Honing My Leadership Skills

In recent years as a medical writer specializing in continuing education I have mostly worked alone. In anticipation of being asked to lead a small group of co-workers in carrying out a formal research study, I am reviewing basic principles of leadership, beginning with what I learned as a Boy Scout.

 

The colorful graphic above, called a learning map, was created using an online   application called GoConqr in the style made famous by Tony Buzan, as described in more detail here. The graphic was completed as a homework assignment for EDT 500, an introductory course in educational technology at West Chester University in West Chester, Pennsylvania. The content shown here is adapted from a pamphlet written for novice patrol leaders and published online by the Boy Scouts of America.


 

New Concept: CME Shark Tank

At a breakout session during the recent annual meeting of the Alliance for Continuing Education in the Health Professions in Orlando, Florida, the idea of a Shark Tank-like format for an educational workshop was proposed. Here is a simple concept sketch of how the program might be set up, modeled after the popular reality show on ABC-TV. This sketch was done using a free online concept mapping application available at: https://bubbl.us/

Concept for a Shark Tank-like CME program.

Designing Workplace Learning Interventions

So there's this learning and development consultant named Clive Shepherd. He has a blog on Blogger called Clive On Learning, where he writes about various applications of media and technology to learning at work. Way back in late 2013 Mr. Shepherd wrote a series of posts about designing workplace learning interventions. One post in particular was about something called PIAF, which stands for preparation, input, application, and follow-up. Apparently if you follow this model you'll get better results. Here is what each of the letters stands for:

• Preparation: Helping the learner to prepare for a productive learning experience.
  
• Input: Providing the formal element which hopefully will inspire the learner and act as a catalyst for changes in behavior and on-going skills development.
  
• Application: Providing opportunities for the learner to test out new ideas and skills in the work environment.
  
• Follow-up: Helping the learner to continue the learning journey using on-demand content, coaching and support from peers.

Calling All CME Writers

 

Graphic Courtesy of AMWA Journal

Two Delaware Valley medical writers are conducting an online survey. Andrew Bowser and Don Harting would like your insights on writing CME needs assessments. The fourth annual survey on best practices closes October 6. Our survey changes yearly. While some questions are repeated to track trends, other questions probe new issues such as interprofessional education, storytelling techniques, and updating reference lists.

If you have written at least several CME needs assessments, please consider investing about 15 minutes to complete all 10 questions. We will provide the raw results to all respondents by Thanksgiving and disseminate the analyzed results during 2018.

Bonus: 10 lucky respondents will win a free book of nature essays, including one essay that won first prize in the Soul-Making Keats Literary Competition sponsored by the National League of American Pen Women. The author happens to be a nurse who writes needs assessments for a leading CME company in Connecticut.

The survey URL is https://goo.gl/4hiJtC

Graphic courtesy of the American Medical Writers Association

This November I will be co-presenting a workshop titled Writing and Editing CME Needs Assessments during the annual meeting of the American Medical Writers Association. We will start by reviewing the latest results of our survey research on best practices and quality indicators, then break up into small groups for a hands-on editing activity. For a copy of the "recipes" we will be following during the breakout session, send me an email: don (at) hartingcom.com.

Poster Summarizes Results from 3rd Annual Survey

This poster (shown above, less than full size) summarizes selected results from our 3rd annual survey of best practices writing CME needs assessments. The full-sized poster (56 inches by 36 inches) was displayed Thursday, November 17 during the annual meeting of the Mid-Atlantic Alliance for CME (MAACME) which took place at the Lehigh Valley Hospital in Allentown, Pennsylvania. We thank MAACME for this opportunity to disseminate these research data.

To view and download a PDF of the full-size poster, visit this link.

Previous Years' Survey Results Now Published

Image courtesy American Medical Writers Association

Results of the just-ended third annual survey of best practices for writing CME needs assessments won't be published until next year. [Exception: people who took the survey will have the raw results emailed to them by Thanksgiving.] BUT . . .  if you're interested in what we found out in the surveys conducted in 2014 and 2015, you're in luck. The American Medical Writers Association (AMWA) last month published a summary of the first two years' worth of survey results. The 4-page AMWA Journal article is posted in the open-access portion of the AMWA website, so you don't have to be a member to read it.

Here's the link to our article. (Scroll to page 128.)

The screenshot below shows you the headline.

Enjoy!

Our Third Annual Survey Has Closed

Image courtesy American Medical Writers Association

Our third annual survey of best practices closed on October 9. Thanks to 118 respondents nationwide, we have received helpful new information about key quality indicators, market conditions, and pricing. A big THANK YOU to all who answered the questionnaire. Everyone who completed the survey and provided an email address will receive the raw results by Thanksgiving. For more info follow Don Harting on this blog, on LinkedIn, or on Twitter (@CME_Scout).

Award-Winning Poster

This poster won the "People's Choice" award during the annual meeting of the Alliance for Continuing Education in the Health Professions in January, 2016. The original poster measured 56 inches across the top. To receive a PDF of the original, send an email to don (at) hartingcom.com. A text report is also available upon request.

What's All This Buzz About SQUIRE?

Medical writers and editors active in the accredited CME space may be interested to learn a bit more about SQUIRE, a new standard outcomes reporting format used by a growing number of peer-reviewed journals. SQUIRE stands for Standards for Quality Improvement Reporting Excellence and was pioneered a few years ago by the British Medical Journal, better know as the BMJ. A special version of SQUIRE has been developed for use by members of the Alliance for Continuing Education in the Health Professions. A conference call aimed at recruiting grant support for wider user of the "ACEhp SQUIRE tool" was held this afternoon, and I was fortunate enough to be invited.

