>>SINGER: Hi, I’m Steve Singer, I’m the Director of Education and Outreach at the Accreditation Council for Continuing Medical Education.
>>DELLERT: Hello, my name is Ed Dellert, I work at the American College of Chest Physicians where I’m the Senior Vice-President for Clinical Education, Informatics and Research.
>>SINGER: Ed, thanks for joining us.
>>DELLERT: Thank you.
>>SINGER: We’re going to talk today about your perspectives leading education at the American College of Chest Physicians. And one of the things I’d like to start with is, let’s talk about the role that you have currently at the ACCP.
>>DELLERT: OK well, it’s a long title, it’s Senior Vice-President for Clinical Education, Informatics and Research and that’s an umbrella for a number of things. The clinical education I think that’s pretty obvious that’s for kind of our medical education, lives and breathes. The informatics part is really about taking data from around the college and data can be in the form of our guideline development and our recommendations coming from those guidelines for standards of care. It can also be registry data that we are collecting. It can also be practice management or reimbursement codes that we might be advocating for our physician communities in their practices. And the research component is things that are scientific research that’s being published in our journal. It can also be educational research. And what we’re trying to do to determine are we really having the best impact on our learners that are participating in our courses, so that’s
>>DELLERT: the encompassing.
>>SINGER: So, you have sort of a mature differentiated organization that does a lot of different things and I think that what would be interesting for our audience is to understand the way in which either by design or by history you don’t, it doesn’t sound like you are operating in a silo, it sounds like you have that your involvement in the organizations sort of across the different aspects of its mission is that you’re bringing values in different ways across different aspects and I guess, probably don’t have time to talk about all those things but maybe we could talk about is, is how you manage that. How you manage the value that you and that education and as an accredited provider bring to the organizational sort of focus in these different areas.
>>DELLERT: So, I think first I’m very lucky to have committees and board and staff that really are working in tandem together to really look at the future of medicine is going and the resources that I’ve described are at and how it all fits together. They use education, it’s really our foundational platform on how we can improve patient care and outcomes. Even though the information and data that we might be using comes from different areas around the college or outside of the college. So, I think, they had the foresight of trying to put some of these resources in a common area with the hopes that we could start connecting the dots. So that it doesn’t get lost over in one area of the college or the committee in another committee or another group that’s focusing on something else. Is actually coming together even though they’re doing important work in their separate entities. So, education really has been a way to, as an example, when we’re focused on evidence-based guideline development we’re already trying to take a look at those recommendations that will come out of that group’s work. How is that going to impact performance metrics that might be out there? How is that going to be impacting clinical practice? And what can we do in our education model to really advance our community further in their practice? Many are very busy practitioners. So, you know, the first time they might be hearing about these recommendations and our guidelines or performance metrics might be at an educational forum that they are participating in at our annual meeting, it might be a separate educational activity throughout the year and our goal is to not only make sure that not only are we disseminating that information effectively but our we actually having an impact on that clinical practice.
>>SINGER: OK. So, so you have what could be perceived as sort of two levels of customer. One is a customer of the physicians and their practices that you’re providing education training and insight to as they respond to new information or respond to changes or new strategies for practice. The other customer is sort of an internal customer and because something is very interesting that you mentioned is that you are, you’re kind of like the quick response team, in a way. So that as things developed you mentioned within the guideline area that you’re already thinking from a strategic standpoint well what is both the impact of those guidelines going to be then how do we integrate those new guidelines with the things that are already up and running.
>>DELLERT: Correct. So, an example of that would be, we’re going to have an update to our lung cancer guidelines. Obviously for our physician community and healthcare team and I use the interdisciplinary component because it is physicians that we’re serving, but it’s also the entire interdisciplinary team that is supporting that physician practice that is being effected. When those guidelines are published we’re already thinking about where can we put some educational initiatives and focus on the critical recommendations. There’s a number of recommendations in that document. Screening is probably the most important part of changes in standards of practice that are coming out there out of that document. So, we want to know how can we implement that into our annual meeting in the Fall? How can we ply that into not only general sessions, a typical traditional method, but maybe we’ll put that into self-study. Maybe we’ll put that into a simulation based activity. Maybe some of those activities might be correlated to maintenance of certification. So, we’re really trying to take that and expand it in regards to how it’ll affect the physician community in their practice.
>>SINGER: To find all the places of value where you can offer
>>DELLERT: And there’s different places for that in that educational curriculum if you will. And where we would place it because some might hear about it in a lecture, some might experience in a self-study station, others might experience it in some type of hands on exercise that we have in a simulation based program and some of those might be related to maintenance of certification. And some will come because they need recertification points, that’s a driver but they’re actually getting more information as a result. So, we’re really trying to tie all those pieces together and make it as easy as possible for them to gain access to new recommendations and how to apply that in their practice and along the way to get, you know, recertification points, or they might have licensing points that they’re looking for all kinds of things that we’re trying to pull back together for them and make it as easy as possible.
>>SINGER: OK. So, we’re talking about the things that you are, you and your team that are actively doing to sort of manage the integration of education across this enterprise. What about the, what about your leadership? The, I would imagine that your leadership cares about both what you are doing and the impact, the effectiveness of what you are doing, how do, what, what approaches do you take to both sort of sort of I suppose in a procedural way to sort of map out but at the same time sort of track and determine how we doing with these things?
