CME Perspective from the South, Continuing Medical Education

Schulich School of Medicine & Dentistry The University of Western Ontario

Schulich School of Medicine & Dentistry

CME Perspectivefrom the South

Continuing Medical Education Office Extended Campus RetreatDepartment of Psychiatry

Jatinder Takhar

March 5, 2007


Where We Were


Challenges

• barriers• needs• history• culture• alliances• impact of closure• business plan

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Design Principles for Culture

Beliefs and Values

Basic Underlying Assumptions

Behaviors and Attitudes

Adapted from Edgar Shein (1997) Organization Culture and Leadership


Bricks and Mortar

Continuing Medical Education100 Collip Circle, Suite 227Mogenson Building, Research ParkLondon, Ontario


CME Organizational StructureAssociate Dean

Dr. Jatinder Takhar661-2111 x86940

Associate Director, Education

John Ruicci x84748

Guidelines Advisory Committee (GAC)

Promotes evidence-based healthcare in Ontario through a network of partners by encouraging physicians to use the best available clinical practice guidelines.

For summaries and links to these guidelines visit: www.gacguidelines.ca

Ontario Medical Associationand Ontario Ministry of Health and

Long Term Care partnership

Administrative AssistantKathy Dantzer

850-2904 (or x82904)

Conference Coordinator

& GAC LiaisonLinda Bruce

661-2111 x81370(contract position)

ManagerJason Eadie

850-2936 (or x82936)

Advisory Committeeon CME (ACCME)J. Takhar – Chair

Members includeCE Directors from

SMD Departments, community Family Physicians & other Allied Healthcare

Professionals

Senior Medical Consultant – Dr. Dave Dixon

November 25, 2005


CME Course Approvals by CME Office Since Inception

Academic Year

# Courses

#Participants

#Participant-Hours

2003-4 100 5,834 36,144

2004-5 154 6,137 37,466

2005-6 162 7,100 50,000

November 25, 2005


Conference Management Servicesavailable from Continuing Medical Education

• Development– Identifying educational needs via focus group or survey– Developing learning objectives based on assessed educational needs– Providing program and evaluation design support– Provide assistance to secure unrestricted educational grants from industry sponsors– Provide support to design/print brochures– Manage CME accreditation process to secure course credits for Family Physicians

and/or Specialists

• Marketing– Management of course promotion via web, direct mail, journal advertising, as

required– Management of registration process via mail, fax, web, e-mail– Manage course finances via dedicated UWO project account – Note 5% admin fee

applied on all expenses– Validate credit card payments, receive and deposit payments to project account– Track workshop choices of participants on spreadsheet– Manage access to videoconferencing technologies that meet accreditation

guidelines for on-line CME to better serve the needs of physicians in rural areas and smaller centres.

• Implementation– Preparation of participant packages to include receipt, certificate of attendance,

name badge, evaluation form– Manage site reservations, catering – Provide on-site staffing support as required


CME Events Developed in collaboration with SMD Departments

Arrhythmia Symposium– Annual program with Div. of Cardiology– Program Chair: Dr. Andrew Krahn– Target: cardiologists– Program dates: Winter 2005, Winter

2006 Endocrinology Update Day

– Annual program with Div. of Endocrinology & Metabolism

– Program Chair: Dr. Terri Paul – Program dates: Fall 2005, Fall 2006

1st Annual Cardiac Imaging Symposium– Program with Div. of Nuclear Medicine &

Dept. Diagnostic Radiology, SJHC, LHSC– Program Chair: Dr. Gerald Wisenberg– Program date: Fall 2005

Cardiology Refresher Day – Annual program with Div. of Cardiology– Program Chair: Dr. Peter Pfugfelder – Program date: September 2006

Travelling the Cardiac Road – Annual program with Div. of Cardiology– Program Chair: Dr. Neville Suskin – Target: general public– Program dates: Spring 2005 (London);

Spring 2006 (London, Windsor, Sarnia)

