The increased focus on the results of professional practice (that is, the health outcomes of individuals and populations) creates two related tensions which will be considered in this paper. The first is the need for improved working and collaboration among different health professionals; the second is the demand for a broader vision of continuing medical education (CME).
Almost everyone who seeks medical care interacts with more than one health professional. The number of professionals involved and the importance of their ability to work collaboratively increases with the complexity of the patient’s needs. New initiatives to improve management of diseases such as asthma, diabetes, or congestive heart failure invariably point out the need for interprofessional collaboration.1 Increasingly, the “myth of the omnipotence of the independent practitioner” is being challenged as we discover the gains in quality and savings in cost when health professionals work together well.2
At the same time, traditional approaches to delivering CME for doctors are being questioned. A recent review of randomised controlled trials of CME concluded that it was undermined by difficulties with its delivery, that it seemed unable to respond to the urgent demands of healthcare reform, and that there was little evidence for its own effectiveness and efficacy.3 The bulk of the studies focused on traditional approaches, although they identified a widening range of CME activities. Further, it was shown that even when there was change in doctors’ behaviour there was “most often a small, less often a moderate, and rarely a large” effect on health outcomes.
In its working paper Continuing Professional Development for Doctors and Dentists, the Standing Committee on Postgraduate Medical and Dental Education (SCOPME) concluded that “conventional continuing medical education is no longer adequate to meet all the education and career development needs of doctors in modern health care.”4 It argued that CME needs to be set in the wider context of continuing professional development. While updates of clinical knowledge for individual doctors remain important, other learning is needed, including strategies for multidisciplinary and multiprofessional working. (Although the SCOPME report speaks of multiprofessional learning, the term “interprofessional” has since gained favour. For many, “interprofessional” better reflects the need for dynamic interaction among professionals to ensure that learning goes beyond merely having members of different professions sharing the same classroom together.)
- Greater focus on results of professional practice creates a need for improved collaboration by medical professionals and a broader vision of continuing medical education
- Effective interprofessional working ranges from loosely coordinated collaboration to closely organised teamwork. Across this range, certain key elements increase the likelihood of success
- Shared goals around patients’ needs, and an approach focus in on processes that serve that need, can help transcend traditional barriers
- Effective adult learning occurs when the topic is important to the learner and when learning combines reflection with concrete experience