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How Do Rural Healthcare Providers Learn?
An FCM Outcome Comparison of Three Learning Modalities: Live, Webinar, and Enduring Internet
Course: Stroke Prevention and Intervention in Patients at High Risk Due to A-fib.
Participants: Physicians, NPs, PAs, RNs, and Pharmacists in rural Alaska, Washington and Oregon who participated in a certified educational opportunity presented in three different modalities including five live activities, five webinars, and an enduring on-line activity. Participant breakdown: 995 internet, 185 live, 162 web. Data derived from the pre and post tests, course evaluations, and outcome surveys were collated as to learning modality and analyzed to determine which modality produced the best outcomes in terms of learning, competence to perform, and commitment to change their practice.
Summary and Conclusions: The FCM Community of Practice (rural PCPs and pharmacists in AK, OR, and WA) were surveyed to determine their preferred course modality. The majority chose live courses, followed by enduring web. The outcomes were revealing in that the strongest came from the live courses and the weakest from the webcasts. Experience with this media found that many rural areas have poor internet bandwidth that did not allow for interaction. The live activities with interaction with the experts seem to lead to better impact on practice and commitment to change.
Tobacco Cessation Performance Improvement Project
In this article we report on barriers and successes in implementing a PI-CME project in rural hospitals and small practices in the Pacific Northwest.
Background: The incorporation of baseline assessment and measureable practice change that positively impact patient outcomes is a growing component of successful continuing medical education (CME) program design. In February 2007, the Agency for Healthcare Research and Quality reported that CME “appears” to be effective in the acquisition and retention of knowledge, attitudes, skills, behaviors, and clinical outcomes.i It has been noted, however, that traditional CME activities lack the ability to assess the clinical impact of this improved knowledge on practice change and patient outcomes.ii The integration of this improved knowledge into clinical practice requires the practitioner’s consideration and self-assessment of their practice patterns before, during, and after the educational activity to improve their delivery of care and provide measureable patient outcomes.iii The development of Performance Improvement (PI) - CME activities has emerged as an approach to incorporate the measurement of practitioner practice patterns linked to education and process interventions to improve care and patient outcomes. The American Medical Association defines PI-CME activities as a structured, long-term three-stage process by which practitioners learn about specific performance measures; retrospectively assess their practice using the selected performance measures; implement interventions/practice changes to improve their performance; and re-evaluate their performance.iv The AMA and the American Academy of Family Physicians (AAFP) as evidence of evaluation of performance in practice that can be used as verification of learning used for the recertification of a practitioner’s credentials adopted this educational format in 2004.v