SACME 2024 Annual Meeting Posters

1. Doctors as Leaders: Implementing a Pilot Cohort-based Leadership Program for Early to Mid-career Physicians

Author

• Ruth Adewuya, MD, CHCP, MEHP Fellow, Managing Director, Center for Continuing Medical Education, Stanford University School of Medicine

 Purpose/problem statement
Rotenstein et al. (2018) stated that “unlike any other occupation where management skills are important, physicians are neither taught how to lead nor are they typically rewarded for good leadership. Even though medical institutions have designated “leadership” as a core medical competency, leadership skills are rarely taught and reinforced across the continuum of medical training.” Evidence suggests that leadership quality affects patients, clinical outcomes, physician well-being, and job satisfaction. Flaig et al. (2020) examined how formal leadership development programs positively influenced individual competencies and organizational outcomes. Their results showed that participants gained management knowledge, increased their confidence and communication skills, and increased job satisfaction.

Methods/Approach(es)
Stanford CME deployed an online needs assessment to practicing physicians in our database. We had 160 respondents: 50% from academic medical centers, 23% from community practice, and 13% from private practice. 89% of respondents were practicing physicians with equal gender spread. Respondents could opt-in to participate in a focus group with the program’s leadership. 60% of respondents have or were in an administrative leadership role, but more than half (57%) had not participated in a formal program. Those who had completed a formal leadership training program, identified gaps such as “lack of training in time management,” “running efficient meetings,” and “specific training on how to manage people,” etc. We designed a 6-month curriculum utilizing synchronous and asynchronous sessions, group coaching sessions, 1:1 coaching sessions, and a capstone project. The curriculum was designed to lead participants through a learning journey, beginning with the self, the team, and the organization. Course materials were developed internally and featured e-learning modules, animations, discussion boards, etc.

Findings
The program launched in January 2022 with 41 participants. Participants evaluated the course’s impact and quality using a post-course survey. 32 participants (78%) completed the survey. 89% of respondents indicated that the program covered content useful to their practice, and 93% indicated that it contributed to their professional growth and was relevant to their current scope of practice. 82% of respondents indicated that the combination of live sessions and asynchronous modules worked well for them. 93% agreed that the program cadence related to frequency and time between sessions worked well for them. 100% of survey respondents indicated that they had applied one or more of the skills they learned in the program to their practice as a leader.

Discussion
The evaluations suggest that the SPLC achieved our stated goals of building the leadership capacity among aspiring, early-mid-career physicians. The experience and results have implications for improving patient safety and healthcare quality. Our work suggests that the SPLC may help participants develop the six core competencies identified by the AMA for leaders in medicine: professionalism, self-management, team management, influence and communication, systems-based practice, and executing toward a vision.

Barriers/facilitations
Impact/relevance to the advancement of the field of CME/CPD
Physician leaders with specialized leadership training are better equipped to design and develop more effective CME/CPD programs. Leadership and communication skills can be applied to designing and delivering CME/CPD innovatively, including implementing quality improvement measures in CME/CPD programs by applying leadership and management principles.

2. Empathy, Equity, and Ultrasound: Enhancing CPD through Point-of-Care Training in Resource Limited and Conflict-Affected Regions

Author(s)

• Shawna Novak, MD, MA, MMSc-GHD, Executive Director, The Canada-International Scientific Exchange Program (CISEPO) and Harvard Medical School
• Muhummed Nadeem Kasmani, MD, MMSc-GHD, Lecturer, Harvard Medical School
• Bram P. Wispelwey, MD, MS, MPH, Instructor in Medicine, Brigham and Women’s Hospital, Harvard Medical School

Purpose/problem statement
As the push for equitable global health advances, the traditional silos of healthcare delivery are being reimagined. Task sharing is not just a logistical pivot but a profound commitment to democratizing healthcare, notably in regions marred by conflict and systemic inequities (Raviola et al., 2019)(Anand et al., 2019)(Joshi & Peiris, 2019)(Rimawi et al., 2022). Despite the transformative potential of task sharing in women’s health, a significant oversight persists: the marginalization of community health workers (CHWs) from technical skillsets. At the community level, there is an established imperative for iterative learning and capacity building (Byungura et al., 2022; Merry et al., 2023; Simkhada et al., 2023) to ensure healthcare remains agile, context-specific, and culturally resonant.

