Specialists Continuing Professional Development (CPD) Needs Assessment Survey

Transcription

1 Specialists Continuing Professional Development (CPD) Needs Assessment Survey Prepared by: UBC Division of Continuing Professional Development (UBC CPD) Dr. Rod McFadyen, MD, FRCPC, Specialty CPD Medical Director Dr. Todd Sorokan, MD, FRCPC, Executive Medical Director Dr. Brenna Lynn, PhD, Executive Director Ms. Alexandra Hatry, MA, Research Coordinator [July 2014]

2 Table of Contents ACKNOWLEDGEMENTS... 3 GLOSSARY... 3 SURVEY HIGHLIGHTS... 4 DEMOGRAPHICS... 6 Faculty Appointment... 8 Mentoring... 8 ELECTRONIC MEDICAL RECORDS... 9 Would you like better tools to use your EMR for practice audits? Would you like to improve your EMR to support CPD? LEARNING FORMATS SKILL DEVELOPMENT Teaching Leadership/management Mentoring CPD ACTIVITIES APPENDIX 1: In what specialty and subspecialty do you primarily practice? APPENDIX 2: Which Electronic Medical Record system do you use? APPENDIX 3: Learning Technology Utilization by Health Authority APPENDIX 4: Learning Technology Utilization by specialty APPENDIX 5: Levels of Participation and Interest for different CPD Activities APPENDIX 6: Considering the type of information session what are the respondent s preferred learning format

3 ACKNOWLEDGEMENTS The University of British Columbia s Division of Continuing Professional Development (UBC CPD) would like to acknowledge the Royal College of Physicians and Surgeons, the Maintenance of Certification (MOC) Program and the regional continuing medical education (CME) offices that supported the development and deployment of the survey. We would like to thank the many specialist physicians who gave their time to complete the survey. GLOSSARY British Columbia Fraser Health Authority Interior Health Authority Northern Health Authority Provincial Health Services Authority Vancouver Coastal Health Authority Vancouver Island Health Authority Electronic Medical Record Continuing Professional Development BC FHA IHA NHA PHSA VCHA VIHA EMR CPD 3

4 SURVEY HIGHLIGHTS UBC CPD could best assist with Self-learning activities (41% of respondents felt this way) Assessment activities (23% of respondents felt this way) Future learning activities included Self-assessment programs had the highest interest as a future activity and the highest interest in receiving more information about such programs. Multi-Source Feedback activities had the lowest current participation rate yet one of the highest for interest in receiving more information about the activity. Current involvement in teaching and mentoring 71.9% of respondents had a university faculty appointment and of those 95.3% were involved in teaching 76.4% of respondents indicated that they were involved in mentoring health profession students or post-graduate trainees. Of those, 89.9% had a faculty appointment. Several respondents are involved in teaching and/or mentoring learners outside of their profession Areas for further skill Development Most respondents were interested in pursuing at least two or more of the listed skills Respondents who were newer to practice indicated an interest indicated an interest in developing skills in teaching and leadership/management Teaching 50.6% of respondents were interested in teaching, of those 57.4% had a faculty position and 56.9% mentored health profession students or post-graduate trainees Leadership/Management 42.1% of respondents were interested in leadership/management; many were in the PHSA (63.5% of respondents who work in PHSA). Mentoring 33.5% of respondents were interested in mentoring (many were also interested in teaching) EMR usage and learning needs 60% of respondents used an EMR and the EMR s with the most users were: 1) Meditech (FHA & IHA), 2) Cerner (VIHA & PHSA) and 3) Optimed (FHA, IHA, VCHA & VIHA) 64% of respondents wanted better tools to use their EMRs for practice audits. EMR users (14%) who did not want further training used: CAIS, Optimed and Plexia 68.5% of respondents would like to improve the use of their EMR to support their CPD 12.1% of EMR users who did not want their EMR to support CPD typically used other EMRs Current and preferred learning formats The most currently utilized learning technologies were: videoconference (62.5%), online learning modules (59.4%) and webinars (47.0%) The top choices for desired information sessions were: 1) structuring a personal learning project (PLP) (32.6%); 2) efficiently searching for medical information (32.6%); and 3) assessing your practice for improvement opportunities (30.9%) 4

