Health Professions Lifelong Learning: A New Vision for Continuing Education & Professional Development.

Visual presentation of the new vision from Health District

Why The Need.

There has long been a recognized need to provide the basis for continuous — just-in-time & dynamic — learning to assist health care professions in keeping pace with the rapidly changing and improving medical services, practices, products, treatments, regulations and enabling-technology.

The pace of knowledge acceleration in all areas of society has reached a point where it is no longer possible for members of health care professions, and society alike, to stay abreast of essential knowledge and practices.

While the traditional approach to education & learning may continue to underpin the initial and basic learning needs within the health care professions, it must be supplemented to keep pace with the need for lifelong learning in a digitally connected world.

There is an urgent need to redesign the present models of continuing medical education (CME) and professional development (CPD) for health care professions around the world. Existing models of education & learning have become outdated, unsustainable and out-of-touch with ground reality.

Listed below are just some of the shortcomings of existing models as I see them:

1. There is little or no accountability of health care professions continuing competence and learning.
2. More importantly though, there is no accountability and transparency expected of health care leadership either.
3. There are no mechanisms in place for ensuring meaningful outcomes from learning initiatives undertaken.
4. There is very little desire and/or willpower to align learning initiatives with quality improvement initiatives.
5. Practice-based professional development is still an “alien” concept.
6. There are tremendous institutional barriers due to lack of understanding and/or resistance to adopt new reality of CME/CPD in a digitally enabled and connected world.
7. Science underpinning health care professions CPD is fragmented and underdeveloped — Academic institutes by large have continued to hold and “control” their status as “guardians of CPD/CME” while “neglecting” to meaningfully support or even accept their responsibilities.
8. There is little or no effort undertaken for any practical measures in establishing learning as collaborative, inter-professional or cross-disciplinary.
9. CPD programs and initiatives are not person-centred or patient-focused. As well, there is no involvement of patients & family representatives in either designing or delivery of learning initiatives.
10. Accreditation standards are not aligned and hence quality of initiatives offered vary tremendously.
11. Funding mechanisms of CPD and quality improvement initiatives do not reflect ground reality.
12. There are no established mechanisms or even support for ongoing CPD research and scholarship.
13. There is an overwhelming mass of information and research accumulating within medical profession in general — medical knowledge is expected to double every year or less at present. Scope of this challenge exceeds the capacity or the capability of any traditional academic institute.
14. Health professions lag behind every other field in adopting new digital enabling technology.

Vision For a New CPD Model.

Learning and quality improvement initiatives must fulfil societal needs.

1. Learning initiatives must be aligned with quality improvement initiatives in ensuring continued competency of health care professions.
2. There needs to be increased focus on more patient safety and better outcomes.
3. Patient safety and health care quality outcomes must be tied to outcome measures of health professions wellness and wellbeing.
4. It is vital to promote accountability and transparency in health systems — from self to society.

Learning and quality improvement initiatives must fulfil users’ individualized needs.

1. Access to information, initiatives, tools etc. should be made available in a just-in-time, dynamic manner.
2. Information provided needs to be cognitive and be able to interact at a human and individual level.
3. Learning and quality improvement initiatives need to utilize interactive, multi-sensory capabilities of its users.

Learning needs to be lifelong and part of the system of care.

1. Learning needs to be collaborative in nature and person-centred.
2. Learning initiatives need to be personalized and aligned with quality improvement, more patient safety as well as health professions wellness and wellbeing.
3. Learning tools developed need to incorporate practice and system-based needs.
4. Evaluation of learning outcomes need to be standardized.

Original illustration by Virpi Oinonen @voinonen (businessillustrator.com)

5. There is an urgent and critical need to embrace enabling technology — optimizing use of limited resources — and contributing towards health care sustainability.

The world won’t wait — Dawn of The New Vision of Lifelong Learning.

Person-Centred Design-Thinking

a) Person-centred design-thinking is about empowering the individuals in a society for a more responsive & learning health care system.

b) It emphasized the need for learning to be contextual and embedded in society.

c) It provides for mechanism in co-creating healthcare solutions with all the partners and stakeholders within an eco-system, including patients and their families.

d) It encourages new models of research & scholarship in lifelong learning — incorporating quality improvement, patient safety, health systems design, health professions wellbeing & wellness, population health, behavioural insights, social determinants of health, etc.

Personalized (Individualized) Initiatives — Empowering Learners, Increasing Ownership.

a) Learning initiatives need to be competency- and quality-based, as well as customized to an individual’s needs and work environment.

b) Design of learning initiatives should be based on an individual’s practice-based needs & goals — including perceived, misperceived and/or unperceived needs.

c) Individualized learning initiatives should be informed by personalized data — not just administrative but clinical data as well — and enabled by digital technology.

d) Reflective practice should be fostered and promoted, particularly through post-program reinforcement activities and tools.

Connected Medicine — Inter-professional/Cross-disciplinary Learning — Learning About, From and With One Another, Collaboratively.

a) We must adopt and promote the use of measurable frameworks designed to assess team-based competencies in medical education and professional development.

b) It is imperative to co-create initiatives and problem solve together — including patients and family representatives.

c) Developing new models of collaborative learning need to be encouraged and supported.

d) More partnerships should be developed and supported — recognizing and valuing diversity, appreciative understanding, integrating and implementing best practices.

