Association of Medical School Pediatric Department Chairs Principles of Lifelong Learning in Pediatric Medicine

Abstract

cademic pediatric departments have significant responsibility in the training of learners through medical school, residency, and fellowship and in the maintained competence of their faculty for the provision of care to significant populations of children. At all levels, departments must foster a commitment to the development of new knowledge that will improve child health. These responsibilities require that department leadership develop mission-based content expertise, administrative infrastructure, and collaborative working relationships with medical schools, hospitals, and external accrediting entities. To be successful, departments need to create and develop a learning community that includes effective strategies for ongoing individual and system improvements to ensure continual cognitive learning, competency, quality, and effectiveness of the educational, clinical, and research environments. In this article, we summarize work by the Association of Medical School Pediatric Department Chairs (AMSPDC) to develop and endorse a set of principles of lifelong learning and the results of a member survey designed to determine the strategies used by pediatric chairs to assess lifelong learning competencies across missions.The recognition that lifelong learning is an important principle in medical and residency training and clinical practice has been emphasized for many years in pediatrics. As an example, a Federation of Pediatric Organizations report explicitly highlighted the reality and expectation that the body of medical knowledge and discovery was "constantly expanding and clinicians must accept the challenge of lifelong learning" across the practicing continuum. 1 The Federation of Pediatric Organizations report identified the importance of learning styles, filling gaps in knowledge, and providing various continuing medical education (CME) approaches and measures of the effect of CME on physician competence and performance. In 2000, the American Board of Medical Subspecialties (ABMS) joined the Accreditation Council for Graduate Medical Education (ACGME) in the development and adoption of 6 core competencies. Not long after, the competencies were incorporated into a new maintenance of certification (MOC) process launched by the American Board of Pediatrics (ABP) in 2003. This effort sought to assess a pediatrician or subspecialist's competence through processes that required and assessed evidence of continuous quality improvement over one's practice career. In 2007, Kind et al 2 detailed the planned Pediatric general and subspecialty care requires continuous effort to maintain knowledge and competencies in clinical practice. Equally important are efforts by investigators and educators to maintain knowledge and competencies in the conduct of research and training. The Association of Medical School Pediatric Department Chairs initiated a survey in July 2015 to define principles of lifelong learning in pediatric medicine and determine the approaches and strategies used by chairs to assess knowledge and competence a...

A Survey of Perceived Effectiveness of Part 4 Maintenance of Certification

“…A number of physician surveys report dissatisfaction with MOC, often citing concerns about relevance and cost. 3,[19][20][21] This discontent has led toward a movement among many state legislatures to ban the use of MOC as a criterion for hospital credentialing. This threatens the ability of physicians, hospitals, and governing bodies to demonstrate a commitment to up-to-date and quality care for patients and families.…”

“…This may have also influenced the relatively higher baseline positive attitude, compared with previous MOC surveys. 3,[19][20][21] Other programs may differ in project design, participation criteria, organizational leadership, and participant support, which could influence the educational effectiveness of their projects. It will be important to further study the performance of this survey by analyzing data collected in other settings and with other groups of physicians, particularly those in communitybased practice or with fewer QI resources.…”

Maintenance of Certification and the Challenge of Professionalism

“…58 The examples in Tables 1 and 2 show that many physicians have successfully embraced the challenges of 21st century professionalism and demonstrably improved care in the context of MOC, yet a number of physician surveys have registered dissatisfaction with MOC across all specialties. 2,3,59,60 Specific concerns have included the perceived burden, relevance, cost, and complexity of the MOC program. At the same time, hospitals have increased their reliance on MOC as a criterion for privileging.…”

To Maintain Pediatric Competence, Walk With Our Patients and Families

“…3 Last year, the Association of Medical School Pediatric Department Chairs (AMSPDC) surveyed its members to determine how they, as representatives of the academic leadership of the pediatric community, feel about this change. 4 The survey was conducted at a time of controversy, during which the American Board of Internal Medicine had suspended its MOC program and physicians in many other subspecialties, including pediatrics, were calling on their subspecialty boards to do the same. 5 The results are not surprising; the survey respondents affirmed the desire among pediatric chairs to hold our profession to high standards, achieving a high degree of consensus on 6 principles of lifelong learning, many of which focus on quality of care.…”

“…However, the chairs did not endorse a statement that the certification process was an appropriate vehicle for assessing an individual professional's commitment to lifelong learning and continuous quality improvement. They felt that "existing formal evaluation practices" 4 were more useful in determining an individual's commitment and progress in these important areas. In particular, they felt the methods currently used by the ABP to assess a pediatrician's clinical performance lacked sufficient evidence to be useful.…”