Tuesday, September 25, 2012

Follow-up Wiki Assignment - Lesson Plan



Followup Wiki Assignment – “Planning CME for Physicians”

This assignment is based upon the “Event Plan” outlined by West & West (2009).

Program Objectives:
After completion of the program, participants will be able to:
  • Recognize the Importance of CME (ACCME Handouts) 
  •  Understand what clinical gaps are and how they might affect patient care 
  •  Identify and utilize websites that are sources to identify competency requirements to identify clinical gaps 
  •  Recognize and Implement the Accreditation Criteria of the ACCME
Based on the objectives of the lesson plan “Planning CME for Physicians,” develop a Wiki site that is designed to plan an event – Continuing Medical Education (CME) conference, based on the following scenario.

You are a program planner working for XYZ University’s continuing education department and Dr. Zee calls/email you to say that he has a physician friend who is a great speaker on diabetes management and would like to bring him in to conduct a conference. Dr. Zee would serve as the program director and would like to host the meeting in a nice vacation location. He asks you to begin searching for a facility that can accommodate 200 people during the month of July, suggesting possible locations: New York City, Orlando, Florida, or somewhere in California. You are also tasked with securing funding for the event to cover event expenses and lower physician registration fees. Finally, the event must be accredited for CME for physicians.

Because Dr. Zee would like the event accredited for CME, you must go through the planning process, as outlined in the lesson plan. First, you must gather additional information from Dr. Zee and other sources to properly plan the program. Here are some basic steps/questions to explore and implement within your Wiki.

  1. Plan a meeting or exchange of information to determine the target audience, purpose of the meeting, tasks, timelines, etc.
  2. Based on the criteria set by the ACCME, develop a Wiki site for planning the conference
  3. Develop a Wiki site with the following pages:
    A.  Home Page
    – include the title, date, and description of the event. Begin the Wiki by developing a flow chart or design that depicts the process of planning a meeting, as outlined by ACCME (planning the event, developing the activity, etc).
    B.  Agenda -
    Include meeting times, location, presenter(s), etc.
    C.  Planning Page(s)
    , based upon information gathered from Dr. Zee & other sources, include the following
    • Tasks and timelines
    • Program Budget
    • Program Flyer, marketing info
      • Target Audience
      • Program Overview (identifying the gap in knowledge or performance)
      • Program Objectives (covering the outcomes based objectives – what they will know or be able to do after the conference)
      • Program Committee (listing those involved in the planning process)
      • Program Logistics: Program Registration Fee, Lodging, etc.
    • Conflict of Interest Disclosures
    • Evaluation planning 
 4.  List references/sources of information

Grading Rubric - 10 Points Maximum
9-10
7-8
5-6
3-4
1-2
  •  All ACCME criteria presented were addressed.
  •    Planning Process was comprehensive
  • Appropriate Needs Assessment was conducted, as outlined in Program Overview
  • Information was clearly presented
  • Layout was appealing with appropriate graphics
  • Most ACCME criteria presented were addressed.
  • Planning Process was less comprehensive
  • Needs Assessment was conducted, as outlined in Program Overview
  • Information was clearly presented
  • Layout was appealing with appropriate graphics
  • Some ACCME criteria presented were addressed.
  • Planning Process was less comprehensive
  • Needs Assessment was conducted, as outlined in Program Overview
  •  Information was clearly presented
  • Layout was appealing with appropriate graphics
  • Some ACCME criteria presented were addressed.
  •  Planning Process was inadequate
  • Needs Assessment was inadequate
  •  Information was clearly presented
  •  Layout was appealing with appropriate graphics

  • Some ACCME criteria presented were addressed.
  •  Planning Process was inadequate
  • Needs Assessment was not conducted
  •  Information was not clearly presented
  • Layout was less appealing with inappropriate graphics

References:

West, J. and West, M. (2009). Using Wikis for Online Collaboration: The Power of the Read-Write Web.  San Francisco, CA: Jossey-Bass.  ISBN: 9780470343333

Wednesday, September 19, 2012

Lesson Plan: Planning CME for Physicians




Planning Accredited Continuing Medical Education (CME) Conferences for Physicians

Target Audience:  Educational planners, consisting of physician planners and administrative professionals who plan CME meetings for physicians.
 
