilities, habits & socio-emotional development
The window for change does not close after age 5, but “catch up” is costly
Worldwide more than 200 million children under 5 are failing to reach their developmental potential
Preschool interventions can enhance development and yield high economic returns
Presentation: Health Reform in Massachusettsmasscare
This is a slideshow presentation that looks at the outcomes of the 2006 Massachusetts health reform law. These are major findings related to insurance coverage, access to care, costs, emergency room use, and other select outcomes from the more comprehensive report by Mass-Care and Massachusetts PNHP: "Massachusetts Health Reform in Practice, and the Future of National Health Reform."
Mobile Health: Pamf engagement mobile health stanford 2011 05-16 albertschan
How PAMF has achieved significant patient engagement with My Health Online. Over 72% of the active adult patients at PAMF use My Health Online, our implementation of Epic's MyChart.
Kharfen: DC HIV Public-Private Partnershipshealthhiv
Michael Kharfen
Bureau Chief, Partnerships, Capacity Building, Community Outreach
DC Department of Health
HIV/AIDS, Hepatitis, STD and TB Administration
AcademyHealth President and CEO Lisa Simpson's presentation for the Richard and Janet Southby Distinguished Lecutreship in Comparative Health Policy at the George Washington University Hospital on April 24, 2012
Brian Prestwich, MD
Assistant Professor of Family Medicine
Keck School of Medicine of the University of Southern California
Thursday, February 23, 2012
How Wise Investments in Research can Save Lives and Reduce Health Care CostsAcademyHealth
Dr. Peter Pronovost of the Johns Hopkins University presented this material at AcademyHealth's 2012 Hill briefing entitled "Health and the Deficit: Using Health Services Research to Reduce Costs and Improve Quality."
Returns to Public Investments in ECEC Oslo, Norway Implementing Policies for ...EduSkills OECD
Why invest in ECEC?
First 5 years lay foundations for language, academic abilities, habits & socio-emotional development
The window for change does not close after age 5, but “catch up” is costly
Worldwide more than 200 million children under 5 are failing to reach their developmental potential
Preschool interventions can enhance development and yield high economic returns
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Best Ayurvedic medicine for Gas and IndigestionSwastikAyurveda
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Basavarajeeyam - Ayurvedic heritage book of Andhra pradesh
Employing Adult Education Principles to Tackle Performance Improvement Challenges
1. Welcome to today’s webinar!
Please take a moment to answer the poll question below.
Boston University Slideshow Title Goes Here
How many people are participating in this webinar at your location
today?
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Welcome to today’s webinar!
Please take a moment to answer the poll question below.
Boston University Slideshow Title Goes Here
What member section do you belong to?
Hospital/Health System
Medical School
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Employing Adult Education Principles
to Tackle Performance Improvement
Challenges
Lara Zisblatt, M.A.
July 12, 2011
2:00 – 3:00 pm ET
2. Presenter
Boston University Slideshow Title Goes Here
Lara Zisblatt, M.A.
Assistant Director
Continuing Medical Education
Boston University School of Medicine
7/8/2011
Disclosures
Boston University Slideshow Title Goes Here
Lara Zisblatt has nothing to disclose with regard to
commercial relationships and is not selling a
technology, program, product, and/or service.
