DOCUMENT RESUME ED 052 323 VI 012 294 AUTHOR Robertson, William 0.; Dohner, Charles W. TITLE Study of Continuing Medical Education for the Purpose. of Establishing a Demonstration Center for Continuing Education in the Pacific Northwest. Final Report. INSTITUTION Washington Univ., Seattle. School of Medicine. SPO:4S AGENCY National Institutes of Health (DHEW), Bethesda, Md. Bureau of Health Professions Education and Manpower Training. PUB DArE 70 NOTE 324p. EDRS PRLCE EDRS Price MF-470.65 HC-$13.16 DESCRIPTORS *Educational Needs, Educational Proc7rams, *Inservice Education, *Medical Education, *Physicians, 4,Protessional Continuing Education. Questionnaires ABSTRACT In modern society, lifelong learning by the physician is essential. This study was conceived to:(1) define the educational needs of practitioners in the Pacific Northwest, (2) assess the resources available to meet these needs, (3) determine what educational programs are needed, (4) develop evaluation methods for these programs, (5) identify physician participation factors, (6) develop evaluation techniques for clinical communication systems, (7) evaluate recent continuing education programs, and(8) develop a comprehensive plan for a continuing education center. The report describes in detail the techniques used to accomplish these objectives, with questionnaires and survey results contained in the appendixes. Ideally, medical education should continue in a lifelong pattern developed during undergraduate study. With improvements in program content, promotional efforts, information networks, and program offerings in individual hospitals, continuing education can be made an integral part of pkysicians' careers. (BH) Id- -- tc, ASTUDY.OF CONTINUING EDUCATION IN THE PACIFIC NORTHWEST: FINAL REPORT UNIVERSITY OF WASHINGTON School of Medicine U S DEPARTMENT OF HEALTH EDUCATION& WELFARE OFFICE OF EDUCATION 7,55 Ur:"C'uN1E.INI'HAS BEEN REPD CLEFD ENACrlY AS FECEIVEO FROM RSON OR ORCAN,ZATIGN OHIO NAT,NC.; POINTS OF V1E'6N OR CP,5 STATEDnONOT NECESSARit, FEF,E SENT CFI iCrAL OFFICE OF EDU POSITION OS P01105 UNIVERSITY oF ,r,.ASOINGTON SCHOOL OF I4IF:OICINE STUDY OF CONTINUING MEDICAL EDUCATION FOR THL PURPOSE OF ESTULISHINO A DEMONSTRATION CENTER FOR CONTINUING EDUCATION IN THE PACIFIC NONTEWEST Project Director William 0. Robertson, M.D. Associate Dean Program Director Charles W. Dohner, Ph.D. Performed under a contract with the United States Public Ilealth Service Contract ho. PH103-66-177 41 PRIXACE In Septcmber, 1964, the Project Director, Will iam 0. IZobertson, M.D., Assoc [ate )onu, cut] ncd in a letter ! D,:an of Medicine at the University of Wasl,iligton the potentils I a;, if. ice of Research in Aedical Education, on ,e one created at the University of Washington (Appendix A) . Received favorably, the next step involved sceking finan- cial f,upport. At approxima!:ely the same time, Dr, John Lein joined the University of Washington as Director of Ccntinuing Ledical Education; his acceptance of this position was the !nitial step in elevating the function of continuing medical education to a status equal to that of educating medical students and house officers. In his new capacity, Dr. Lein also exprtsscd interest in the benefits to be derived from en Office of Research in Medical Educationespecially in the co,etinuing education field. Such was seen as particularly relevant in formulating programs in his relatively new venture. When these aspirations were shored with representatives of the Public Health Service and its thee Division of Community Affairs (Miss Cecilia C. Conrnth)--particularly in view of the unique geographic, educational and historical facets of our situation -- interest was pressed in possibly developing a collaborative program by contract. Over several months, th e cnallenges of a contractual relationship were worked out. Of significant import is the fact that, simultaneously, details of the Regional Medical Program were also being worked out nationally and locally and, from the beginning, possibilities of ii overlap were recognized. Thus, by July, 1966, the contract was signed with nine sp'r.cified objectives. It should he noted that tho agreed- upon pro;,,ram also served as an initial step within the University o: Washington School of :ledicine in davelopir its Office of Research in Medical Educ iti on Recruitment prebles precluded the appointment of a qualified Program Director for more than one year. Fortunately, in July, 1967, Dr. Charles W. Dol.:r agreed to join the faculty of the University of Washington both as Program Director and as Arector of the Office of Research in Medical Education. While several activities had begun prio: to his arrival, only subsequenly did full pursuit of objectives begin. iii The development of n study such as this involved several i;v1ivi- duals. We sought advice frc:1 and would express appreciation to many people, including Miss Cecilia C. Conrath, who assisted in drawing up the original contract; Dr. Alan S. Kaplan and Dr. John Lscovitz for their encouragement; and tt,o Project Officers, Mr. Norman E. Tucker and Mr, Norman