The Efficacy and Utility of Online Education for Continuing Medical Education

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In today’s healthcare environment, continuous professional development (CPD) is a must for medical professionals and those supporting the healthcare enterprise, such as hospital administrators and medical travel facilitators. It is more important now than ever, to focus on “continuous” development because of the rapid cycles of global discovery, improvement, and creation in both the clinical and administrative realms of healthcare.

ATTAINING GLOBAL COMPETITIVENESS

Patients are increasingly researching foreign lands for economical, high-quality care and then traveling the world to obtain that care. Thus, from the patient’s perspective, updated skills are critical in the selection of a physician or surgeon. Most importantly, in our opinions, state of the art skills are necessary to ensure that patients receive the best care possible. Secondarily, these skills are needed to remain competitive from a marketing perspective.

In addition to the clinician, the business personnel supporting the clinical activities must be knowledgeable of the global best practices, as well as, standard international requirements in healthcare administration. For example, administrators need to know the best ways to submit claims to insurance companies to ensure timely payment of their claims and manage their “days in accounts receivable”. Can the hospital file claims electronically? Does the claim need to be on a specific form (e.g., a HCFA)? As another example, for new building projects, administrators must understand state of the art facility designs which maximize clinical quality and efficiencies, energy conservation, and patient satisfaction, while reducing full time equivalents and the necessary space requirements to accomplish required activities.

In the “flat”, global, clinical environment in which we live and work, no one person or organization has a monopoly on efficient, quality care. New and more effective methods of treating patients are developed constantly. These include new surgical methods, technologies, or pharmaceuticals. For example, a new procedure may be developed and performed in one hospital, medical school, or country. Until other organizations learn about the new procedure, they can neither perform the procedure nor improve upon it. Continuous education assists healthcare providers in learning about, discussing, and improving upon the ideas and technologies discovered by others.

CURRENT METHODS OF CONTINUING PROFESSIONAL DEVELOPMENT

Currently, a variety of options exist for CPD. One option is for a hospital to identify and pay a subject matter expert to travel to one’s facility to provide the training to the clinical or administrative staff. Another option is for a facility to send one or several healthcare providers to a conference or seminar to attend training. A variation on this theme is to use a “Train-the-Trainer” model where a single clinician or staff member represents a group at offsite training, receives the training, and then returns to a facility or medical group to train the clinical or administrative staff who did not attend the offsite meeting.

These methods of education have several disadvantages. First, the cost of sending staff members to a conference or several conferences can be expensive; a typical clinical staff member must attend more than a single conference to stay current with his or her discipline. Second, depending on one’s local laws and regulations, in the case of a train-the-trainer model, the staff receiving the training from the individual who attended the offsite training may not be eligible for Continuing Medical Education (CME) credits, potentially impacting their professional licenses or the facility’s accreditation. Third, while the conference attendees are absent, additional staff must cover for them, compounding costs, and, in certain circumstances, utilizing staff members trained in other specialties to care for patients.

THE ONLINE SOLUTION

One way to overcome or temper these disadvantages and to ensure that an organization’s staff is current in global best practices and cutting edge ideas and technologies is through the use of online education programs. Today, virtually everyone in healthcare has access to the internet all of the time or, at a minimum, a portion of the time. Staff members can utilize the online education from the convenience of their homes, after hours, or during a “slow time” at work, thus, preventing the extra staffing that has to occur for one to attend an offsite conference.

We are not suggesting that staff members never attend professional conferences. In fact, we support attendance at professional conferences, and view online continuing education as a high quality supplement to conference attendance and an opportunity for professionals to increase their knowledge even more than they would have increased it by only attending a conference. In certain situations, online education has been combined with a face-to-face session. For example, one group of surgeons discovered a new surgical procedure developed elsewhere through an online educational program. They then invited the inventor of the procedure to their facility for an in person demonstration. The combination of these methods was far more effective than either one utilized independently.