5 The most popular formats for these information sessions were: online (webinar) with 40.3%, followed by workshop (26.3%) and rounds (21%). 5

6 % of Respondents DEMOGRAPHICS Over a six week period we received responses from a total of 580 physician specialists, of those 515 completed the entire 24-question survey yielding a response rate of 10.5% which was comparable to the response rates reported by other Canadian provinces. Most of the BC respondents indicated that they were a Fellow of the Royal College (93.2%). Are you a Fellow of the Royal College? 6.8% Yes No 93.2% Half of the respondents had been in practice for more than 20 years while 15% of respondents had been in practice for 0-5 years. What is your total number of years in practice? 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% 24.0% 24.9% 26.5% 3.6% 11.4% 9.6% Less than Over 30 Years in practice Physician respondents were from all five BC Health Authorities, with the highest response rates from Vancouver Coastal (31.5%), Fraser (20.8%) and Vancouver Island (17.6%). In which Health Authority do you practice? Northern 4% Interior 10% Provincial Health Services 11% Not Applicable 5% Vancouver Coastal 31% Vancouver Island 18% Fraser 21% Both urban and rural practitioners responded to the survey. Most respondents (81%) indicated that the 6

7 Adjusted Relative Frequency community/population in which they practiced was 100, 000 and above. However, when asked to describe their work, only 32.9% indicated that they worked in an urban setting. Yet, the 9% of respondents who indicated that they practiced in a community with a population of 10,000 or below was comparable to the 9.8% who described working in a rural setting. What is the approximate size of the community/population in which you practice? 10,001-49,999 8% 50,000-99,999 10% Under 10,000 1% 100, ,999 33% Over 500,000 48% Survey respondents indicated that they specialized in a large range of medical specialties; with 28 specialties identified. Most respondents indicated that their primary specialty was: 1) Internal Medicine (23.8%); 2) Psychiatry (11.5%); and 3) Anesthesiology (9%). While many (33.6%) also indicated that they worked in a subspecialty. Please refer to Appendix 1for further details. A large percentage of respondents indicated that their work was: a full-time medical practice (72.5%); involved teaching (43.1%); and was urban based (32.9%). Which of the following describes your work? (Please select ALL that apply) 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% 72.5% 18.4% 6.9% 20.6% 17.7% 43.1% 32.9% 9.8% 4.1% 7

8 Adjusted Relative Frequency Respondents top setting(s) that best described where they worked were: office/clinic (63.2%), inpatient care (54.1%), hospital outpatient care (42.4%) and the emergency department (23.05%). Please indicate which setting(s) best describe where you work. (Please select ALL that apply) 100.0% 80.0% 60.0% 63.2% 54.1% 42.4% 40.0% 20.0% 3.0% 23.0% 11.9% 0.0% Office/Clinic Long Term Care Facility Emergency Inpatient Care Department Hospital Outpatient Care Other Faculty Appointment The majority of respondents had a university faculty appointment (71.9%) and of those respondents, most indicated that their work involved teaching (95.3%) and/or administrative duties (89.2%). The majority had an appointment with the University of British Columbia while some had joint appointments with McGill, Simon Fraser University, University of Calgary, University of Northern British Columbia and University of Victoria. Several had appointments with other universities such as the University of Saskatchewan, University of Victoria, and University of Western Ontario. Mentoring The majority of survey respondents (76.4%) indicated that they were involved in mentoring health profession students or post-graduate trainees in their practice. Of those, 89.9% had a faculty appointment. Are you involved in mentoring health profession students or post-graduate trainees in your practice? No 23.6% Yes 76.4% 8