Developing Tomorrow’s Leaders in Health Care and Health Professions Education — Towards a Learning, Responsive and Sustainable Health & Care Ecosystem.

1. All stakeholders in a health care eco-system should support the development and provision of personalized leadership development opportunities. These initiatives must be contextualized to an individual’s practice/working environment, as well as needs-based.
2. Development of leadership skills should be promoted in the context of societal needs as well as ensuring a healthy, open and productive work environment.
3. Personalized leadership development initiatives need to be competency-based, using a framework of behavioural objectives and developed specifically for leading in a health care system.

Venn Diagram from Jeff Weiner, CEO LinkedIn, article “The Three Qualities of People I Most Enjoy Working With”

“If a goal is truly visionary, it’s going to be confronted by doubters, skeptics, and those threatened by its realization. As a result, there will always be walls put up on the way to achieving the objective. Some of the most capable people I’ve worked with know how to go over, around, or straight through those walls by virtue of their resourcefulness and sheer force of will. In other words, they just get s**t done.” — Jeff Weiner, CEO LinkedIn.

Digital Enabling Technology in Health — Adopting New Information and Education Technology — Promoting Efficiency, Optimizing Resources, Ensuring Health Care Sustainability.

1. We need to understand the distributed nature of health care settings and the health care professions that serve those areas. In order to adequately address their needs, we must adapt and adopt new emerging digital technologies and unlock their vast potential.
2. Learning initiatives must be made accessible in a ‘just-in-time’ environment using enabling technology.
3. Models need to be in place for capturing not just administrative data, but also clinical, behavioural, best practices and evidence-based data as well — to truly create a system of personalized care and professional development.
4. Enabling technology should also be utilized to promote self-assessment / professional development as well as evaluating outcomes.

Conclusion.

Fostering a Learning System That Is System and Practice-based: Promoting Accountability & Transparency To Society As a Professional Responsibility.

a) Strong advocacy efforts are needed to incorporate the new innovative models of lifelong learning across the educational continuum in the face of rapidly evolving digital world.

b) New learning initiatives must be co-designed with all stakeholders in a health care ecosystem in order to respond to and align with system’s needs, as well as ensuring wider “buy-in”.

c) It is imperative that any new initiatives designed assimilate the concept of health professions wellbeing and wellness as an essential outcome measured.

d) Knowledge translation activities should additionally serve to contribute towards a networked governance model and help in making policy decisions.

e) Appropriateness in health must be promoted as a professional responsibility — improving systems of care, promoting more patient safety, ensuring wellbeing and wellness of health care professions and using resources wisely.

Ultimately, It’s All About Culture Change & Brave Leadership.

All the partners and stakeholders within a health care system need to work together to overcome the resistance and barriers to the much needed change and ensure development of systems’ resiliency.

At the same time, it is also imperative to engage with the front line health care professions and the society in a meaningful manner and co-create solutions.

Creative Confidence

“Creative Confidence is the notion that you have the ability and the courage to act on your new, innovative and big ideas.

Creativity is something you practice, not just a talent you’re born with.”

Delivering right care and needs-based learning, in a just-in-time environment, is critical to the creation of an efficient, responsive and sustainable health care ecosystem.

As such, there is a growing need and demand for learning opportunities for health care professions to be provided virtually, including, but not limited to, e-learning initiatives, e-quality improvement tools, e-health, telehealth, digital health, virtual care networks etc.

It is also vital to leverage enabling technology in integrating health databases to further develop capacity in data analytics, machine-learning and the use of real world evidence to inform clinical practice and learning needs.

Embrace Ambiguity

“Giving yourselves the permission to explore lots of different possibilities so that the right answer can reveal itself.”

To deliver the changes required, healthcare decision makers need to focus on encouraging better use of enabling digital technology, providing individualized opportunities for development of personalized leadership skills and supporting research, innovation and transformation in delivery of lifelong learning — as a professional responsibility to society.

Critical to the success of this goal is also to empower front-line health care professions, patients & their families. As well, it is also essential to engage “ordinary” health professions and communities in a meaningful manner — developing more personalized services and learning opportunities.

Authored by Khurram Jahangir.

Khurram is the Former Inaugural Associate Dean of Lifelong Learning and Physician Learning Program, Faculty of Medicine & Dentistry, University of Alberta. As the inaugural Dean of Lifelong Learning he successfully realized his revolutionary new vision of Lifelong Learning — expanding the scope of his office significantly, and with great success.

Khurram has a particular passion for and expertise in using digital enabling technology in health systems and has successfully mastered the technique of automating workflow design in creating innovative new learning initiatives as well as optimizing system and service (re)design.

Khurram is the Founder and Chief Experience Officer (CEO) of Health District — A Health Care & Health Professions Learning Design Consultancy.

He is a Health Care Value Proposition, Interaction & Improvement Design Strategist & Consultant.