Methods/Approach(es)
A hybrid Continuing Professional Development (CPD) program was conceptualized and implemented. This initiative sought to capacitate community health workers (CHWs) and midwives, who are integral pillars of the local health ecosystem, with skills in point-of-care ultrasound (POCUS) using the Obstetric Volume Sweep Imaging Protocol (ObVSI). Over a span of three months, a cohort of 20 participants, equally divided between CHWs and midwives, followed an adaptive curriculum. This encompassed a combination of virtual didactics, in-person instructional sessions, hands-on practical training, longitudinal mentorship, and active engagement in a community of practice. The program aspired to cultivate a profound sense of community responsibility and empowerment among the participants, beyond technical acumen

Findings
All members of the learner cohort met or exceeded the target performance metrics for technical and interpersonal competencies. Evaluations from observed structured clinical exams (OSCE) conducted one month post-training confirmed that each learner either maintained or enhanced their skill levels. Feedback highlighted the essential role of tailoring CPD best practices to the local setting, particularly emphasizing linguistic accessibility and incorporating community-centric elements.

Discussion
The observed performance within the learner cohort accentuates the paramount importance of Continuing Professional Development (CPD) initiatives that are not only contextually and culturally attuned but also intrinsically motivating. The tangible benefits of integrating community-centric values and positive social reinforcements into training reveal a promising frontier for CPD; one that transcends conventional didactic approaches to embrace methodologies rooted in empathy, mutual respect, and equity. As global health seeks to address systemic disparities, especially in regions challenged by conflicts and inequities, evolving our CPD frameworks to be both globally informed and locally resonant becomes crucial. This approach ensures that healthcare remains agile, adaptable, and most importantly, centered on those it aims to serve.

Barriers/facilitations
Barriers: 1. Infrastructure Constraints 2. Geopolitical Tensions. 3. Cultural and Linguistic Diversity 4. Initial Resistance 5. Resource Limitations Facilitators: 1. Community-Centric Approach 2. Blended Delivery Model 3. Peer Support and Shared Learning 4. Feedback Mechanisms 5. External Collaborations:

Impact/relevance to the advancement of the field of CME/CPD
This initiative underscores the intrinsic synergy between global CPD best practices and contextualized local knowledge. By seamlessly integrating cutting-edge technology with community-centric care and collective learning, this work not only positions itself as a potential exemplar within the CPD sector but also advances the clarion call for a CPD paradigm that advocates for disruption, innovation, and the re-envisioning of a just and equitable global health framework

3. The Interdisciplinary MAP of Mentorship: A Circular Model to Integrate Junior Faculty within Health Professions Education

Author(s)

• Sarah Harendt, MS, Manager, Education and Professional Development, Carilion Clinic/ Virginia Tech Carilion School of Medicine
• Mariah Rudd, MEd, Director, Office of Continuing Professional Development
• Virginia Tech Carilion School of Medicine/Carilion Clinic
• Shari Whicker, EdD, MEd, Senior Director, Office of Continuing Professional Development & Assistant Dean, Faculty Development, Carilion Clinic/ VTCSOM
• David Musick, PhD, Senior Dean, Faculty Affairs, Virginia Tech Carilion School of Medicine
• Avery Mahaney, MHA, Faculty Affairs Manager, Virginia Tech Carilion School of Medicine

Purpose/problem statement
Scholarly literature highlights numerous benefits of mentorship with emphasis on improved engagement, job satisfaction, academic promotion, leadership preparation, skill development, career advancement, and retention. Mentoring, when utilized as a mechanism to support early faculty development, can be a powerful tool for supporting diversity and retention of faculty across an organization while supporting career advancement and fostering belonging and well-being.