9 Many respondents interpreted mentoring to include teaching activities and described how they taught medicine to undergraduates and residents. While other respondents indicated the discipline or field that they mentored for: army medical corps epidemiology genetic counselling graduate studies IMGs mechanical engineering midwifery nursing paramedics pathologists pharmacy psychology public health social work technologists ELECTRONIC MEDICAL RECORDS Sixty percent of survey respondents indicated that they used an electronic medical record (EMR). Do you use an Electronic Medical Record in your practice? No 39.7% Yes 60.3% The top EMR s were: 1) Meditech (20.4%), 2) Cerner (19.4%), and 3) Optimed (14.9%). Please refer to Appendix 2 for details regarding which EMRs are used in the specific health authorities. Several respondents indicated that they used an EMR, but did not provide the name of the EMR they used (6.8%). There were also several respondents who indicated that they used an EMR but included in the comments box I don t know [which EMR] implying that some physicians are unaware of the EMR platform they use. Of those who indicated that they used an EMR, there was a small subset (15.8%) who indicated that they used more than one EMR. Interesting to note a small portion of these multi-emr users (24.5%) worked in oncology (internal medicine and radiology) and use CAIS as their additional EMR. Survey respondents who did not use an EMR (39.7%) commonly worked in the following specialties: 1) Anesthesiology (71.4% of anesthesiologists who responded); 2) Medical Microbiology (66.7% of medical microbiologists who responded); 3) Dermatology (60.0% of dermatologists who responded); 4) Ophthalmology (52.2% of ophthalmologists who responded); and 5) General Surgery (51.8% of general surgeons who responded). 9

10 Would you like better tools to use your EMR for practice audits? The majority of survey respondents wanted better tools to use their EMRs for practice audits. However, of those who indicated that they did not want better tools to use their EMRS (35.9%) many of whom did not use an EMR (21.6%). Would you like better tools to use your Electronic Medical Record for practice audits? No, use an EMR 14.3% No, DO NOT use an EMR 21.6% Yes 64.1% Those who did use EMRs and did not want further training (14.3%) used the following EMRs: 1) CAIS (25.9% of CAIS users) 2) Optimed (22.4% of Optimed users) 3) Plexia (22.0% of Plexia users) Would you like to improve your EMR to support CPD? The majority of the survey respondents indicated that they would like to improve the use of their EMR to support their continuing professional development (CPD). Of those who did not want their EMRs to support their CPD (31.5%) many of whom did not use an EMR (19.4%). Many respondents who did use an EMR and did not want their EMR to support their CPD indicated that they used an EMR that fell in the other category in our survey. Would you like to improve the use of your Electronic Medical Record to support continuing professional development? No, DO NOT use an EMR 19.4% No, use an EMR 12.1% Yes 68.5% 10

11 Adjusted Relative Frequency LEARNING FORMATS Survey respondents were asked to indicate if they used the following learning technologies: videoconference, webinars, online learning modules, online journal club, and other. Of those who responded the following were the most utilized learning technologies: 1) Videoconference (62.5%); 2) Online learning modules (59.4%); and 3) Webinars (47.0%). Please refer to Appendix 3 for more information regarding learning technology utilization by health authority. Do you utilize any of the following learning technologies? (Please select ALL that apply) 100.0% 62.5% 80.0% 60.0% 40.0% 20.0% 0.0% 47.0% 59.4% 14.9% 14.2% 6.9% There were no observable differences in learning technology utilization associated with the size of the community. However, there were differences noted amongst specialties and technology utilization. Please refer to Appendix 4 for more information. SKILL DEVELOPMENT Survey respondents were asked if they would like to pursue additional skill development in the following areas: teaching, mentoring, coaching, leadership/management, advocacy, communication, patient safety and ethics. Respondents were most interested in further developing their skills in: 1) Teaching (50.6%); 2) Leadership/management (42.1%); and 3) Mentoring (33.5%). 11

