Professional Development Perceptions and Practices Among U.S. Physicians: A Cross-Specialty National Survey

Purpose Professional development (PD)—both for-credit continuing medical education (CME) and informal self-directed or point-of-care learning—is vital to all physicians. The authors sought to understand physicians’ PD perceptions and practices and how these vary by specialty and practice type. Method The authors administered an Internet and paper survey, from September 2015 to April 2016, to randomly sampled U.S. physicians. Survey items addressed perceived PD needs and barriers and how physicians identify knowledge/skills gaps. Results Of 4,648 invitees, 988 (21.6%) responded. Respondents believed that they already know what they need to learn (mean 5.8 [1 = strongly disagree; 7 = strongly agree]), can answer clinical questions using available resources (5.9), and want credit for learning during patient care (5.1). They did not strongly desire help identifying learning gaps (4.0) or indicate difficulty accumulating CME credits (3.1). Most PD was done during personal time (5.5). Competencies regarding medical knowledge/skills, wellness, informatics, and practice/systems improvement were rated the highest priority, while research, teaching, and professionalism were rated the lowest. The most important sources used to identify knowledge/skills gaps were immediate patient care needs (4.1 [1 = not important; 5 = extremely important]), personal awareness (3.8), and practice updates (3.7). The most important barriers were time (3.5) and cost (2.9). Differences by specialty and practice type were generally small and not statistically significant. Conclusions Physicians feel confident in identifying their own learning needs, perceive medical knowledge/skills as their highest-priority need, and desire more credit for learning during patient care.

[1]  Kevin W Eva,et al.  Towards a program of assessment for health professionals: from training into practice , 2016, Advances in health sciences education : theory and practice.

[2]  Jane M. Young,et al.  Audit and feedback: effects on professional practice and healthcare outcomes. , 2012, The Cochrane database of systematic reviews.

[3]  Michael Fordis,et al.  Accuracy of physician self-assessment compared with observed measures of competence: a systematic review. , 2006, JAMA.

[4]  N. Freemantle,et al.  Continuing education meetings and workshops: effects on professional practice and health care outcomes , 2001 .

[5]  T. Ostermann,et al.  General Practitioners' preferences and use of educational media: a German perspective , 2009, BMC health services research.

[6]  V. Curran,et al.  A comparative analysis of the perceived continuing medical education needs of a cohort of rural and urban Canadian family physicians. , 2007, Canadian journal of rural medicine : the official journal of the Society of Rural Physicians of Canada = Journal canadien de la medecine rurale : le journal officiel de la Societe de medecine rurale du Canada.

[7]  H. Fineberg,et al.  Health professionals for a new century: transforming education to strengthen health systems in an interdependent world , 2010, The Lancet.

[8]  J. Prescott,et al.  Rethinking CME: an imperative for academic medicine and faculty development. , 2011, Academic medicine : journal of the Association of American Medical Colleges.

[9]  P. Arn,et al.  Education format and resource preferences among registrants of a pediatric-focused CME website , 2009, Medical teacher.

[10]  M. Ebell,et al.  Analysis of questions asked by family doctors regarding patient care , 1999, BMJ.

[11]  Guilherme Del Fiol,et al.  Use of Classification Models Based on Usage Data for the Selection of Infobutton Resources , 2007, AMIA.

[12]  E. Holmboe,et al.  Perspective: the ACGME toolbox: half empty or half full? , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[13]  Mark H Ebell,et al.  Information mastery: integrating continuing medical education with the information needs of clinicians. , 2003, The Journal of continuing education in the health professions.

[14]  Trends in Physician Preferences for and Use of Sources of Medical Information in Response to Questions Arising at the Point of Care: 2009–2013 , 2014, The Journal of continuing education in the health professions.

[15]  David M. Irby,et al.  Calls for Reform of Medical Education by the Carnegie Foundation for the Advancement of Teaching: 1910 and 2010 , 2010, Academic medicine : journal of the Association of American Medical Colleges.

[16]  P. Gorman,et al.  Clinical questions raised by clinicians at the point of care: a systematic review. , 2014, JAMA internal medicine.

[17]  J. Sargeant,et al.  Practicing physicians' needs for assessment and feedback as part of professional development. , 2013, The Journal of continuing education in the health professions.

[18]  Jill Steinbruegge,et al.  Results of the First National Kaiser Permanente Continuing Medical Education Needs Assessment Survey. , 2002, The Permanente journal.

[19]  David A. Cook,et al.  Features of Effective Medical Knowledge Resources to Support Point of Care Learning: A Focus Group Study , 2013, PloS one.

[20]  G. McMahon What Do I Need to Learn Today?--The Evolution of CME. , 2016, The New England journal of medicine.

[21]  J. Mandrekar,et al.  Using social media to improve continuing medical education: a survey of course participants. , 2012, Mayo Clinic proceedings.