Methods/Approach(es)
The TEACH Mentoring Advancement Program (T-MAP) consists of mentoring circles comprised of two senior faculty mentors from separate clinical or non-clinical departments who are paired with two or more junior faculty mentees from those same departments. Circles incorporate a peer mentoring model across departments in addition to the mentor/mentee model. This approach supports a more holistic context for mentoring where individuals can engage with, and learn from, individuals outside their primary department but within the greater healthcare system. Over the course of a year, T-MAP mentees and mentors participate via three engagement formats: In-person Quarterly Sessions, monthly Circle Meetings, and Quarterly Learning Modules. Engagement formats incorporate hybrid, virtual, and in-person opportunities and address needs identified through a needs assessment as most salient to mentees at this juncture in their career trajectories.

Findings
Preliminary feedback illustrates at the midpoint of year one that both mentors and mentees capitalize on the variety of engagement formats offered in ways that foster work/life integration, provide flexibility in scheduling, and allow participants to tailor content to their specific professional needs. Participants also report that content provided via quarterly in-person sessions and curated learning module offerings increases content knowledge, supports skill-set development, and increases individual interest in the areas of equity/inclusion, leadership, teaching skills, and well-being. Mentees describe having an increased understanding of navigating the promotions process at the institution, which supports career advancement. Both mentees and mentors indicate that mentoring circles have created a space for cross-departmental research and scholarship engagement. Post-programmatic data will be collected in early Fall 2023 and will be available for reporting at the end of 2023.

Discussion
T-MAP has allowed for increased engagement and networking and has aligned with individualized participant learning needs by leveraging technology and creating flexible participation modalities. T-MAP has also facilitated deconstructing departmental silos that can hinder scholarly research, clinical collaborations, and inhibit sense of belonging among faculty.

Barriers/facilitations
There are barriers to creating, implementing, and evaluating a mentorship program such as T-MAP. Given the constraints on faculty (clinical and non-clinical) time, creating a program that demonstrates it is a value-add to participants, and of benefit to the organization, can be challenging. Implementation requires staff with dedicated time and available budget to cover costs related to programmatic implementation. Additionally, creating a sound plan for program evaluation requires forethought and intentionality.

Impact/relevance to the advancement of the field of CME/CPD
T-MAP successfully facilitates cross-departmental collaborations, enhances content knowledge, creates understanding of the promotion and tenure process, and augments individual needs for system navigation and career advancement. By breaking down departmental silos and providing a space for interdisciplinary research and scholarship, T-MAP also serves as a catalyst for enriching faculty experiences and fostering a sense of belonging.

4. Overcoming Barriers to Effective Treatment and Enrollment in Clinical Trials for Black and Underserved Patients with Multiple Myeloma – Incorporating the Patient Voice through Focus Groups

Author(s)

• Natalie Sanfratello, MPH, CHCP, Senior Program Manager – Quality Improvement, Educational Programs, and Contracts, Boston University Chobanian & Avedisian School of Medicine, CCE
• Julie White, MS, FSACME, CE Director, Boston University Chobanian & Avedisian School of Medicine, CCE
• Michael J. Burk, BS, Senior Program Operations Manager, Projects, Boston University Chobanian & Avedisian School of Medicine, CCE
• Raphael Szalat, MD, PhD, Assistant Professor, Hematology & Oncology, Boston University Chobanian & Avedisian School of Medicine
• Frances Arters, MD, Assistant Professor, Medicine, Boston University Chobanian & Avedisian School of Medicine

Background/purpose/inquiry question
Boston University Chobanian & Avedisian School of Medicine and the Multiple Myeloma Program at Boston Medical Center (a safety net hospital) conducted patient focus groups to gain a greater understanding of health issues faced by patients with MM, how those needs are currently being addressed, and where there are opportunities to better address needs in the future. A second key objective was to gain insights into why or why not MM patients might want to try different treatments or be a part of a clinical study.

Theoretical framework(s)
The results of the qualitative analysis informed the creation of two accredited CE enduring activities. The first program included videos of two actors portraying the experiences of those who participated in the focus groups and the second activity was an interprofessional clinician panel discussion delving deeper into the results of the focus groups and sharing best practices.

Methods
Patients with Multiple Myeloma who receive care at Boston Medical Center identifying as Black and their caregivers were recruited to participate in focus groups. In January 2023, four focus groups were held with those who agreed to participate (12 participants total – 11 patients and 1 caregiver). A qualitative analysis of the findings was completed by Datagain.