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Competency Area 2.1
Boston University Slideshow Title Goes Here
Use evidence based adult learning principles to guide
the practice of CME
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Objectives
Boston University Slideshow Title Goes Here
Following this session, you will be better able to:
Describe how adult education principles inform the
practice of Performance Improvement (PI) CME
Use adult learning principles in the planning of
effective PI CME activities
Employ adult education principles to confront PI CME
challenges
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7/8/2011
Experience in PI CME
Boston University Slideshow Title Goes Here
Began planning first PI Initiative in 2004
First initiative was launched in 2006
To date we have planned and implemented 18
activities, some that have lasted for a few years
Clinical areas have included:
Adolescent Vaccinations Depression
Attention Deficit Hyperactivity Disorder Diabetes
Asthma Obesity
Chronic Obstructive Pulmonary Disease Osteoporosis
Coronary Artery Disease Urinary Incontinence
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Models for PI CME
Boston University Slideshow Title Goes Here
2 National PI CME Initiatives completed, 1 ongoing, 1 in planning
phase
(COPD, Depression, Type 2 Diabetes, Obesity)
Online, distance education
3 completely self-directed, 1 on BUSM-directed schedule
3 small regional PI CME Programs
(2 CAD and Overactive Bladder)
Connected to an annual meeting
11 local PI CME Programs
(Adolescent Vaccination, ADHD, 7 COPD, 2 Obesity and Osteoporosis)
Providers complete all stages of the PI CME activity during their regularly
scheduled practice meetings or grand rounds
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4. Example of Outcomes from a Local
COPD PI CME Activity
100% 96% 98%
Boston University Slideshow Title Goes Here 94%100%
90% 85% 81%
79% 77% 82%
80% 75% 76%
74%
68%
70%
60%
60%
60%
50%
50%
38%
40%
30%
21%
20% 15%
9%
10%
0%
Influenza Vaccine
Intervention
Rehabilitation
Initial Spirometry
Pharmacology
Pneumococal
Long-Term
Saturation
Assessment
Spirometry
Oxygen
Pulmonary
Smoking
Oxygen
Repeat
Smoking
Vaccine
Pre-Intervention Post-Intervention
Statistically significant improvement seen in initial spirometry,
repeat spirometry, pulmonary rehabilitation, flu vaccination, and
smoking assessment
7/8/2011
The Challenge
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How do we motivate clinicians to engage in and
complete a performance improvement activity?
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Malcolm Knowles – Father of Adult Ed
6 Assumptions about Adult Learners
Boston University Slideshow Title Goes Here
1. Have a Need to Know
Help the clinician-learner identify the gap between where
they are now and where they want to be.
2. Are Self-Directed
PI CME is self-directed and allows for clinicians to
choose their own interventions and design their own
action plans.
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5. 7/8/2011
6 Assumptions about Adult Learners
Boston University Slideshow Title Goes Here
3. Bring a Lot of Experience to the Learning Environment
Acknowledge this, incorporate it, employ it in the planning of the
educational interventions – give them practical tools to use.
4. Are Ready to Learn
Adult clinician-learners will be in various stages of readiness to learn
and change. PI CME can help them move through this process.
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6 Assumptions about Adult Learners
Boston University Slideshow Title Goes Here
5. Have a Real-life Orientation to Learning
Adults learn best when new information is presented in
the context of real life – PI CME is embedded in the
“real-life” practice setting.
6. Are Motivated to Learn
Internal motivators are the most potent.
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PI CME Strong Basis in Learning Theory
Boston University Slideshow Title Goes Here
Not just about outcomes data
Performance Assessment addresses the issue of
clinicians inability to accurately assess their own
practice (Davis, 2006)
The serial and active nature of PI CME have been
shown to be effective in improving performance
(Grimshaw, 2001, Davis, 1999)
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6. Behavioral Basis for PI CME
Boston University Slideshow Title Goes Here
PI CME is based on Edward W. Deming’s industrial
and statistically driven model for quality improvement:
Plan, Do, Study, Act
The idea is to look at the data from patients, examine
the system of practice, and make a change to improve
care
If we had total control of the practice environment, we
could implement an intervention that would
automatically change behavior
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More to PI CME
Boston University Slideshow Title Goes Here
But we don’t have total control of the environment
Clinician involvement in improvement is crucial
To Err Is Human expressly states that the IOM is “not…pointing
fingers at caring health care professionals who make honest
mistakes.” (Institute of Medicine, 2001)
Many have wondered: where are the clinicians?
PI CME is a great way to promote clinician involvement
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Why clinicians participate
Boston University Slideshow Title Goes Here
“I figured I could learn more”
“Great if we could take an organized look at this”
“Clinically significant...it seemed like it was an area
where we had a lot of room to improve”
“We could really...help our patients”
“I’ve been always somebody who likes to improve”
“Many hours of CME didn’t hurt”
“My job is QI and organization of improvement for
diabetes care and so I thought it was interesting”
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How Theory Can Help
Boston University Slideshow Title Goes Here
We don’t have the answer to the retention problem for
online PI CME programs
Local activities where practices complete each stage as a group
Physician champions and buy-in from the leadership are key
Theories can help identify gaps in your planning
Theories can give meaning to your planning choices
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Learning Paradigms
Boston University Slideshow Title Goes Here
Behaviorists (Skinner, Pavlov):
Stimulus-response. All behavior caused by external stimuli (operant
conditioning). All behavior can be explained without the need to
consider internal mental states or consciousness.
