Continuing Education for Skills Development of Rehabilitation Professionals
2022 年 7 巻 論文ID: 20220056
詳細
2022 年 7 巻 論文ID: 20220056
Rehabilitation professionals (RPs) have an obligation to update their knowledge and skills and maintain their professional competence by participating in continuing education (CE) and continuing professional development (CPD) programs each year. Such practices are crucial for the delivery of ethical, safe, high-quality, evidence-based care in the modern healthcare environment.1) The majority of RPs appear to choose formal, course-based education2) because informal education in CE does not allow the continuing advancement of professional learning.3)
The evidence for the effectiveness of CPD programs is mixed. The results of a systematic review have shown that CE programs can enhance patient health outcomes by enhancing knowledge, abilities, attitudes, and behaviors of the participants.4) On the contrary, another study found that participation in structured CPD programs augments the knowledge and practice behaviors of clinicians without impacting patient outcomes.5) However, there are concerns regarding a lack of control on standards of education, resulting in variations in clinical competence within the same country.6)
There is an urgent need to switch to learner-centered CE from the traditional instructor-centered training model that focuses on “giving recipes and approaches” with little ability to critically evaluate knowledge. In a learner-centered approach, a teacher’s job is to foster learning environments that encourage participants to take more ownership of their education. Courses should be designed using approaches based on educational theory, adult learning principles, and research findings to influence patient outcomes.7) CE programs should aim to maximize clinical skills by incorporating practical content.8) Such programs can maintain clinicians’ hunger for knowledge and help them to learn on their own.
Participants should be able to learn from an interactive course curriculum that acts within the context of evidence-based and patient-centered practice.9) The utilization of digital learning environments and hybrid learning alternatives constitute a novel and possibly useful technique to integrate situated learning closer to the point of practice when combined with appropriate face-to-face interactions.
An experienced mentor who facilitates learning can offer direction, support, and fresh learning opportunities. The resultant questioning, discussion, and critical feedback will enable the participant to recognize their assimilation of concealed knowledge.10) Clinicians will be able to review new literature much more effectively thanks to improved criticality toward practice knowledge and research. This allows participants to shift from uncritical acceptance to critical evaluation and application of propositional knowledge, leading to overt metacognition.11) The acquisition of metacognitive abilities during the learning process enables the use of competences in a variety of contexts and aids in knowledge retention over time. The results will be further enhanced if at least 25% of knowledge learned is used in an active learning intervention.12)
Problem-based learning and individualized learning opportunities are examples of learner-centered approaches. In problem-based learning, learners identify issues raised by specific problems to help develop an understanding of underlying concepts and principles. In this “problem first learning” approach, new knowledge and understanding are discovered through working on the problem. Individualized learning gives students a structured environment to specify their long-term professional goals, self-evaluate areas of strength and weakness, and design plans and strategies to attain the defined goals. By tracking their progress, students can revise their goals and plans in light of self-evaluation. Furthermore, decontextualizing conceptual information is crucial for enabling its use in novel contexts by giving learners a variety of scenarios in which to apply concepts. A competency that is transferable across environments will be developed as a result of this interaction between personal and contextual factors.
The process adopted by the Stony Brook University School of Medicine to implement personalized learning plans for fourth-year medical students is an example of how such programs can be created and used to support self-directed learning.13) Participants in this course were invited to individually identify their learning objectives using the SMART (specific, measurable, attainable, realistic, and timely) criteria and the core competencies of the Accreditation Council for Graduate Medical Education. Each student was placed under the supervision of an experienced mentor and given a self-study module that included reading material on learning-plan construction and a template. Throughout the program, students met with mentors on a regular basis to review their progress and accomplishments with reference to their goals. The program required students to produce a reflective essay about their time in the course and the process of developing their own learning objectives.
Some professional governing bodies expect that CE for members should be based on ongoing self-evaluation.14) When clinicians self-evaluate their educational needs, the following aspects of their employment are likely to dictate their choices: the obligation to comply with and maintain knowledge of state requirements, mandatory knowledge and abilities required by the place of employment, obligations that prepare clinicians for advanced positions, and personal strengths, weaknesses, and interests. However, self-directed CE may encourage people to remain in their “comfort zone.”15) When governing bodies provide a list of approved courses for license renewal, they are obliged to monitor the quality of these courses to ensure the teaching strategies are appropriate for the learning outcomes. Ethically, they must also ensure that the standards of professional competence and care are appropriate and that evidence-based content is presented in an approachable, impartial, and representative manner in a non-profit setting.16)
Employers should establish a system for routine evaluation of employee needs based on clinical audit evaluations and employee performance assessments in relation to the institution’s mission and objectives. RPs should be able to enroll in evidence-based courses that allow them the freedom to challenge the quality of the data supporting the concepts and methods, while being able accept responsibility for the results. There must also be a mechanism by which RPs can monitor and report CPD activities. Practitioners need to be mindful of the “fast fix” promises made by programs that rely solely on clinical dogma.17) Professional consensus should always be used to establish the knowledge and skills required for particular fields of practice, regardless of context or practical application in the workplace. In addition, environmental scanning of CEs is necessary to look beyond immediate demands and to identify what is significant for the profession and for society.
The author declares no conflict of interest.