Here's a link via DropBox to a very brief (7 slides) presentation based on our call, pared way back to focus on elements of interest to my fellow medical writers active in the accredited CME space.

Isn't it cool how SQUIRE originated with an effort to promote EXCELLENT WRITING???

By the way, the photo above comes from a brochure promoting a writer's conference to be held next month at Dartmouth College in New Hampshire. Sounds like fun, sure wish I could go.

Wanted: A Deep Dive into CME Needs Assessment

The CME Cycle

The American Medical Writers Association just asked for my input on a survey aimed at helping our organization develop a plan for serving members in the future. I filled it out and added this when asked for additional suggestions on educational topics:


"A deep dive into the CME needs assessment as a special type of document: what it is, why it is so important, how to write one, sources of evidence, how to present the evidence, how to reference and attribute your sources, how to get hired to write NAs, what the NA of the future will look like, how much to charge, how much lead time to insist upon, how to include the patient perspective, how PI-CME and QI-CME are affecting how we write needs assessments, and how to overcome the most common barriers encountered while writing needs assessments, including the appearance of commercial bias."

2nd Annual Survey of Best Practices in CME Needs Assessment

The CME Needs Assessment Cycle

We had such good results last fall we are coming back for more. This year's survey contains 5 totally new questions and 5 repeat questions. We also have a new co-investigator: Nathalie Turner, MS, ELS. Survey closes Oct. 9; the first 100 people who respond will receive the raw results by Thanksgiving. Here's your chance to keep abreast of this fast-changing field, and contribute to our profession at the same time.

Another Reality Check: Good Charting Vs. Good Care

This article by Greene and Moreo is one of my favorites because the journal is top-tier and the writing style is so clear and pragmatic. For example, in the "Lessons and Limitations" section, the authors note that some of the physicians involved in the chart audit pointed out that just because a patient's chart is not up to date doesn't mean that the patient is receiving poor quality care. Again, the sample size is rather small (N=30 gastroenterologists) but the choice of quality measures seems unassailable because they align with both the National Quality Strategy as well as the Physician Quality Reporting System.

Here's a Published Example of a Failed Intervention

I love how this article from Canada by Shah et al  doesn't mince words: "The cardiovascular disease management toolkit failed to reduce clinical events or improve quality of care for patients with diabetes." I also love how the article includes a plain and simple "Editors' Summary" near the top, the style of which will be familiar to anyone who has used the Standards for Quality Improvement Reporting Excellence (SQUIRE). Funding for this large-scale intervention came from the Canadian government, and the poor outcomes highlight how we need to do more -- much more -- than just mail boxes of brightly colored printed materials to family physicians if we want to improve the quality of diabetes care.

EHRs Frustrate British Docs, Too

This outcome report by Michael and Patel from a hospital in England is a favorite because it sheds light on how physicians on the other side of the Atlantic are trying to cope with 2 problems often encountered in the United States: docs' frustration with electronic health records (EHR) and poor weekend safety for hospital patients. While measurable improvement using EHR was noted, even after the training ended, nearly half of physicians surveyed said they found using the computer too time consuming.

Another Scalp on This Lead Author's Belt

This article by S. Stowell, et al. is an easy read, no doubt in part because the lead author has been involved in writing so many CME outcomes reports in recent years. It's also shorter than many other articles, and it deals with an unusual topic: shared medical visits, where a single physician cares for more than one diabetes patient at a time. A nice feature of the intervention is how a control group was included -- you don't see that very often. Outcomes showed significant increases in several important areas, even after 30 days of followup.

They Even Published the Meeting Agenda

This article from 2014 remains a favorite for a number of reasons. First off the lead author, Wendy Nickel, works next door at the American College of Physicians in Philadelphia. Next, the full text is available on a fancy new Elsevier open access platform. It's a train-the-trainer type project, aimed at building self-confidence among leaders of quality improvement projects by giving them some easy practice. The specific intervention involved preventing infections from catheters. I'm no clinician, but that sounds like a simple way to get started. Colorful graphics make the article easy to read. Here's the cherry on top: Elsevier's editors saw fit to publish the live meeting agenda, complete with learning objectives, continental breakfast, lunch, and 2 breaks (!) 

When CME Becomes Foreign Aid, and Vice Versa

The project reported in this article by J. Lowe, et al. comes from the country of Guyana on the continent of South America. While technically this is a continuing medical education intervention, it also an example of foreign aid, as the project was funded by the Canadian government. I like how the intervention was based on a firm understanding of adult learning principles, and how it involved an interprofessional team of key opinion leaders. Best of all: reported outcomes are strong. A total of 340 Guyanese health professionals were trained to improve care for diabetics, and a significant reduction in the number of foot amputations was observed.

When No Change is Good News

This article from London tears at my heart strings. P. Lachman, et al. based their intervention in a small inpatient ward of a children's hospital and aimed to determine ways that both children and parents could more effectively report any harm being done to them by hospital employees. The overall goal was to measure nurses' perceptions of any change in the ward's safety culture over the course of a year. Investigators tested 10 different versions of a reporting tool. (Not surprisingly the kids liked the version with the most pictures.) The bad news is also the good news: safety climate scores were already high, and no significant change was observed during the study period.

A Report on 50 Reports

This study from Italy is interesting for how it is designed as a meta-analysis of performance improvement (PI) initiatives aimed at increasing compliance with clinical guidelines regarding management of sepsis. It's a bit long, with many data tables, but the upshot appears to be that implementation of PI programs increases guideline compliance and decreases mortality in patients with sepsis. Clearly the Italian definition of "performance improvement" differs from the American definition, as the authors based their meta-analysis on 50 studies (!)