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Continuing Medical Education. Stephanie Giberson, MCE Director, Rural & Northern Manitoba CME. “Best Practices” Quality Assurance Application to Rural & Northern CME. Society for Academic Continuing Medical Education, Spring 2007 Meeting, Copper Mountain, Colorado. W5.
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Continuing Medical Education Stephanie Giberson, MCE Director, Rural & Northern Manitoba CME
“Best Practices”Quality Assurance Application to Rural & Northern CME Society for Academic Continuing Medical Education, Spring 2007 Meeting, Copper Mountain, Colorado
W5 • Where - Rural & Northern CME challenge • Why • ‘traditional’ programs , • IMG CME needs • Who - politics and perspectives • What - the Quality Assurance model • How – cycles, CoPs, communication
500 Rural & Northern physicians Spread Over…. 1400 km 400 km
New grads • Experienced, but transient • 67% International Medical Graduates
Personal adjustment • Family adjustment • Clinical adjustment -health profiles, -pharmaceuticals, -protocol & procedures • Staff Shortages of All Health professionals
“We need to participate” “Need” = clinical + collegial
My Challenge • Meet EVERYONE’s clinical and collegial CME needs • Retain physicians in community/province Introduce CPD !
My Reality???? Politics & Perspectives
Regulatory Bodies • Manitoba Medical Association • College of Physicians & Surgeons of Manitoba • Royal College of Physicians & Surgeons Office of Rural & Northern Health Winnipeg RHA Central RHA Brandon RHA Assiniboine RHA Churchill RHA Parkland RHA NorMan RHA SEMan RHA COMMUNITY CHARACTERISTICS • Education … • -secondary • Advanced… • -university • -community colleges Manitoba Health RHAM-Regional Health Authorities of Manitoba POLITICAL Reality
The new Dean’s perspective Sandham, J. D. , Chrusch, C. (2005). Canadian Collaboration to Improve Patient Care and Safety in the ICU: Improvement Guide “All models are wrong, some are useful” George E.P. Box Research Accountability Improvement Science
The Improvement Model (PDSA) Sandham, J. D. , Chrusch, C. (2005).
Building knowledge sequentially Breakthrough Results Evidence & Data Learning & Development Theories, hunches, best practice & change concepts Sandham, J. D. , Chrusch, C. (2005)
Cycle 1 Data collection & verification • annual needs assessment to ALL R & N mds with f/u telephone interviews • Travel OUT • Bring ‘chairs’ IN twice/year • May – Strategic Planning as focus group and evaluators • December – evaluation, recognition • Create ext. & int. advisor committees • Assess costs/develop budgets for growth
Building Rural & Northern CME through a Communities of Practice Lens (aka Data Collection) R&N health/social programs R&N communities visits by CME staff 6..now.. 7 community FP ‘Chairs’ Internal CME Committee U of M, medical 9 medical unit/department ‘reps ’ Welcome(vs control) others as we find them! External CME Advisory Council regional, provincial, community health foundations, med association, colleges
Cycle 2 Erosion control & Exploration • Stabilize losses of ‘old’ visiting lecturer program • Modify videoconferencing program • Explore web-base contributor • Explore R & N conference • develop CME ‘presence’ at U of M • contribute to CME nationally/internationally
Power of QA Improvement Guide • To push ourselves (staff, faculty, admin.) • To pulltogether int/ext stakeholders • To empower rural mds • To cut, adjust, transform as needed… • To risk with confidence • To promote our activity as a key part of the continuum of medical education vs “on the edge” of the faculty.
Cycle 3 • Grow old “transformed” visiting lecturer colleague CME/CPD series • Growth in videoconferencing program • Web-based CME partner/contributor • Successful first ‘hands-on’ R & N Conference • High rating for clinical and collegiality • Noted as ‘industry- free’ event
references Deming, W.E., Out of Crisis, MIT Press, 1986. Langley, G., Nolan., K., Nolan, T., Norman, C., Provost, L. Improvement Guide: A Practical Approach to Enhancing Organizational Performance. San Francisco, CA., Jossey-Bass Publishers, 1996.
Continuing Medical Education Quality Assurance Application to Rural & Northern CME