From numbers to intelligence

Insights from 2010 National Physician Survey about CME/CPD

in physicians’ lives

We have no conflicts of interest to disclose

… except our personal interest in competent

physicians.We need data to support that

interest.

Never5%

Once a year11%

Once every six months

28%

Once a month25%

More than once a month20%

NR12%

2010 National Physician Survey – Anesthesiologists’ use of evidence

based resources

Hematology Nephrology Respirology0%

10%20%30%40%50%60%70%80%90%

100%

Estimation of effect of CME/CPD

NRDon't useVery significantSomewhat significantNeutralSomewhat insignificantVery insignificant

FP/GPs

Other S

pecia

lists

All Phy

sician

s0

1.53 2.9 3.4 3.13 3.4 3.23.1 3.3 3.2

Weekly CPD/CME time (hours)

200420072010

Numbers… numbers… noise

But every number tells a story

How much of the story do you know?1. How many

hours per week do MDs spend on CPD/CME?

a)1 hour or lessb)2-3 hoursc)3-5 hoursd)Over 5 hours

2. From this list, what is the most significant barrier to MDs’ participation in CPD/CME?

a)Time away from practice family

b)Lack of locum reliefc)Cost of traveld)Lack of opportunitye)Lack of relevance

How much of the story do you know?3. From this list, what

is the CPD/CME method that has the most impact on MDs’ practice?

a)Accredited conferences

b)Unaccredited conferences

c) Peer-reviewed journals

d)Self-assessmente)Simulation

4. What is the CPD/CME method that MDs use >1/month?

a)Accredited conferencesb)Unaccredited

conferencesc) Peer-reviewed journalsd)Self-assessmente)Simulation

Objectives1. Describe the types of CPD activities in which FPs and

SPs participate and their deemed level of impact on practice.

2. Identify potential types of CPD activities that will have significant impact on practice

3. Discuss types of CPD activities will will increase significant attendance and participation

4. Identify barriers to MDs’ participation in CME/CPD5. Identify how much time MDs report spending on

CME/CPD6. Discuss potential new areas of NPS research into CME/CPD

National Physicians Survey (NPS) 101• Respected Canadian source of

reliable information about the profession of medicine and issues in health care.

• Conducted jointly by:– Canadian Medical Association– College of Family Physicians of Canada – Royal College of Physicians and Surgeons of

Canada

NPS 101- continued• 3 completed cycles: 2004, 2007 and 2010• Next cycles: 2012, 2013 and 2014• Data on current and future Canadian

physicians• Questionnaires developed with broad input• Data used widely in health care planning and

research

Time spent on CME/CPD• Average physician work week was 51.4 hours,

excl. call• 2010 average time on CPD/CME was 3.2

hours/week• Time spent by Family Physicians increasing since

2004.• Variability in other specialties

FP/GPs Other Specialists All Physicians00.5

11.5

22.5

33.5

42.9

3.4 3.133.4 3.23.1 3.3 3.2

Weekly CPD/CME time (hours)

200420072010

Time a

way fro

m pract

ice

Lack o

f locum

relie

f

Time a

way fro

m family

Cost of

trave

l

Cost of

actua

l CPD

/CME

Lack o

f opp

ortun

ity

Lack o

f relev

ance

11.9% 31.1% 13.9% 12.9% 13.1% 18.8% 22.8%24.0%39.5%

25.0% 32.4% 34.8%53.5% 53.0%33.7%

14.9%30.0% 35.8% 36.8%

21.1% 18.0%30.4% 14.5% 31.1% 18.9% 15.3% 6.6% 6.2%

Physicians’ rating of barriers to parti-cipation in CPD/CME

N/A or NR Not significant Somewhat significant Very Significant

Types of CPD/CME• Conferences (accredited / unaccredited)• Journals (peer-reviewed / non peer-reviewed)• Evidence-based resources (CPGs, etc)• Electronic education (online / offline)• Small group activities (hospital rounds etc.)• Self-assessment• Practice audits• Simulation