>>DELLERT: So, it’s definitely a team based approach. I mean they come at it from not only leadership support but also from content expertise in certain areas. We help facilitate that process with them by, some years ago, designing a curriculum, some would call it a taxonomy, some would call it tags. But, it is to help map out over a given year where all of our activities fit within that curriculum. And that really is designed to develop our program overall. So, if you think about it as a in an Excel spreadsheet where a column might be a list of all these curricula items and curriculum being for us clinical areas that our leadership and committees can identify with. And on a row below that is some very targeted learning and teaching methods that we have also assigned some very specifics to, some might be a lecture you know, as one category, it might case-based, problem-based learning exercises is another category, it might be simulation-based, hands-on; some of it’s quality improvement. But, nonetheless, if you look at it and you map out your program and you start seeing where there are gaps in the program and they can also determine on the things that we have done there are outcomes associated with each one of those teaching methods that we have used in any particular clinical domain. So, you might find that in a traditional lecture we might improve knowledge by some of the assessment tools that we have used as opposed to what we might do in a case-based exercise where we get a little more information from the learners in finding out the impact that it has versus a simulation-based where we reproduce a clinical environment and getting some more information and data and how it’s impact, versus a quality improvement component where we’re maybe giving them some tools to take home to measure what they’re actually doing in performance at home, which kind of falls into the maintenance of certification process, you know where from a QI standpoint. So, all of those things are helping us from a curricula design perspective, but it’s also helping us how we teach, and measure, in trying to get a handle on how we’re measuring the effectiveness of what we’re teaching.
>>SINGER: As you look at what you could probably call a dashboard approach that you’ve taken, it’s really interesting to think about that you’ve found sort of a meeting place between as you’ve said sort of needs assessment and looking at if there’s a certain clinical area a certain sort of practice based skill that needs to be advanced you could look across your enterprise and see what are the different methods and different approaches that we’re using to address that and where are there gaps and things we need to fill in. That’s at the same time, you know it’s sort of, your assessment of need relative to content and method of your education methodology, at the same time it is organizational reflection about how successfully or how completely you are managing sort of a number of aspects of one clinical problem but not managing all the aspects of another clinical problem so that can give you sort of big picture insight. And then you mentioned assessments and performance and quality and metrics where you’re actually looking at well what’s the impact of not only the education sort of the effectiveness of the education but also what’s the impact on performance and care sort of going forward. So, as you look sort of across the spectrum of all those things how, do you see sort of an easy alignment between what the approaches that you’re taking to manage that educational enterprise and your being able to deliver value to the overall mission of the large of the entire organization?
>>DELLERT: Yes, is the short answer. I think going back to the dashboard component and your point there is our leadership on a quarterly basis will kind of get their performance of the organization if you will, and where it sits. Some of that is financial some of it is critical project basis that they’re wanting to keep kind of their eye on to see if it’s moving forward. An element of that is things that are related to ACCME’s PARS report they will see a number of activities that we have had in a given year, up to that current point, they’ll look at the number of CME credits that we have offered, they’ll look at the number of physicians versus non-physicians that are participating; and then they’ll start looking at our learning categories and where it falls out so it’s a little more of an
>>SINGER: So those are sort of as organizational not accreditation but organizational metrics on how well are we serving our audience, our membership
>>DELLERT: Well, we try to tie it that into and we’re using ACCME as a guide as to information we know we are going to have to report on, on an annual report. But it also serves as a good process for us to start benchmarking where we’re at in our program, because we might take a look at our past history of what we have submitted under the PARS program as a way to guide us, we get a little more specific which is more internal driven for our purposes, you know, but the ACCME is and its reports are actually serving as a guide for us to move down that pathway. Some of the financial reports in the CME program helps guide us as to where we’re at you know, from one year to the next. The big annual report that comes out about all providers cumulatively serves as a another benchmark
>>SINGER: And where are you within that spectrum.
>>DELLERT: Correct. So, we can, you know, we might break it down to even a more specifics for us of what I’m describing on our teaching methods and measuring our effectiveness in those teaching which is not necessarily related to ACCME that’s more for us to determine how we’re trying to determine our own success and outcomes and effectiveness in what we’re doing. Because if something is not producing what we thought it was intended to do, well, then we need to reevaluate and determine a different way of approaching it.
>>SINGER: And I mean it’s interesting to me, I don’t hear you talking about accreditation. You know, you’re not talking about the filling the boxes of compliance and noncompliance. You are really, you are transcending that to say: what in the work that we do every day is, what can we evidence and what is helping us in our educational function and then our leadership and sort of the function of, of running an effective organization that delivers value to its members.
>>DELLERT: Right. And you’ve got to put it in the context of what’s going to make sense to when you have your content experts and your leadership coming to the table, their time is very valuable, so when they’re there you’ve got to grab their attention. And the more that you can funnel that information into a dashboard or a quick report that makes sense to them so that they can understand the business of what we’re doing and this organization and they’re certainly going to want to know what benchmarks can we gauge to see if we’re successful in that. That might be ACCME, it might be other CME providers it could be what’s out in the educational literature in regards to what’s successful what’s not successful and how we’re trying to apply that into our own programs. So, it is definitely a multi-tiered approach.
>>SINGER: Ed, I think that’s a great way for us to end. Thank you again for coming on.
>>DELLERT: Thank you, Steve, it’s been a pleasure.
This is a transcript of Integrating CME into Member Services.
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