[22]  J. Ioannidis,et al.  Evolution of Reporting P Values in the Biomedical Literature, 1990-2015. , 2016, JAMA.

[23]  Regina Nuzzo,et al.  Scientific method: Statistical errors , 2014, Nature.

[24]  C. Lucey Medical education: part of the problem and part of the solution. , 2013, JAMA internal medicine.

[25]  S. Straus,et al.  What is the effectiveness of printed educational materials on primary care physician knowledge, behaviour, and patient outcomes: a systematic review and meta-analyses , 2015, Implementation Science.

[26]  Grant D. Stewart,et al.  The continuing medical education activities and attitudes of Australian doctors working in different clinical specialties and practice locations. , 2009, Australian health review : a publication of the Australian Hospital Association.

[27]  Paul E Mazmanian,et al.  Continuing medical education and the physician as a learner: guide to the evidence. , 2002, JAMA.

[28]  P. Volberding,et al.  Clinician attitudes about commercial support of continuing medical education: results of a detailed survey. , 2011, Archives of internal medicine.

[29]  Kevin W Eva,et al.  Knowing When to Look It Up: A New Conception of Self-Assessment Ability , 2007, Academic medicine : journal of the Association of American Medical Colleges.

[30]  F. Goodyear-Smith,et al.  Experiences and preferences of general practitioners regarding continuing medical education: a qualitative study. , 2003, The New Zealand medical journal.

[31]  Christine A. Sinsky,et al.  Changes in Burnout and Satisfaction With Work-Life Balance in Physicians and the General US Working Population Between 2011 and 2014. , 2015, Mayo Clinic proceedings.

[32]  S. Straus,et al.  Learning in practice The case for knowledge translation : shortening the journey from evidence to effect , 2003 .

[33]  S. Nissen Reforming the continuing medical education system. , 2015, JAMA.

[34]  David A Cook,et al.  Physician Attitudes About Maintenance of Certification: A Cross-Specialty National Survey. , 2016, Mayo Clinic proceedings.

[35]  P. Pluye,et al.  Number Needed to Benefit From Information (NNBI): Proposal From a Mixed Methods Research Study With Practicing Family Physicians , 2013, The Annals of Family Medicine.

[36]  Glenn Regehr,et al.  "I'll never play professional football" and other fallacies of self-assessment. , 2008, The Journal of continuing education in the health professions.

[37]  L. Dyrbye,et al.  Single Item Measures of Emotional Exhaustion and Depersonalization Are Useful for Assessing Burnout in Medical Professionals , 2009, Journal of General Internal Medicine.

[38]  Kevin W Eva,et al.  Self-Assessment in the Health Professions: A Reformulation and Research Agenda , 2005, Academic medicine : journal of the Association of American Medical Colleges.

[39]  David A Cook,et al.  Barriers and decisions when answering clinical questions at the point of care: a grounded theory study. , 2013, JAMA internal medicine.

[40]  Alanna Kulchak Rahm,et al.  Assessment of barriers to changing practice as CME outcomes* , 2010, The Journal of continuing education in the health professions.

[41]  Kristi J. Sorensen,et al.  A Comprehensive Information Technology System to Support Physician Learning at the Point of Care , 2015, Academic medicine : journal of the Association of American Medical Colleges.

[42]  J. Norcini,et al.  Assessment in the Context of Licensure and Certification , 2013, Teaching and learning in medicine.

[43]  A. Hassell,et al.  Musculoskeletal Health Professional Use of Internet Resources for Personal and Patient Education: Results from an Online National Survey , 2012, The open rheumatology journal.

[44]  M. Rieger,et al.  German ambulatory care physicians' perspectives on continuing medical education—A national survey , 2009, The Journal of continuing education in the health professions.

[45]  V. Hasselblad,et al.  Effect of Clinical Decision-Support Systems , 2012, Annals of Internal Medicine.

[46]  D. Rowley,et al.  Continuing professional development for surgeons. , 2008, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland.

[47]  Guilherme Del Fiol,et al.  Research Paper: Effectiveness of Topic-specific Infobuttons: A Randomized Controlled Trial , 2008, J. Am. Medical Informatics Assoc..

[48]  Todd Dorman,et al.  Effectiveness of continuing medical education. , 2007, Evidence report/technology assessment.

[49]  L. Miller,et al.  Handling Nonresponse Issues. , 1983 .

[50]  T. Gallagher,et al.  Internists’ Attitudes About Assessing and Maintaining Clinical Competence , 2014, Journal of General Internal Medicine.

[51]  D. Cook,et al.  Incentive and Reminder Strategies to Improve Response Rate for Internet-Based Physician Surveys: A Randomized Experiment , 2016, Journal of medical Internet research.