Continuing Professional Development, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
Med Educ. 2018 Jan;52(1):125-135. doi: 10.1111/medu.13407. Epub 2017 Oct 6.
Many of those involved in continuing professional development (CPD) over the past 10 years have engaged in discussions about its goals and activities. Whereas in the past CPD was viewed as an education intervention directed towards the medical expert role, recent research highlights the need to expand the scope of CPD and to promote its more explicit role in improving patient care and health outcomes. Recent developments in quality improvement (QI) and competency-based medical education (CBME), guided by appropriate theories of learning and change, can shed light on how the field might best advance. This paper describes principles of QI and CBME and how they might contribute to CPD, explores theoretical perspectives that inform such an integration and suggests a future model of CPD.
Continuing professional development seeks to improve patient outcomes by increasing physician knowledge and skills and changing behaviours, whereas QI takes the approach of system and process change. Combining the strengths of a CPD approach with strategies known to be effective from the field of QI has the potential to harmonise the contributions of each, and thereby to lead to better patient outcomes. Similarly, competency-based CPD is envisioned to place health needs and patient outcomes at the centre of a CPD system that will be guided by a set of competencies to enhance the quality of practice and the safety of the health system.
We propose that the future CPD system should adhere to the following principles: it should be grounded in the everyday workplace, integrated into the health care system, oriented to patient outcomes, guided by multiple sources of performance and outcome data, and team-based; it should employ the principles and strategies of QI, and should be taken on as a collective responsibility by physicians, CPD provider organisations, regulators and the health system.
在过去的 10 年中，许多参与继续专业发展（CPD）的人都参与了有关其目标和活动的讨论。虽然过去 CPD 被视为针对医学专家角色的教育干预，但最近的研究强调需要扩大 CPD 的范围，并促进其在改善患者护理和健康结果方面的更明确作用。最近在质量改进（QI）和基于能力的医学教育（CBME）方面的发展，以适当的学习和变革理论为指导，可以阐明该领域如何最好地取得进展。本文描述了 QI 和 CBME 的原则，以及它们如何为 CPD 做出贡献，探讨了为这种整合提供信息的理论观点，并提出了未来的 CPD 模型。
继续专业发展旨在通过提高医生的知识和技能并改变行为来改善患者的结果，而 QI 则采取系统和流程变革的方法。将 CPD 方法的优势与 QI 领域中已知有效的策略相结合，有可能协调彼此的贡献，从而导致更好的患者结果。同样，基于能力的 CPD 被设想为将健康需求和患者结果置于 CPD 系统的中心，该系统将由一套增强实践质量和医疗体系安全的能力指导。
我们建议未来的 CPD 系统应遵循以下原则：它应立足于日常工作场所，融入医疗保健系统，以患者结果为导向，以多种绩效和结果数据为指导，并以团队为基础；它应运用 QI 的原则和策略，并应由医生、CPD 提供者组织、监管机构和医疗体系共同承担责任。