Humanists (Maslow, Rogers):
Learning is a personal act to fulfill one’s potential.
Social Cognitivists (Bandura):
People learn from one another, via observation, imitation, and
modeling.
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Behavioral Learning Theories
Boston University Slideshow Title Goes Here
The teacher can help institute interventions that lead participants
to respond appropriately
Insert changes to the environment to precipitate improvement without
additional burden on clinicians
Electronic reminders
Standing orders
Data collection by Medical Assistants
Stage A and Stage C act as reinforcement of positive and
reminder of negative behaviors
Yet - provider involvement and motivation is important
Difference between PI and QI
Clinicians need to believe in the change to make it happen
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8. Humanistic Learning Paradigms
Boston University Slideshow Title Goes Here
How can you make the education more personal?
We found that those who were used to looking at data found the
individual chart review process personalized the process, making it
more meaningful
But what else could make the experience personal?
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Example of from the practice
Boston University Slideshow Title Goes Here
Interviewer: would you ever want to go to a model just for ease of it to look at it through epic or do
you think keeping this piece of it?
Physician: I think keeping the individual chart reviews? I think they are always going to be
valuable. Um you know…as we get further and further into an EMR would we be able to replicate
every single thing…I don’t know, um I don’t know, um but I think looking yourself I think looking, I
don’t know. I just found it to be really helpful. Looking at a patient that I know that I have known
for 10 years, who has COPD and realizing I don’t know, what, that they really could’ve used
pulmonary rehab and I had never suggested it. And I think that is very valuable. And its different
from getting a piece paper spat out saying number who could have used it and number
who…cause you know, cause you feel like you are letting this particular patient down. That’s
powerful.
Interviewer: yeah a little bit of the emotional tug
Physician: Well, yeah, because when you are doing chart reviews if you are a primary care doc
whose been in practice for any amount of time you are really reviewing individual…you know these
people, right, so….I think, I think it has value from that perspective. Even if you could do it
completely out of the computer.
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Social Cognitive Learning Paradigms
Boston University Slideshow Title Goes Here
How can you create an environment for online learning
programs where participants can observe and model
appropriate behavior?
The chart audit form itself can identify appropriate behaviors
How else can you encourage interaction so that participants can
observe appropriate behavior? How can you give participants the
ability to try out behavior?
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9. 7/8/2011
Example of from the practice
Boston University Slideshow Title Goes Here
Interviewer: How did that make you feel when you saw that data? Were you just…what was your attitude
towards seeing that gap in practice?
Nurse: Well, I probably said okay nice, interesting to know how can I incorporate something. I did show that
first audit to doctor and I showed him what it said toward the national average and recommendation umm
what it says what you should do so um I didn’t feel it as a critique against our work no.
Interviewer: mhum mhum
Nurse: if we call critique constructive criticism
Interviewer: mhum mhum
Nurse: What it was geared to be
Interviewer: Yep
Nurse: Since it was a performance improvement program
Interviewer: mhum mhum, yes [laugh]
Nurse: [laugh] it was for us to identify was is the gold standard, right?
Interviewer: mhum mhum
Nurse: and What you should strive for to improve the quality of care for your patients
Interviewer: and then so when you showed it to your doctor when did you decide to do that, were you always
planning on doing that
Nurse: I did it after I printed it off and looked at it and said sean I did this program I told you about that I was
going to do and this is the result of my first audit this is what it says and he goes ohh interesting
25
Boston University Slideshow Title Goes Here
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Incorporating Humanist Learning Theory
Boston University Slideshow Title Goes Here
Motivate through Feeling:
Emails with cases and other descriptions to help participants become
emotionally involved in the program.
Emphasize that the charts represent real patients. Don’t always
focus on the final percent.
Promote Mindfulness:
Open Action Plans can ask probing questions that promote reflection
about practice and how to implement change.
A coach can call participants to encourage reflection about practice.
Encourage Transformational Learning:
Learners not threatened by negative feedback. Can use this as a
transformational experience.