Program Overview: This course is designed to train educational planner in developing programs that are designed to address clinical practice gaps, which medical professionals can utilize to improve patient care

Program Objectives:
After completion of the program, participants will be able to:
  1. Recognize the Importance of CME (ACCME Handouts) 
  2.  Understand what clinical gaps are and how they might affect patient care 
  3.  Identify and utilize websites that are sources to identify competency requirements to identify clinical gaps 
  4.  Recognize and Implement the Accreditation Criteria of the ACCME
Handouts:
Accountable to the Public (ACCME)
Examples of Profesisonal Practice Gap – ACCME Video
Accreditation Criteria
 - http://accme.org/requirements/accreditation-requirements-cme-providers/accreditation-criteria
 
Wiki Assignment:
After completing the online course, student groups must develop a Wiki site to demonstrate their understanding of the principles presented.                                               10 points maximum.
Based upon the contents of this online course, group members must develop a Wiki that can be utilized as an assessment of the course materials. This should cover relevant ACCME Criteria presented in the course.  Develop a combination of 10 multiple choice, Yes/No, and open-ended questions to assess knowledge gained after completion of the course. Be creative and interactive. It is desirable to  provide participants immediate feedback, if possible.

Grading Rubric - 10 Points Maximum
9-10
7-8
5-6
3-4
1-2
All ACCME criteria presented were addressed.
Layout was appealing with appropriate graphics
Appropriate Questions were drafted
Assessment was formulated to allow immediate feedback
Information was clearly presented

Most ACCME criteria presented were addressed.
Layout was appealing with appropriate graphics
Appropriate Questions were drafted
Assessment was formulated to allow immediate feedback
Information was clearly presented

Some ACCME criteria presented were addressed.
Appropriate Questions were drafted
Assessment was formulated to allow immediate feedback
Information was clearly presented

Some ACCME criteria presented were addressed.
Appropriate Questions were drafted
Assessment was completed


Activity was completed
Some ACCME criteria presented were addressed.
Questions were drafted

References:
Loyola University School of Medicine, Continuing Medical Education Department. CME at Loyola University Medical Center  A Primer for CME Course Directors. Retrieved from  http://www.stritch.luc.edu/lumen/MedEd/softchalkhdht/CMEFacDevWebPage/index.html?mobile=false&page=CMEFacDevWebPage11.html

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Page 1
CME at Loyola University Medical Center
A Primer for CME Course Directors

 
Understanding ACCME's Updated Criteria for Accreditation
This module is meant to educate CME Course Directors at Stritch on the educational theory
and planning processes required for compliance with ACCME's updated criteria for accrediting Continuing Medical Education.
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Page 2

Driving Force in CME
The driving force in contemporary CME is the data that suggests that contemporary health care is not measuring up to expectations in terms of desired health outcomes.
Actual care lags behind expected or desired care.

There is a performance gap!

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CME as an Ecosystem
The ACCME (Accreditation Council for Continuing Medical Education) invites CME providers to play an important role in helping to narrow the performance gaps of practicing clinicians. In the contemporary health care environment, CME needs to serve as a "change agent" - an ecosystem linked to professional practice that is meant to:
  • Change behaviors to
  • Enhance performance to
  • Improve Patient Outcomes
for the sake of continuous quality improvement in health care delivery.

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 Historical Perspective CME traditionally was an activity directed to the exchange of information and the transmission of knowledge.
Licensure, specialty certification and hospital credentialing demanded a system that assured the ongoing acquisition of knowledge by practicing clinicians.
For this type of CME activity, educators simply asked themselves "What interesting topic should we lecture on?"
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Today...
Contemporary health care is vastly more complex.
Consequently CME needs to be more focused and purposeful.
Clinicians must not only know, they must know how to, and they must do well whatever is called for by the patients they treat.
CME today must play a role at all three levels...
  • Transmitting knowledge
  • Enhancing competence
  • Improving performance
for the sake of improved patient outcomes (quality improvement).
CME has a stake in providing clinicians with not only knowledge but practical and targeted strategies that can change
behavior and enhance performance in everyday practice.

Providers of continuing medical education are now being challenged to ask their learners:
  • "What do you plan to do with the new information you have been given?"
  • "What will you do differently in your practice?
  • "Has doing so made a difference in your patients' health?"
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What ACCME requires...
Planning your CME Event:
Performance Gap Analysis
Determination of Educational Needs
Setting your Goals for the Activity
Stating your Learning Objectives
Developing your Educational Activity
Creating Evidence-based content
Choosing your Educational Format (lecture, discussion, role play, panel, simulation activity)
Assuring independence from Commercial Support (disclosure, resolving conflict of interest)
Analyzing the Impact of your Activity
Gathering information on changes in knowledge, confidence, intent to change practice, measure performance
Setting your Plan for the Future to Address Ongoing Gaps, and Educational Needs
These requirements are reflected in each of the steps of the Application that you submit for approval of your CME Activity.
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Step I: Planning Your CME Event
Practice Gap Analysis and Assessing the Needs of Your Learners

Why am I doing this educational activity?
This is the critical question that should be the starting point for any CME activity.


