An Innovative Approach to Remedial Continuing Medical Education, 1992???2002

Abstract

The authors describe the process of remedial retraining programs organized and planned for Quebec physicians by the College des medecins du Quebec (CMQ) and report the outcomes of these efforts from April 1992 to March 2002. The CMQ (the Quebec medical licensing authority) developed a process to identify physicians who had shortcomings in their clinical performance, determine their educational needs, propose, in collaboration with the four medical schools in the province, personalized retraining programs (clinical training programs, tutorials, focused readings, workshops, and refresher courses), and subsequently evaluate the impact of these retraining programs. During the ten-year period reported, 305 physicians (216 family physicians and 89 specialists) were referred to the Practice Enhancement Division of the CMQ for personalized remedial retraining. The vast majority of these physicians were men (81%). The following difficulties were identified: therapeutic knowledge (37%), diagnostic knowledge (32%), record-keeping (14%), technical skills (10%), clinical judgment (5%), and communication skills (2%). A total of 329 personalized retraining programs were completed: 273 clinical training programs, 41 tutorials, and 15 focused readings. A reevaluation of all these physicians showed that 70% of the retraining programs had succeeded, 15% were partially successful and only 13% had failed. The remaining 2% involved missing data or withdrawal of physicians. The authors conclude that the collaborative CME process described has important and effective original features.

Getting back on track: a systematic review of the outcomes of remediation and rehabilitation programmes for healthcare professionals with performance concerns

“…For five physicians that did not improve themselves at reassessment, Hanna et al 40 found that an intensive remedial continuous medical education programme resulted in improvement for one physician, whereas another remained the same and three deteriorated. Two studies concerned Quebec Medical College (CMQ), and Goulet et al 41 found that of individualised retraining activities, 70% led to attainment of the training objectives, whereas 15% led to partly attained objectives. Of poorly performing physicians that completed a remedial professional development programme, 30%–40% succeeded in improving their performance for record keeping, clinical investigation, diagnostic accuracy and treatment and follow-up 42.…”

Knowledge and Attitude of General Practitioners Regarding Autism in Karachi, Pakistan

“…Furthermore, among the GPs who reported knowledge about autism, only 12.8% reported symposia or seminars as their source of knowledge about autism. Professional isolation of older GPs might be a contributing factor to their lack of knowledge of autism as they may be cut off from the teaching environment and may not have comparable opportunities to consult with their colleagues (Goulet et al 2005). Countries like Canada and the UK have mandatory continuing medical education (CME) programs with competency assurance systems aimed at ensuring high quality and acceptable performance in practice to provide lifelong learning for physicians (Duffy and Holmboe 2006;Rauf and Saeed 2007).…”

Toward Meeting the Challenge of Physician Competence Assessment: The University of California, San Diego Physician Assessment and Clinical Education (PACE) Program

“…Active programs for physician assessment started in the mid-1980s in the Canadian provinces of Manitoba, 24 Ontario, 24 -27 and Quebec, 24,28 and almost all of the Canadian provinces have them now. Successful physician assessment programs are also currently conducted in Australia, 29 New Zealand, 29,30 and the United Kingdom.…”