12 Adjusted Relative Frequency Would you like to pursue additional skills development in any of the following areas? (Please select ALL that apply) 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% 50.6% 33.5% 13.3% 42.1% 17.2% 23.4% 29.4% 23.9% 24.0% Most respondents indicated an interest in pursuing additional skills in at least two or more of the listed areas. However, there was a subset of respondents (24.0%) who indicated that they were not interested in pursuing additional skill development in any of the suggested areas. Interestingly, many of these respondent s specialty included some form of surgery; 75% of plastic surgeons, 37% general surgeons and 35.7% of orthopedic surgeons of survey respondents. Teaching Teaching had the most interest (50.6%) for further skill development. Of those respondents, 18.8% indicated an additional interest in both mentoring and coaching, 55.4% respondents indicated an additional interest in mentoring and 20.3% respondents indicated an additional interest in coaching. Those who were interested in teaching had a faculty position (57.4%) and mentored students/resident (56.9%.) 70.4% of respondents interested in teaching had been in practice for 6-10 years) followed by those who had been in practice for 1-5 years (62.5% of respondents). Respondents who were most interested in developing their teaching skills were in PHSA (63.4% of all those in PHSA) followed by respondents in VCHA (52.0% of respondents in VCHA). Several specialties were identified as having the highest level of interest in additional skill development for teaching, these included: emergency medicine (68.8% of EM who responded to the survey); otolaryngology (60% of all otolaryngology respondents); internal medicine (59.2% of all internal medicine respondents); and ophthalmology (56.5% of all ophthalmology respondents). Leadership/management Leadership/management was another area of interest with 42.1% of respondents interested in additional skill development. Interest for further leadership/management skill development was more common in those with less practice experience: 50% of respondents with less than 1 year in practice, 50% with 1-5 years experience and 70.4% with 6-10 years experience. Additionally, many of those who were interested in developing their leadership/management skills were from PHSA (63.5% of respondents). 12

13 Interest was across specialties, and the following are the specialties with the most interest: urology (58.3% of respondents); radiation oncology (76.9% of respondents); and pediatrics (60.0% of respondents). Mentoring Mentoring was an area of interest for 35.5% of survey respondents. Orthopedic surgeons (85.6% of orthopedic surgeon respondents), cardiac surgeons (100% of cardiac surgeon respondents), general surgeons (70.4% of general surgeon respondents), plastic surgeons (100% of plastic surgeon respondents) and vascular surgeons (100% of vascular surgeons) were not interested in further development of mentoring skills, comprising 13.4% of the disinterest. CPD ACTIVITIES Survey respondent were asked to indicate the types of CPD activities in which they were currently participating in and the kinds of CPD they might consider in the future. They were allowed to select as many categories as they desired. Most respondents currently participate in conferences, journal reading and internet searches while the fewest participate in multi-source feedback, fellowships and traineeships. Further, when considering respondents future activities fellowships and traineeships had the lowest interest. The majority of survey respondents have been in practice for over 11 years which could explain why there is decreased participation and interest in these areas of activity. Respondents were most interested in participating in future activities that included self-assessment programs, journal clubs and formal courses. The theme of assessment was reiterated when respondents indicated that they would be most interested in receiving more information about self-assessment programs, multi-source feedback and educational/administrative assessment activities. Please see Appendix 5 for the highest/lowest level of participation and highest/lowest level of interest from a list of 21 CPD activities. Over half of respondents anticipated logging most of their MOC credits in the next 1-3 years in the domain of group learning (51.7%), followed by self-learning (45.3%) and lastly assessment (3%). Recognizing that specialists engage in a variety of CPD activities, in which domain described in question 20 do you anticipate logging MOST of your MOC credits in the next 1-3 years? Assessment 3% Self-learning 45% Group Learning 52% 13

14 Adjusted Relative Frequency Of those three domains, respondents felt that UBC CPD could best assist them with self-learning (40.7%), group learning (36.5%) and assessment (22.8%). In which domain do you feel that UBC CPD can best assist you with CPD activity? Assessment 23% Group Learning 36% Self-learning 41% Respondents were asked to indicate if they would be interested in participating in information sessions on: review the MOC Program sections and the MAINPORT online eportfolio tool, structuring a Personal Learning Project (PLP), assessing your practice for improvement opportunities, efficiently searching for medical information, identifying and managing your lifelong learning/cme/cpd needs and none of the above. The top choices were: 1) structuring a personal learning project (PLP) (32.6%); 2) efficiently searching for medical information (32.6%); and 3) assessing your practice for improvement opportunities (30.9%). Aside from the top choices, there was a subset who indicated that they were not interested in any of the options (37.5%). Please indicate if you would be interested in participating in an information on: (Please check ALL that apply) 100.0% 80.0% 60.0% 40.0% 20.0% 0.0% 19.7% 32.6% 30.9% 32.6% 24.4% 37.5% Information Sessions Respondents were asked which learning format they would prefer to receive further information. The most popular format, when comparing all of the respondent s choices, was online (webinar) with 40.3%, followed by workshop (26.3%) and rounds (21%). 14