In the answer to this question lies the relevance of your activity to the needs of your audience,
and the potential for effecting change in your learner's performance.

CME planners should query themselves in the following fashion:
  • What problem (in clinical practice) do we want to address?
  • Is this a significant problem for our learners?
  • What is the magnitude of the problem? (so you can track outcome improvement)
  • Why does the problem exist?
  • What change do we seek?
  • What should we do to make change happen?
This is the part of educational planning that is about practice gap analysis and needs assessment.
Practice gaps are expressions or manifestations of a need on the part of the clinicians who are your learners.
You are encouraged to investigate real practice gaps and practice-based needs for your activity by taking advantage of internal and external sources of performance data:
  • Performance databases and web sites (i.e., AHQR)
  • Input and Feedback from your Learners
  • Institutional Performance Data and Benchmarks
  • Practice-Based Audits
Having identified and quantified a practice gap that you wish to address in your activity, you reflect on the educational needs that underlie the problem.
The need may be a need for new information, but it may be a need to provide clinicians with practical strategies, behavioral skills, or system improvement information.
These needs must be given consideration in your educational planning of CME.
You are then expected to develop and articulate concrete learning objectives linked to the needs you have identified among your learners.
This process has a funneling effect going from broad and general to more specific:
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Step II: Designing your CME activity
Developing Your Content and Choosing an Effective Educational Format
Having selected the educational needs that you will address, you then develop the evidence-based content and choose the format of your activity.
The traditional CME activity targets knowledge-based needs and then, typically, employs a lecture as the educational delivery format.
But when seeking to address learners' needs that are more performance-based, might not learning activities that are more hands-on
such as simulations, role play, panel discussions be called for?

We invite you to consider including more dynamic learning formats into your CME activities where appropriate.
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Step III: Assuring the Integrity of the Educational Process
"The concepts of independence from industry and collaboration with industry in the development of CME content are mutually exclusive.
Although commercial interests may provide commercial support for educational activities as defined by the ACCME's Standards for Commercial Support,
there is no role for ACCME-defined commercial interests in the content-planning, development or evaluation of accredited CME activities." (ACCME)

This defines the "independence" of CME.
The steps required by ACCME to assure independence from commercial support included:
  • Providing disclosures for all planners, reviewers, and speakers for your activity
  • Making disclosure to the audience (either verbally, or in written form)
  • Resolving all conflicts of interest prior to the activity
  • Processing all monetary sources according to ACCME standards
  • Managing vendors and exhibits according to ACCME standards*
*Loyola University Medical Center, as a not-for-profit entity, does not allow vendors or exhibits on-site during CME events (PS 11)
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Step IV: Assessing the Impact of Your Activity
You began the process of planning your CME activity by exploring the practice gaps relevant to your learners and
choosing a performance area that you wished to address.

You identified the learning needs of your targeted audience related to that clinical problem and then developed the
learning objectives that you wished to focus on in your CME event.

You tailored the learning environment and the educational format of your activity to be the most effective means for
participants to learn what they needed.

You put on your event, meeting or conference and hopefully it all goes successfully!
But at this point you really don't know whether you've accomplished your goal.
You still have a responsibility to evaluate the impact of your activity.
The goal is to see whether you enhanced the learners confidence or competence, changed their practice behaviors, or impacted
health outcomes in their patient populations.

The Office of CME at Stritch works with you to gather data related to these types of outcomes, in order to get information on the impact
of your activity.


This process fulfills the Plan, Do, Study, Act cycle espoused by Deming et al. that should govern all activities.
  • Plan: You are aware of a practice based problem, and have come up with an educational intervention to help address the problem.
  • Do: You put on the educational activity hoping to impart knowledge, change behaviors, improve performance, impact health outcomes.
  • Study: You collect information to analyze whether you were successful or not.
  • Act: Applying what you have learned from your analysis, you prepare to enter into a new planning phase intent on addressing the residual gaps in the future.
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    Page 11
Self Assessment Test
The driving force of CME is which of the following


Correct Answer is...B.

We thank you for taking the time to learn what we believe is relevant for you know as a CME Course Director...
[Please proceed to the final page to check your grasp of this material]
--
Conclusion:
Whew, this was most challenging, given the short amount of time for completion and my ignorance in creating lesson plans and designing a blog!! Sorry, it's not more eye-appealing. Hopefully, it's somewhere in the ballpark of the stated assignment. Sigh...