Fowler Kennedy Sport Medicine Symposium – Annual program with Department of Surgery– Program Chairs: Drs. Litchfield & Peter Fowler– Program date: Fall 2004, Fall 2005, Fall 2006

Update in Gynecologic Malignancy: Ovarian Cancer – Program with Division of Gynecologic Oncology,

LHSC– Program date: Fall 2005– Program Chair: Dr. Monique Bertrand

Pathology Update Day – Bi-annual program with Dept. Pathology– Program Chair: Dr. Mariamma Joseph– Program date: Fall 2005

Annual Clinical Day in Family Medicine– Annual program with Dept. of Family Medicine– Program date: May 2006– Program Chair: Dr. John Jordan

Vascular Surgery Day– Program with the Dept. Surgery, Division of

Vascular Surgery– Program chair: Dr. Tom Forbes– Program date: April 2006

Diabetes Update Day– Program with Div. of Endocrinology & Metabolism– Program Chair: Dr. Wael Haddara – Program dates: Fall 2005, Fall 2006


CME Programs - non-traditional format

Online Programs• Panic Disorder, Asthma, and Diabetic Nephrology, (approved February 2006)• NSAIDs (approved January 2005)• Preventative Measures in Traveler’s Diarrhea (approved December 2005) • Hypertension Control (approved November 2005)• Hepatitis A & B (approved August 2005)• Preventative Measures in Malaria (approved June 2005)• Metabolic Syndrome Discussion Forum (approved March 2005)• Gastroesophageal Reflux Disease (approved March 2005)• Virtual Patient module in Diabetes (approved October 2006)• Psoriasis, Diabetes, Ankylosing Spondylitis, Psoriatic Arthritis, Crohn's Disease & Ulcerative

Colitis

Accredited Self-Assessment Programs (SAPs)• Medical Debate in Lipid Management- Meeting the Challenge of Evolving Evidence• Emerging Trends and Treatment Options – Dyslipidemia• Tardive Dyskinesa – Advances in Management• ADHD

Personal Learning Programs (PLPs)• What should I know about recent developments in the area of vascular and mixed dementia?• How can I improve my knowledge of mood disorders and the options available for disease

management?• How can I improve my knowledge of the human papillomavirus and the disease management

of cutaneous and anogential warts?


Traineeship/Preceptorship Program

• Training program to facilitate one-on-one clinical skills training

• Launched February 2007 • Defined as a “Structured educational activity developed

to meet specific professional based needs (knowledge, skills, or attitudes)”

• Accredited under Section 4 of the Royal College of Physicians and Surgeons of Canada’s CPD framework

• Documentation required for credit validation:• Objectives for the traineeship• Confirmation of completion of the traineeship by the

coordinator• Outcome of learning (impact on practice)

• Application forms available from CME office


Self-directed Learning Portal

• Hosted by CME unit, featuring: – Online Programming

• e.g. accredited self assessment programs– Grand Rounds archives (Schulich Medicine &

Dentistry departments)– Educational surveys– Resources

• Expected launch date May 2007


Self Assessment Programs, 30%

Accredited on-line Programs, 17%

Endorsements, 13%

Course Management Fees, 10%

Application Fees (external customers), 9%

Mainpro-C renewals, 9%

Miscellaneous Sponsorships, 7%

Personal Learning Projects, 3%

Application Fees (internal customers), 3%

Percent Revenue from Programs & Services for 2005/6

CME Office


Collaborative Research Projects

• 2003 - CPDiQ (Continuous Professional Development Project issues of Quality)

• 2004–CEQM Project (Knowledge Transfer)• 2006 – CME Bias Management Process• 2006 – Preceptorship Program in Geriatric Medicine

(Pilot) (Dementia/Osteoporosis - in progress)• Guidelines Advisory Committee (GAC Guideline

Dissemination) – Ongoing• 2003 & 2005 SWO Needs Assessment Surveys• Unperceived Needs Assessment research (ongoing)


