Hello, my name is Katie Swimm, with the Education and Outreach department at the ACCME. In this video tutorial, Dr Murray Kopelow explores one way to plan and implement a “Learning from Teaching” CME activity that supports the compliance expectations of the ACCME's Accreditation Criteria. You may want to download the planning tool from this Web page — he'll refer to it during his presentation. Also, you may find the hyperlinks on this Web page useful to learn more about the resources that Dr. Kopelow explores during his presentation. Enjoy the tutorial.
Dr. Murray Kopelow:
The providers' success at meeting the ACCME‟s requirements isn't necessarily to be dependent on them following a series of steps in a stereotypical fashion and prospectively planning an activity. But, success could generally be looked at as creating the circumstances where a learner integrates their needs into a learning experience. Perhaps interchange, perhaps not, but in these cases, the provider is an agent of change. In the new formats of continuing medical education, things other than the didactic lecture, than the preplanned update, can be examples of this.
And, a specific example of this is what the ACCME terms “Learning from Teaching.” In this circumstance, imagine that one of your faculty wants to turn their experience of being a faculty member into their own CME activity. Perhaps you create the circumstance where you communicate that to them through saying something like: Thank you for agreeing to teach in our event. Your "assignment" can be recognized as a learning project for you, in support of your own continuing professional development — if you so choose. In order to do so, we‟ll need to do some work together to ensure the best outcome for you.
Like a contract between you and the learner, where you‟re not forcing something on the learner, where you're offering something to the learner, who can take advantage of it or not.
As a second step you could ask them: Describe for yourself the area of your professional practice that this learning project will or did inform, or improve. You could say to them: Describe this in terms of new knowledge sought or gained, or a new strategy or practice developed for you.
Now, as a provider you probably see the link to ACCME Criterion 2, where the provider incorporates into activities the educational need[s] that underlie the professional practice gap of their own learners. What you are doing here is you are asking the learners to describe for you what area of their practice you want to help them change. It supports the adult learning principle of activities: describe needs assessment and describe how the activity is tailored towards the needs of the learners.
Next, you could ask the learner to describe for you where and when you can apply this learning. What outcome for your practice did it or will it have? What assistance or resources did or would you need from us in this learning project?
Now, [a] few parts about this. One is it's self-directed. You're asking them to tell you how this is going to have application. But, it's also the way I've worded it, in what I've just said is it's prospective or retrospective. There's nothing about any of this that makes it more valuable if it prospective. If in fact, they're preparing or providing this education in retrospect turned into a learning project and they can identify how they're going to change their practice, that is as much value, and maybe more value, as if that had been decided prospectively.
Again, you can see the ACCME Criterion Number 3: The provider generates interventions that are designed to change competence, performance, or patient outcomes as described in its mission statement. By offering this opportunity — retrospectively or prospectively — you're designing an intervention where change is going to happen.
Criterion 4 says: The provider generates activities around content that matches the learners' current or potential scope of professional activities. And here, you‟re getting evidence from your learner of where in their practice this educational activity fits. And it supports the adult learning principle of making sure that learners would recognize in the activity that it has practical or immediate value to their own work or their own lives. So, you‟re fulfilling the adult learning principles and the ACCME requirements with getting that information from the learner.
Next, you could say: Describe what you did or will do, as an active learner, to complete this project. Is there anything we can do to assist you? So, what this does is that it attends to Criterion 5, where the provider chooses educational formats that are appropriate for the setting, objectives and desired results of the activity. You and the learner are in partnership. And the learner is offering to you, in this area, what it is that she thinks that would be the best thing to happen and what kind of assistance. So, they're building their own activity. Examples could be — of ways that you could help, would be to connect the learner with other persons with similar projects, connecting the learner with local professionals with experience in this area. Or you could make available your simulation center, for example, to use in support of this project. You can also ask them: Did you encounter any barriers to achieving your desired result while working on this project? That‟s sort of an added value to use [as] an accredited provider to meet other criteria that the ACCME offers.
But it supports the adult learning principles of asking the learner to identify or choose the questions that they answer, that they actively contribute to finding the answer that they're seeking. Or that the results of their own learning projects can be taught to others or shared with others, if you offer them the opportunity to interact with others doing similar projects. Also, the adult learning principle of making sure that the learners received complete freedom to pursue independent study or projects as part of their learning. This supports that adult learning principle.
And as you draw the educational activity to a close or they draw the activity to a close, you could say to them: As an end to this project, we ask you to describe for us, what you learned, what the outcome of this learning will be for you, or your patients, or the system in which you work. Or what barriers to implementation exist for you now? And you as an accredited provider could tell the learner to report this to you in a manner that works best for the facts and the circumstances. It could be a brief email after the activity; it could be sharing with you, the accredited provider, their presentation with the slides circled that identify these important areas of what they learned and what the outcome for them was. This would be in support of ACCME Criterion 11: The provider analyzes changes in learners achieved as the result of the overall program's intervention. You're bringing the activity to a close with asking them to reflect. And the adult learning principles that would be supported include: The CME activity describes mechanisms that are specifically intended to help learners reflect on their learning, and that the activity includes mechanisms for providing formative and summative feedback to the learners. So, this information that they create and generate is information for the learners about what they've changed and learned as a result.
One of the things that I've done in creating this model and in this description is to describe a learner-centered model for the planning and presentation of accredited continuing medical education. You as an accredited provider create the opportunity and the construct where a learner can focus on what it is that she wants to do and get out of an activity. But, at the same time, we all understand that there's a provider-centered component to all of this, where you're getting accredited and maintaining your accreditation at a program level. And that accreditation is the result of all your activities taken together in aggregate. So, it's important for me to add in here for you the value of offering this kind of educational activity and that this information and data generated from this kind of activity is hard data in support of your compliance with the Accreditation Criteria. But not every activity has to demonstrate compliance with every criterion.
What I refer to is Criteria 2, 3, 4 and 5; you could see how you could add in Criterion 6 by it being about systems-based practice or medical knowledge, and I talked about the information being generated being used in Criterion 11. That‟s the kind of data and information that's produced at an activity level for you to use in support of your compliance with the Criteria at the provider level, at the program level. Not every criterion for every activity, and the more learner-centered the activities are, the more they'll be focused on Criteria 2, 3, 4, and 5, where you generate information that is appropriate and you use a format that is appropriate for the moment.
So, here you can create an educational activity that meets the ACCME requirement by just creating the circumstances where the learner can integrate their own needs into this learning experience. Maybe they change, maybe they don't, but you're the agent of change by creating a context and a system in which they could implement these varying steps to learn and to potentially change.
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