The Emergence of a Real “Profession” in Continuing Education

The content in the embedded video below dates back to a talk I developed in 2011, shortly after I first  read the Alliance’s retrospective on its first 20 years. I recently recorded an audio track to archive the presentation and to begin to explore what’s changed over the past 3-4 years. In this blog post I will dig a bit more deeply into where we are today as we begin to see signs of the emergence of a real “Profession” in continuing education.

 

As this community endeavors to establish itself as key stakeholders in the healthcare Quality Improvement arms race, I have found myself reflecting back on countless conversations about whether or not we (those focused on continuing education in healthcare) can define ourselves as a true profession.

As you will see in the video, the first place to start any conversation about what makes a “Profession” is to work from a common ground or established definition, for instance: A Profession in medicine or science is derived from a cadre of like-minded and connected individuals working within a common framework or science. From here we can deconstruct these elements to better understand what is meant by ‘like-minded’, by ‘connected’, and by a ‘common science’.

When this presentation was given in 2011 the conversation within the CE community seemed to suggest that becoming a professional in CE was simply an element of one’s job – if you were employed within an organization that supports CE for healthcare professionals then you had the right to call yourself a professional. Conflating matters even more, at the time the new Alliance competencies and the NC-CME certification process seemed to validate this belief. The end effect was that there was a broad scale lowering of the bar and an undermining of the community’s real aspirations.

That was then…

Over the past few years I have seen a significant shift in this community to embrace what are the foundational elements of our emerging Profession. While it is early in this process, I think it is essential to recognize the elements that are in play and (hopefully) accelerate this critical transformation.

Perhaps the best way to do this is to give clear examples of where I see the emergence of cadre of like-minded and connected individuals working within a common framework or science.

We are becoming more ‘like-minded’ –

I have always been hard-pressed to believe that developing education for education’s sake was going to have the impact on healthcare that this community hoped for. Yet for the better part of the past 20 years, this was what was actually going on. And whether or not the designers and planners recognized it or would admit it, by-and-large I still see this approach taken today my many within the community.

But over the past year or two I have seen a significant uptick in the recognition that high quality healthcare is a product of a culture and a system; that educational interventions must be tied to non-interventional strategies; and that properly supporting the process of learning is critical to empowering clinicians to evolve. To be frank, I am seeing more and more members of this community embrace the reality that education outside a system for implementing change is a relatively low-fidelity solution – and that more and more of our resources and efforts must be directed to those interventions proven to be most effective and efficient.

In support of this belief I point to two examples: 1) the advent of the QIE Roadmap by the Alliance and 2) the launch of the NCQA’s Transformation of the PCMH model. These examples arise from two organizations arriving at a like-minded solution and a recognition that the greatest impact of CE lies in support of a healthcare organization’s quality culture transformation.

We are becoming more ‘connected’ –

This will come as no surprise to many, but I whole-heartedly embrace the opportunity that new media have to level the playing field and empower the masses to learn, to share, and to evolve. Dating back to the launch of the CMEAdvocate blog, to our weekly CMEchats (#CMEchat), and through to the construction of the ArcheMedX Resource Center – I have been making a constant effort to make learning and sharing more accessible and to better connect this community.

But what I feel began as a very small network of early adopters, bloomed to a mainstream Professional expectation with last week’s CMEPalooza. Largely on the volunteer effort of Derek Warnick and Scott Kober, nearly 30 moderators and speakers contributed to what amounted to a seven-hour long conversation and sharing of best practices with nearly 500 learners. These sessions have already been archived and serve as wonderful assets for the community to share. Add to this that there are now more than 9,500 members of the LinkedIn CME group started by Lawrence Sherman and hundreds of active discussions to partake in. In 2014 this community seems to have fully embraced the notion that the collective is more powerful than the individual!

We are focusing in on our ‘common framework or science’ –

But for this shift to a cadre of like-minded and connected individuals to truly become a Profession we must have commit to a shared praxis or common framework– this become the unifying body of evidence that drives the transformation. Our framework is that of the science of adult learning and implementation science. And here too I have seen dramatic shifts in what how this community thinks and acts. More and more members of this community are elevating their practices to build interventions based on solid evidence, focusing efforts on areas of proven need, and committing to publish their findings in peer-reviewed journals or present their work in broadly accessible and credible ways.

As one example, a brief manuscript describing work from our Partners at ANCC and UVA has recently been received and accepted by the Journal of Continuing Education in Nursing – this is the first CE-focused report on the use of the flipped classroom and we couldn’t be more proud to have supported the planning, design, implementation, and analysis of this project. We will share much more about this important work when the article is published in early November!

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To be clear, culture change is not easy; sometimes there needs to be tremendous forces applied from both external and internal sources before the elements properly align. But having lived through these turbulent times, I see this community being reshaped. I see a new era of like-mindedness, of connectedness, and I see the community hungry for more and more evidence to focus their efforts and demonstrate their successes. And, while perhaps the community has not invited these pressures in, I am starting to see signs that we are reacting and adapting in ways that have us on a path for better things – our collective challenge is to stay this course and to allow this new shared vision and openness to guide us on the path to truly becoming a Profession.