Wednesday, September 12, 2012

Wiki's: Pros...and cons

Having worked on a group project creating a Wiki, I can attest to the advantage of immediate collaboration versus exchanging emails or chat sessions. Beyond the obvious challenges of group projects, it was much less stressful than any other group project I’ve every done. The only challenge was the actual “meeting” times for our group to collaborate on how we would collaborate on the Wiki. That is just one of the challenges of online learning.

Clearly, there are many more advantages of using Wikis in adult education, especially in the online setting. As the figure demonstrates (source http://www.wikinomics.com/blog/index.php/2008/03/26/wiki-collaboration-leads-to-happiness/) , using Wiki collaboration is much more efficient than a chain of emails and edits.
 
As our authors for this week’s readings have mentioned, one of the challenges is the public forum aspect of Wiki’s – as with blogs. I was certainly concerned and was concerned about grammar, sentence structure, and the like (King & Cox, 2011). It is also different in that your peers, as well as the world wide web, can see your work and style of writing. The advantage is that you can also see your peers’ writings and learn from them (Hazari, North & Moreland (2009).

Regarding faculty’s use of Wiki’s, the software allows them to track participation and judge whether there has been equitable contribution of all members, which is always an issue with group projects (West & West, 2009). From a teaching perspective, use of Wikis’ incorporates the pedagogical/andragogical foundation through “situated learning discussions” - a group working together to accomplish a goal, providing a “community of practice”, which allows for social interactions between learners (King & Cox, 2011, p. 124).

I think those are enough for now? I think we’re all convinced of the advantages of Wikis and that the few cons are negligible, almost not worth mentioning. After all, there are always pros and cons to anything, you have to sort of put the cons behind you.

References:

Hazari, S., North, A., Moreland, D. (2009). Investigating pedagogical value of Wiki technology. Journal of information systems education. 20(2). 187-198. Retrieved from http://search.proquest.com.er.lib.k-state.edu/docview/200157232/abstract?accountid=11789

King, K. & Cox, T. (2011). The Professor’s Guide to Taming Technology. Charlotte, NC: Information Age Publishing. 

West, J. and West, M. (2009). Using Wikis for Online Collaboration: The Power of the Read-Write Web.  San Francisco, CA: Jossey-Bass. 



Wednesday, September 5, 2012

Blogging versus Discussion Boards (pros/cons)





While I have created a blog for an undergraduate class, as well as a Wiki for a graduate course, I am relatively green when it comes to blogging. The very notion that your thoughts/words are visible on the web, and to anyone, makes me a bit leery. I guess I am from the old school train of thought of “who cares about your personal thoughts”. I am among those who ask, “why the heck do I need to tweet or blog?” I guess I am just in that age bracket of those who just don’t have an interest in blogging – “Young Boomers”, according to Zickuhr (2010) – see image.

However, there is no denying there are definite benefits of blogging over discussion boards, although I strongly prefer the discussion board and the privacy it provides. Among those advantages are those noted by Carter, in King and Cox (2011), such as the ability of educators to create virtual learning environments where learners can become collaborators, creators and community builders (p. 89).

Despite what Carter purports, “the ability for readers to comment on posted entries, which are dated” is not a “distinctive feature of the blog” (p. 90). Perhaps that was once true, but today’s discussion boards also allow this same functionality – unless I’m missing something here? I agree that a unique feature of blogging is the ability to “connect to other Web sites in hyperlinks, resulting in an interactive publishing space linking resources as well as authors to permit easy sharing of information” (p. 90).  This is the biggest advantage of blogging versus discussion boards – the level of interactivity and collaboration.

This week’s supplemental readings also support the merit of blogging, especially with younger age brackets. Today’s youngsters have grown up with computers and are adept at blogging (Facebook, Twitter, etc) and it only seems natural to engage them on their level of interest (Witte, 2007). Santos (2011) discussed the engagement model, which seems to tie in perfectly with the use of blogging in the classroom. Through blogging, students utilize the three engagement theory concepts of “Relate-Create-Donate” (p. 16). Hopefully at the end of this class, I’ll have a greater appreciation of blogging…we’ll see??


References:

King, K. & Cox, T. (2011). The professor’s guide to taming technology. Charlotte, NC: Information Age Publishing.

Santos, A. (2011). Blogs as a learning space: creating text of talks. Contemporary Issues in Education Research, 4(6), 15-19.

Witte, S.  (2007). That's online writing, not boring school writing: Writing with blogs and the Talkback Project. Journal of Adolescent & Adult Literacy, 51(2), 92-96.

Zickhrh, K. (2010). Generations Online in 2010. Retrieved from http://pewinternet.org/Reports/2010/Generations-2010/Overview/Findings.aspx