15 Respondents preferred mode of session was then compared to the type of information session. Please see Appendix 6 for more information. 15

16 APPENDIX 1: In what specialty and subspecialty do you primarily practice? Specialty Count Percent* Adjusted for missing Anatomical Pathology 9 1.6% Cytopathology 1 Forensic Pathology 1 Gastroenterology 1 Anesthesiology % Adult Echocardiography 2 Clinician Educator 1 Critical Care Medicine (pediatric or adult) 2 Cardiac Surgery 1 0.2% Dermatology 5 0.9% Diagnostic Radiology % Adult Echocardiography 1 Neuroradiology 1 Pediatric Radiology 2 Emergency Medicine % Infectious Diseases 1 Pain Medicine 1 Sport and Exercise Medicine 1 General Pathology 4 0.7% Forensic Pathology 1 General Surgery % Colorectal Surgery 3 General Surgical Oncology 2 Trauma General Surgery 1 Hematological Pathology 3 0.5% Internal Medicine % Adult Echocardiography 1 Cardiology 7 Clinical Immunology and Allergy 3 Critical Care Medicine (pediatric or adult) 2 Endocrinology and Metabolism 21 Gastroenterology 7 General Internal Medicine 8 Geriatric Medicine 9 Hematology 3 Infectious Diseases 5 Medical Oncology 22 Nephrology 9 Occupational Medicine 3 Respirology 11 Rheumatology 6 Medical Biochemistry 1 0.2% Medical Genetics 1 0.2% Medical Microbiology 3 0.5% Neurology % Neurosurgery 6 1.1% Nuclear Medicine 2 0.4% Obstetrics and Gynecology % Gynecologic Oncology 2 Gynecologic Reproductive Endocrinology and Infertility 1 Maternal-Fetal Medicine 4 Opthalmology % Orthopedic Surgery % 16

17 Sport and Exercise Medicine 1 Otolaryngology Head & Neck Surgery % Pediatric Surgery 1 Pediatrics % Adolescent Medicine 1 Clinical Immunology and Allergy 1 Developmental Pediatrics 3 Gastroenterology 1 Infectious Diseases 1 Neonatal-Perinatal Medicine 3 Nephrology 1 Pediatric Emergency Medicine 2 Pediatric Hematology/Oncology 2 Physical Medicine and Rehabilitation % Plastic Surgery 4 0.7% Psychiatry % Child and Adolescent Psychiatry 10 Forensic Psychiatry 3 Geriatric Psychiatry 4 Pain Medicine 1 Public Health and Preventative Measure % Occupational Medicine 3 Radiation Oncology % Urology % Clinician Educator 1 Vascular Surgery 1 0.2% 17

18 APPENDIX 2: Which Electronic Medical Record system do you use? (Please select ALL that apply) Electronic Medical Records VCHA FHA VIHA PHSA IHA NHA NA Count Percent* of total respondents (n=309) Intrahealth % OSCAR % Med Access % Osler Systems % EyeMD EMR % MOIS % Optimed % Plexia % Skunkwerks iclinic % Wolf EMR % Cerner % Meditech % Other: % Accuro % CAIS % Paris % Don t know % Sunrise % Sunset/Sunquest % PCIS % McKesson % iphis % IFA % iclinic % Proprietary % Profile % Praxis % Panorama % PACS % OHM % Nightingale % Inteleris % Eve % Elliott % Care Connect % 4D scheduling & billing % custom program Self-created % Valant % Telus/PSS % Total Responses

19 APPENDIX 3: Learning Technology Utilization by Health Authority (Please select ALL that apply) Learning Technology VCHA FHA VIHA PHSA IHA NHA NA Count Percent* 536 Videoconference % Webinars % Online Learning Modules % Online Journal Club % None of the above % Other % Audio Digest % Conferences % Journal Club % Journals % Lectures % List Serve % Literature Search/Review % Podcasts % Teleconference Rounds % This Changed My Practice % Grand Rounds % YouTube % 19