Dissemination of Knowledge to Stakeholders

• Presentations– “Are the Continuing Medical Education Needs of Physicians Dynamic

Over Time? Going beyond the quick fix” - AFMC Meeting – London, May 2006 (Poster)

– “Managing Bias in CME” • CACHE Workshop – September 2006 • CFPC Accredited Providers Conference – October 2006• RCPSC – September 2006 (Poster)• GAMES Education Conference October 2006 (Poster)

• Publications – Davis D, Ciurea I, Rogers J, Drazin Y, Perrier L, Tomalty L, Takhar J – on

behalf of the Guidelines Advisory Committee, MOHLTC (Ontario) and the OMA. The GAC and Ontario’s Medical Schools: Guideline Adoption and Collaboration. Canadian Journal of CME. April 2005

– Takhar J, Visser K. Capitalizing on learning opportunities: design a PLP for MOC credits, Royal College Outlook. Volume 1, Issue 3 Fall 2004.

– Takhar J. “The Evolution of a Personal Learning Project”. CPA Bulletin. October 2002.

– Takhar J, Dixon D, Silver I, Marlow B, Campbell C, Eadie J, Monette C, Donahue J, Rohan I, Sriharan A, Raymond K, “Illuminating Bias in CME: A Pilot Project” – submitted to JHECP in October 2006

• Editorials in Canadian Journal of CME - 2004, 2005 & 2006 issues• Health Canada Report CPDiQ Project – book chapter


Collaboration with Stakeholders

• Canadian Collaborative– The Canadian Connection: A model for

International Healthcare Collaboration– CME has recently submitted a letter of

commitment to work with various academic institutions and leaders nationally and internationally to create a telehealth network to deliver educational programs to the Middle East, Africa and other developing nations.

– Partnership will create a knowledge transfer network for initial health care education and training, continuing professional development and support of health care workers

– Through monitoring and evaluation, the program will evaluate the efficiency and efficacy of the telehealth network to provide specific healthcare interventions

– This will determine if the program can be utilized as a model for future expansion to other countries. The proposal has been submitted to CIDA and Health Canada for approval and funding.



• CME Portal developed in collaboration with Canada’s Medical Schools – hosted by McGill



• MDcme.ca• Online CME portal featuring

accreditated programs for Canadian physicians

• Hosted by Memorial University• Content contributed by Canada’s

Medical Schools


CME Objectivesfrom Education Group Strategic Plan 2006 - 2010

Commit to the sharing of program information & resources 1.2 Bi-annual meetings between Faculty Development, CME, UGE, PGE & SWOMEN programs to

coordinate annual program planning and opportunities for collaborative activities 1.3 CME to conduct workshops for Postgraduate students with emphasis on CPD requirements as

defined by RCPSC, as well as CME principles

Build capacity for education research/seek opportunities for promoting educational research

3.3 Participate in the national CME research collaborative currently chaired by UBC3.4 Conduct comparative biennial SW Ontario needs assessment survey of Schulich's physician

target of 4,000 FPs & Specialists; present results of 03-05 surveys at AFMC in May 2006 via poster

3.5 Collaborate with academia and industry on a proprietary CME Bias Audit Tool

Develop faculty and/or curriculum 2.2 Utilize CME needs assessment results to begin development of a CME curriculum to address

individual needs; track progress, identify and develop Fall Curriculum for 2006 based on 2005 results

Confirm Schulich's reputation as a leading Medical School in Canada 1.6 Develop self-directed CME learning opportunities, develop expertise in creating Personal

Learning Projects (PLPs), Self Assessment Programs (SAPs) and online formats/programs

Efficiency through Information Technology 3.16 Create a web portal to deliver self-directed learning programs for physicians

Continue revenue-generating opportunities for Education; seek new opportunities 4.2 Develop a 3 year vision for the CME program; communicate strategic direction, financial

potential and resource requirements


Questions ?

Documents

CME Perspective from the South, Continuing Medical Education