Types of CPD by % of physicians using

Accredited live events

Peer-reviewed journals

Evidence-based resources

Online Electronic Education

Self-assessment

Simulation

98%82%

95%81%

95%68%

80%83%

71%48%

35%

Types of CPD by % of physicians using once/month or more

Accredited live events

Peer-reviewed journals

Evidence-based resources

Online Electronic Education

Self-assessment

Simulation

33%25%

74%44%

58%21%

38%51%

20%4%

3%

Accredited live eventsUnacredited live eventsPeer-reviewed journals

Non peer-reviewed journalsEvidence-based resources

Offline Electronic EducationOnline Electronic Education

Hospital Rounds / Small groupsSelf-assessment

Practice AuditsSimulation

70%40%

61%28%

59%26%

35%48%

26%15%

11%

% of physicians who rate impact of following CPD/CME methods as “somewhat significant” to “very sig-

nificant”

Live Accredited Conferences• 98% of physicians attend at least one a

year

• 33% attend one at least once a month

• Has highest ranking of “very significant impact on practice” at 31%– By comparison only 11% said that unaccredited

conferences have a “very significant impact”

Peer-reviewed journals• Easiest method to access and most frequently

used• 74% of physicians read these at least once a

month• < FP/GPs report significant impact on practice

compared to other specialists overall (57% vs. 65%)– > impact among Rheumatol (79%), Rad Onc (77%),

Nephrol (77%) and Microbiol/ID (77%)– < impact among Diag Rad (52%), Otolaryng (52%) and

Plastic Surg (51%)

Small group activities• 83% of physicians participate in small group activities

(e.g. hospital rounds)– < frequent among FP/GPs (39% do 1/month) vs other specialists

(64% do 1/month)– 48% FP/GPs and 57% other specialists deem impact on practice as

significant (> variability among other specialists)

Family Medicine

Other Specialties

0%20%40%60%80%

39% 57%

Small group activities once a month or more

Radiation Oncologists (81%)

Neurosurgeons (79%)

Ophthalmologists (48%)Public Health / Preventative

Med (30%)

Evidence-based learning• Use of evidence-based resources on a

monthly basis: 63% FP/GPs: 52% other specialists)– 31% of physicians rate the impact of these resources as “very

significant” – equalling the impact of live conferences.

Family Medicine

Other Specialties

0%20%40%60%80%

63% 52%

Use of evidence-based resources once a month or more Geriatric Medicine Specialists

(75%)Microbiology & Infectious

Diseases (75%)Diagnostic Radiologists (29%)

Plastic Surgeons (19%)

Computer-based CPD/CME• Neither online or offline computer CPD/CME methods

receive high assessment of impact.

• 80% of physicians use online electronic CPD/CME tools and 70% use offline versions.

• Impact of these tools rated as significant by 26% of physicians for offline methods and by 35% for online.

• Online methods are used at least monthly by 38%, and offline by 21%.

Other CPD/CME methods• While 20% of physicians use self-assessment at

least monthly, only 26% rate its impact as significant.

• Practice audits are used by less than half of physicians (48%) with only 15% reporting a significant impact on practice

• Simulation registers as the CPD method with least impact – only 11% report it had a significant one. It is only used by 35% of all physicians.

How much of the story did you know when we started?

1. How many hours per week do MDs spend on CPD/CME? Between 3 and 5 (3.2)

2. From this list, what is the most significant barrier to MDs’ participation in CPD/CME? Time away from practice

3. From this list, what is the CPD/CME method that has the most impact on MDs’ practice? Accredited live events

4. What is the CPD/CME method that MDs use >1/month? Peer reviewed journals

Some takeaways from this story• Much available and relevant CME/CPD content

• Live accredited events: most used and deemed most impactful – Associated with most barriers (time and money)

• Peer-reviewed journals: frequently used and deemed impactful

• E-based resources: frequently used but deemed of limited impact

• Self-assessment: used by 7 of 10 but few deem impactful on practice

Some takeaways from this story

• No single strategy fits all – Great variability by type, specialty – and practice setting

• Need to complete the storyline so more research and analysis is needed.

National Physician Survey 2013

• Next NPS: spring 2013– Watch for it– Complete it – Use it

• Become a part of the story

Contact us• Danielle Fréchette - Executive Director,

Office of Health Policy and Communications, Royal College of Physicians and Surgeons of Canada. dfrechette@royalcollege.ca

• Artem Safarov – National Physician Survey Project Manager, College of Family Physicians of Canada. artem@cfpc.ca