E. Cronquist, for their valuable guith:nce as the con- tractual objectives were pursued. Dr. ].eVerne S. Collet and Mr. Ronald L. Haeberg, research assist- ants, provided invaluable assistance in areas of statistics and research design. Mr. Darrell hull and Mr. Haigh Fox contributed of their tae anu expertise in the compilation and analysis of much of the data. Mrs. Lurie Pracht and Mrs. Velta Censon have been Trost patient, under- standing, and cooperative in perfarming secretarial. and other tasks essential in such a study. Without the cooperatioa of the !.'ashington State Med..cal Education and Research Foundation staff, the Washington/Alaska Regional Medical Program staff, the Division of Continuing Medical Education at the. University of Washington, and a Lost of physicians who willingly parti- cipated in these studies, this study could not have been completed. To all of these individuals, we are extremely grateful. C.W.D. iv TABLE OF CO;;If,NTS PREFACE .1 SECTI) I The Problcc. 1 Scope of Work. 5 Report Outline 7 SECTION II Objective 1 9 Objective 2 14 Objective 3 23 Objective 4. 28 Objective 5 66 Objective 6 72 Objective 7 74 Objective 8 75 Objective 9 77 SECTION III Problems Encountered 37 Reccmmendstions 91 Implication of Study !)3 f; APPLNDLU.S A. ;.etter to Dean Hogness B. Computer-assisted instruction C. Yakina Project D. Washington State Medical Association Survey E. Open-ended Questions-4!ashington State Medical Association Survey F. Publications CAE Short Course Olympia Paper Consultant's Report Closing the Information Gap (Rho Gam) Sock It To Us Publish, Perish or Poop Out Research in Continuing Medical Education G. Internship Study Abstract H. Semantic Differential Graphs vi 1 SECTION I This docade has seen continuing medical education along with under- graduate curriculum revision, aJAinsions of minority students, arguments about relevance, the "mediums of the message" concept--these and other issues vie for notoriety on the medical education scene. Certainly, a host of factor; have been responsible for the resultant "unrest"; a few seem particularly contributory in spurring on continuing medical education. Fighlights include: 1. The scientific and technalogic exLlosion. While lx!,medical historians can substantiate the point that no actual chanpe in the rate of g-owth has occurred since the 1700's, in abso- lute numbers the products and developments have become vir- tually overwhelming. W'-_n one considers that 80 to 90 per cent of all the scientists th,lt have ever lived arc living today--and the number can be expected to double within 15 to 20 years--and that 80 to 90 per cent of today's drugs were unkncwn in 1940, the basis of the current dilemma becomes obvious. 2. The commitment to _uecialization in medicine. Starting at the turn of the century and reaching full steam immediately after World War II, specialization night be said to have run amuck. As a consequence, today's actitioner both expects and is expected to be far better informed in speci- fic areas than was his predecessor of a generation ago. 2 3. The commanication reyohajon. with the advent of the radio, the telephone, televi len, and computers, information transmittal techniy, h,ve taken a quantum jump comparable to th,it initiated by the d.rival of the printitv press 300 years ago. 4. The transportation e_x_plosion. Wilktbe at-i-val of the modern automobile roadway network :11.1 jet Jitplanes, the potential for isolationism and re;.cti:.airles would seem to be lost. 5. A violent disruption of social philosophy. Now the public and its politicians as well as the profession would seem to subscribe to the the;Je that "health care is a right of the entire population." As a consequence, costs of health care are receiving incr,:ased scrutiny; cries to enhance thy' efficicncy of the health care system echo throughout Congress--ard over the United States.All make new and different demands as yesterday's health professional assumes a new image tomorrow. 6. The reincarnation of humanism. In the years immediately following World War II, science became deity. Uowever, the past three years has seen a burgeoning of considerations of philosophy, ethics, moralities, etc., on campuses and among the population. The reaction has redirected, to some extent, the image of what constitutes acceptable con- tinuing ealncation endeavors in the eyes of many professionals. 3 7. Exploitation of the Hawthorne effect. identified during World War II, the concept of inducing change for change's sake and its resultant improved behavior has gained wider and recognition. The import of this ingredient in the personal as well as professional life of the physician is being recognized with increased frequency. The summation of these and other factors makes more than plausible the need for physicians to acquire additional knowledge, skills and attitudes after leaving the formal education years. Put differently, lifelong learn'.ng becomes critical. In centuries gone by, the individual physician to a large extent not only was responsible for, but actually tended to, the conduct of his individual updating.