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10. Incorporate Social Cognitive Theory
Boston University Slideshow Title Goes Here
Observe others
Performance data from peers
Modeling through videos demonstrating positive behaviors, like
motivational interviewing and best practices
Instructors as Mentors
Teleconferences and office hours can help encourage one-on-one
time with participants and faculty
Social Interaction
Discussion boards, open teleconferences, meet-ups
Encourage clinicians to participate as a group
28
Boston University Slideshow Title Goes Here
Humanism Approach
Enhanced
Knox’s Proficiency Theory
Boston University Slideshow Title Goes Here
Knowledge
Attitude
Skill
Leads to improved performance
11. Proficiency Theory - Knox - 1990
Boston University Slideshow Title Goes Here
Examined CME participation applying adult education
principles. Recommendations:
Employ testimonials, success stories and human
interest stories to encourage participation
Portray benefits
Recruit an entire practice
State discrepancies between current and desired
proficiencies
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Knox - 1990
Boston University Slideshow Title Goes Here
Build in opportunities for positive feedback and
success along the way – to build proficiency and
sense of self-efficacy
Include examples of how others used ideas
Build in variety and measures of progress
“harness encouraging influences and deflect
discouraging influences”
Encouraging influences - MOC, PQRS, QI
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“Deflect discouraging influences” (Knox)
Boston University Slideshow Title Goes Here
Address barriers whenever possible
Consider number of chart reviews – process,
performance, outcome measures
Time commitment
Lack of knowledge about PI CME process
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12. 7/8/2011
Self-Determination Theory –
Theory of Motivation
Boston University Slideshow Title Goes Here
A framework for the study of motivation (Deci and
Ryan)
Intrinsic and extrinsic motivation
How social and cultural factors can help or hurt
motivation
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Motivation
Intrinsic Extrinsic
Boston University Slideshow Title Goes Here
Positive Desire to help patients Increased Pay
Wishes to improve job skills Promotion
Love of learning/curiosity Recognition
Personal development Performance evaluation
Desire to close clinical gap Popularity/fame
Licensing/certification
requirements
Demonstrated competency
Negative Fear of failure Failure to achieve recertification
and/or re-licensure
Failure to demonstrate
competence
Poor opinion of performance by
peers and/or patients
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Motivation – How PI Can Respond
Intrinsic Extrinsic
Boston University Slideshow Title Goes Here
Positive Providing better care – gaps in care Pay-for-Performance
become personalized and motivating (payers, CMS)
Clinical relevance to patient Board MOC approval
population State licensure
Provide feedback through chart Joint Commission –
summary OPPE
Compare to peers Supervisor
Compare to national benchmarks /organizational
Provide opportunities for reflection requirement
Possible career
advancement
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13. 7/8/2011
Summary
Boston University Slideshow Title Goes Here
Using theories and frameworks can help you make
decisions on what auxiliary components you can add
to your PI CME activities
Use theories and frameworks to make your case to
funders, collaborators, and participants
37
References
Boston University Slideshow Title Goes Here
Aparicio, A., & Willis, C. E. (2005). The continued evolution of the credit system. Journal of
Continuing Education in the Health Professions, 25(3), 190-196.
Brennan TA. Physicians' professional responsibility to improve the quality of care. Academic
Medicine. 77 : 973 2002.
Davis, D. A., Mazmanian, P. E., Fordis, M., Van Harrison, R., Thorpe, K. E., & Perrier, L.
(2006). Accuracy of physician self-assessment compared with observed measures of
competence - A systematic review. Jama-Journal of the American Medical Association,
296(9), 1094-1102.
Deming EW. The New Economics for Industry, Government, Education. Cambridge, MA: MIT
Center for Advanced Engineering Study, 1982.
Duffy, F. D., Lynn, L. A., Didura, H., Hess, B., Caverzagie, K., Grosso, L., et al. (2008). Self-
assessment of practice performance: Development of the ABIM practice improvement module
(PIMSM). Journal of Continuing Education in the Health Professions, 28(1), 38-46.
Epstein et al. “Self-Monitoring in Clinical Practice: A Challenge for Medical Educators.” The
Journal of Continuing Medical Education in the Health Professions. 28.1 (2008): 5-13.
Goulet F, Gagnon RJ, Desrosiers G, Jacques A, Sindon A. Participation in CME activities.
Canadian Family Physician. 1998;44:541-8.
Grimshaw JM, Shirran L, Thomas R, et al. (2001) Changing provider behavior: an overview of
systematic reviews of interventions. Med Care 39:II2–II45.
38
References
Boston University Slideshow Title Goes Here
Holmboe, E. S., Meehan, T. P., Lynn, L., Doyle, P., Sherwin, T. & Duffy, F. (2006). Promoting
Physicians' Self Assessment and Quality Improvement: The ABIM Diabetes Practice
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