Online education  is appropriate for a variety of audiences, but discretion must be used. We recommend online education for clinicians who have developed their core skills and need to improve them. For example, a practicing surgeon could benefit greatly from observing a new surgical procedure; this person, after all, has the fundamental surgical skills and could understand both the conceptual explanation and tactile maneuvers. However, we would not advocate this training for someone who has never touched a scalpel.

In healthcare, some of the audiences and potential topics include: (1) Surgeons receiving instruction on how to use a new piece of technology; (2) Nurses receiving instruction about treating specific types of patients or how to improve customer satisfaction; and, (3) Medical Travel Facilitators participating in a certification program. In fact, it was recently announced that an online Medical Tourism Certification Program is being offered by the Medical Tourism Association (MTA) and the University of Richmond’s School of Continuing Studies.

Within online education, a professional can receive the education via a variety of formats. First, the instruction could be delivered live via a webinar where students can interact with the instructor. Second, the instruction could include a video of a previous live presentation or one produced specifically for the online format. Third, the material may be presented by text and slides that the recipient of the education reads. Finally, the material may be a combination of a portion or all of the above.

EVALUATION AND REPORTING FOR CME, CPD AND ACCREDITATION

It is important for personnel receiving the education to understand the information. In many cases, testing can be performed by the provider of the educational program to ensure that the “students” understand the conceptual material. This also assists the educator in understanding the portions of the material that were clearly communicated to participants and which sections should be revised for enhanced understanding by the participants.

While a high-quality, online program coupled with an evaluation mechanism to ensure that the audience understands the material are critical, advanced systems can also record, track, and summarize these results for participants and external parties. Specifically, when participants want to utilize their participation in the program for external purposes, such as government-mandated CME or CPD credits, JCI accreditation documentation, or marketing purposes, advanced systems can provide the summarized documentation. In our experience, a question commonly asked by US patients seeking care internationally is, “Has Dr. X had any training in the US?” With the right system and documentation, if “Dr. X” has taken online courses developed and approved in the US, he can easily prove that he has taken the courses and this can be verified by the independent third party offering the online program.
Therefore, online education can potentially improve clinical and administrative quality, ensure that global breakthroughs are disseminated quickly and efficiently, and be tracked and used for marketing, CME, and CPD purposes. In the traditional model of face-to-face continuing education, costs can be significant on a per person basis. With online CPD and CME, packages or memberships are available for hospitals or governments to purchase for a wide variety of the healthcare clinicians and administrators, typically, costing far less than educating each person individually or even utilizing a train-the-trainer model.

CONCLUSION

In conclusion, online education can be extremely beneficial to clinicians and administrators who want to identify cutting edge technologies, pharmaceuticals, procedures, and management techniques to improve the quality of the healthcare, the efficiency of the organization, and the marketing position of the organization. In addition, it is a cost effective method to provide CPD and CME credits to clinical and administrative professionals.

About the Author

Chad D. Holloway, Ph.D., is founder and president of Global Health Solutions LLC, an international healthcare company providing continuing professional development, economic analysis and recommendations, and marketing, contracting, and strategic planning services for hospitals, governments, insurance companies and other stakeholders. For information about Global Health Solutions, please call (618) 444-1552 or email info@globalhealthsolutionsus.com.

Junhui (Grace) Yan Johnson, Ph.D., is a partner with Global Health Solutions and an Assistant Professor of Economics at Lindenwood University. Professor Johnson’s research interests include development economics, financial economics, and health economics, with a recent focus on healthcare financing, comparative cost-effectiveness analysis of international healthcare systems, and the impact of continuing professional development on various healthcare settings.

Daniel K. Mueller, Ph.D., is a partner with Global Health Solutions and past assistant vice chancellor for International Affairs at Washington University School of Medicine and the director of International Healthcare Services for BJC Health System. In his combined position, Dr. Mueller worked to increase global awareness of the reputations and available services of BJC hospitals and of Washington University School of Medicine physicians.