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继续专业发展对卫生专业人员绩效和患者结局的影响:知识综合的范围评价。

Effect of Continuing Professional Development on Health Professionals' Performance and Patient Outcomes: A Scoping Review of Knowledge Syntheses.

机构信息

A. Samuel is assistant professor, Department of Medicine and Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0001-9488-9565 .

R.M. Cervero is professor, Department of Medicine, and deputy director, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

出版信息

Acad Med. 2021 Jun 1;96(6):913-923. doi: 10.1097/ACM.0000000000003899.

Abstract

PURPOSE

Continuing professional development (CPD) programs, which aim to enhance health professionals' practice and improve patient outcomes, are offered to practitioners across the spectrum of health professions through both formal and informal learning activities. Various knowledge syntheses (or reviews) have attempted to summarize the CPD literature; however, these have primarily focused on continuing medical education or formal learning activities. Through this scoping review, the authors seek to answer the question, What is the current landscape of knowledge syntheses focused on the impact of CPD on health professionals' performance, defined as behavior change and/or patient outcomes?

METHOD

In September 2019, the authors searched PubMed, Embase, CINAHL, Scopus, ERIC, and PsycINFO for knowledge syntheses published between 2008 and 2019 that focused on independently practicing health professionals and reported outcomes at Kirkpatrick's level 3 and/or 4.

RESULTS

Of the 7,157 citations retrieved from databases, 63 satisfied the inclusion criteria. Of these 63 syntheses, 38 (60%) included multicomponent approaches, and 29 (46%) incorporated eLearning interventions-either standalone or in combination with other interventions. While a majority of syntheses (n = 42 [67%]) reported outcomes affecting health care practitioners' behavior change and/or patient outcomes, most of the findings reported at Kirkpatrick level 4 were not statistically significant. Ten of the syntheses (16%) mentioned the cost of interventions though this was not their primary focus.

CONCLUSIONS

Across health professions, CPD is an umbrella term incorporating formal and informal approaches in a multicomponent approach. eLearning is increasing in popularity but remains an emerging technology. Several of the knowledge syntheses highlighted concerns regarding both the financial and human costs of CPD offerings, and such costs are being increasingly addressed in the CPD literature.

摘要

目的

继续教育计划(CPD)旨在提高卫生专业人员的实践能力并改善患者的预后,这些计划通过正式和非正式的学习活动向各种卫生专业人员提供。各种知识综合(或综述)试图总结 CPD 文献;然而,这些主要集中在继续医学教育或正式学习活动上。通过这项范围综述,作者试图回答以下问题:目前有哪些知识综合研究关注 CPD 对卫生专业人员绩效的影响,绩效定义为行为改变和/或患者预后?

方法

2019 年 9 月,作者在 PubMed、Embase、CINAHL、Scopus、ERIC 和 PsycINFO 数据库中搜索了 2008 年至 2019 年期间发表的专注于独立执业卫生专业人员并报告了 Kirkpatrick 第 3 级和/或第 4 级结果的知识综合研究。

结果

从数据库中检索到的 7157 条引用中,有 63 条符合纳入标准。在这 63 项综述中,有 38 项(60%)包括多组分方法,有 29 项(46%)纳入了电子学习干预措施-无论是单独还是与其他干预措施结合使用。虽然大多数综述(n=42 [67%])报告了影响医疗保健从业者行为改变和/或患者预后的结果,但大多数在 Kirkpatrick 第 4 级报告的发现并不具有统计学意义。有 10 项综述(16%)提到了干预措施的成本,但这并不是它们的主要关注点。

结论

在所有卫生专业中,CPD 是一个涵盖正式和非正式方法的多组分方法的总称。电子学习越来越受欢迎,但仍是一种新兴技术。一些知识综合研究强调了对 CPD 产品的财务和人力成本的关注,这些成本在 CPD 文献中越来越受到关注。

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