20 APPENDIX 4: Learning Technology Utilization by specialty (Please select ALL that apply) Specialty Videoconference Webinars Online Learning Online None Modules Journal Club Anatomical 66.7% 55.5% 44.4% 22.2% 22.2% Pathology (n=9) Anesthesiology 55.1% 22.4% 71.4% 8.1% 10.2% (n=49) Cardiac Surgery (n=1) 100% - 100% - - Dermatology (n=5) 60% 60% 40% - 40% Diagnostic Radiology 85.3% 50% 61.8% 11.8% 5.9% (n=34) Emergency Medicine 65.6% 62.5% 56.2% 6.2% 15.6% (n=32) General Pathology 100% 100% 50% - - (n=4) General Surgery 44.4% 29.6% 48.1% 33.3% 22.2% (n=27) Hematological 66.7% 100% 100% - - Pathology (n=3) Internal Medicine 62.3% 46.2% 55.4% 14.6% 14.6% (n=130) Medical Biochemistry - 100% 100% 100% - (n=1) Medical Genetics 100% (n=1) Medical 66.7% 66.7% 33.3% 33.3% 33.3% Microbiology (n=3) Neurology (n=12) 66.7% 8.3% 33.3% 16.7% 25% Neurosurgery (n=6) 66.7% 66.7% 50% 16.7% - Nuclear Medicine % - 50% (n=2) Obstetrics and 70% 55% 75% 10% 5% Gynecology (n=20) Opthalmology (n=23) 56.5% 60.9% 73.9% 21.7% 8.7% Orthopedic Surgery 67.9% 60.7% 50% 14.3% 10.7% (n=28) Otolaryngology 80% 50% 30% 20% 10% Head & Neck Surgery (n=10) Pediatrics (n=30) 60% 46.7% 53.3% 13.3% 13.3% Physical Medicine 36.4% 45.4% 63.6% 9% 9% and Rehabilitation (n=11) Plastic Surgery (n=4) 75% 75% 75% 25% - Psychiatry (n=63) 49.2% 38.1% 61.9% 17.5% 17.5% Public Health and 58.3% 66.7% 66.7% 8.3% 16.7% 20

21 Preventative Measure (n=12) Radiation Oncology 61.5% 38.5% 61.5% 7.7% 30.8% (n=13) Urology (n=12) 66.7% 58.3% 66.7% 25% 8.3% Vascular Surgery (n=1) 100% APPENDIX 5: Levels of Participation and Interest for different CPD Activities (Please select ALL that apply) Current CPD Activities Highest participation Lowest participation 1. Conferences (n=502) 1. Multi-source feedback (n=19) 2. Journal Reading (n=472) 2. Fellowships (n=29) 3. Internet Search (n=434) 3. Traineeships (n=40) Possible Future CPD Activities Highest interest Lowest interest 1. Self-assessment Programs (n=117) 1. Fellowships (n=30) 2. Journal Clubs (n=110) 2. InfoPOEMS or other Clinical News alerting services (n=48) 3. Formal Courses (n=99) 3. Traineeships (n=49 Would Like to Receive More Information About Activities Highest interest Lowest interest 1. Self-assessment Programs (n=71) 1. Journal Reading (n=14) 2. Multi-Source Feedback (n=61) 2. Rounds (n=14) 3. Educational/administrative assessment 3. Journal Clubs (n=16) (n=56) 21

22 APPENDIX 6: Considering the type of information session what are the respondent s preferred learning format. (Please select ALL that apply) Information Session Learning Format*Adjusted Relative Frequency Review the MOC Program sections and the 75.0% preferred online (webinar) MAINPORT online eportfolio tool Structuring a Personal Learning Project (PLP) 77.3% preferred online (webinar) 47.1% preferred workshop Assessing your practice for improvement 68.7% preferred online (webinar) opportunities 55.8% preferred workshop 42.9% preferred Rounds Efficiently searching for medical information 79.1% preferred online (webinar) 50.6% preferred workshops 41.3% preferred Rounds Identifying and managing your lifelong 76% preferred online (webinar) learning/cme/cpd needs 55% preferred workshop 40.3% preferred Rounds 22