Results/findings
Patient-reported suggestions to promote greater participation in clinical trials: Communication with a trusted medical professional Talk about the benefits and drawbacks to them and their families Address concerns Address cultural and health system barriers Patient-reported facilitators of trust in the care team: Being treated with kindness Being treated like family Being treated with respect, free of discrimination Creating a cheery, positive atmosphere Professionalism and expertise Providing contact information and permission to “call anytime” Keeping the patient up to date with information Educating on side effects, medication, what to expect from the disease and the various treatments

Discussion
MM disparities in care exist along racial lines due, in part, to differences in biology, socioeconomic status, and healthcare access. Higher representation of Blacks in clinical trials is needed because the medications studied may affect them differently. A team-based approach to improving care is vital.

Limitations
Participation in the focus groups was voluntary, so only the opinions and experiences of patients willing to participate in this research study were included. Focus groups were only conducted in English although we tried unsuccessfully to recruit patients who were non-English speakers.

Impact/relevance to the advancement of the field of CME/CPD
Utilizing patient focus groups to inform accredited CE can create a more robust educational program and provide invaluable insight into the patient experience.

5. Let’s Do it Together: Integrating a Clinical Education Librarian into the Continuing Professional Development (CPD) Team to Support Identification of Practice Gaps

Author(s)

• Michelle Lieggi, MLS, Clinical Education Librarian, Dignity Health
• Lindsey Gillespie, MLIS, Medical Librarian, Dignity Health
• Monica Bourke, MSN, RN, Director, Continuing Professional Education, Dignity Health

Purpose/problem statement
Medical librarians conduct expert literature searches on topics relevant to the interprofessional healthcare team. Data from searches can provide insight into practice gaps, but it is rarely used to plan and develop CPD activities. Medical librarians typically support CPD by locating references for best evidence, cultural and linguistic competency and/or implicit bias. Although some medical librarians participate in coordination and planning, they are not typically integrated into a CPD team. Integrating a librarian into a CPD team who participates in planning and in practice gap identification is a novel practice in aligning education to clinician and organizational needs.

Approach(es)
In 2022, our division CPD program began supporting 5 additional hospitals due to organizational restructuring. With increased demand for educational activities, the CPD team needed more support from the division’s medical librarian. However the librarian could not accommodate the additional requests. With backing from division leadership, the CPD director got approval for an additional staff person, the clinical education librarian (CEL). The CEL conducts literature searches for the team and also participates in the planning of CPD activities.

Findings
Once the role began, the CPD team discovered the CEL had data from librarian-led literature searches conducted for clinicians across the division. The CEL proposed analyzing the data retrospectively to see how topics correlated with subsequent CPD activities. In partnership with the division’s medical librarian, the CEL reported the retrospective data, and began reporting on current data semi-annually. The CEL also began to regularly monitor incoming literature searches to determine urgent needs. The data thus far demonstrates some correlation between search topics and actual CPD activities.

Discussion
Librarian-led search data was primarily collected to assess search volume, not to identify practice gaps. The CEL and the division’s medical librarian are now examining processes to intentionally collect data that could be tied to practice gaps and/or education needs. The CEL is also examining other means of identifying practice gaps, in particular conducting proactive searches of the literature to determine emerging topics where education may be needed. With a more proactive approach, it is hoped that more practice gaps can be identified and developed into education that supports clinician and organizational needs.

Barriers/facilitations
Collecting data from librarian-led literature searches has been challenging given it was previously collected for a purpose unrelated to CPD. The CEL and the division’s medical librarian are examining how to streamline data collection via online forms and how to systematically identify topics where education may be urgently needed. They are also partnering with a CPD team analyst to provide more thorough and robust analysis of the data.

Impact/relevance to the advancement of the field of CME/CPD
The CPD team can now better identify practice gaps based on real-time insight provided by the CEL. Since the CPD team does not have the resources to support every activity proposed, the CEL’s regular monitoring of literature searches along with a systematic means of capturing urgent topic needs can help prioritize requests for education. The integration of a CEL into the CPD team is another tool in better aligning education with identified practice gaps and organizational needs.55. Forging a Greener Tomorrow via Sustainable CME/CPD Meetings

Author

• Kurt Snyder, JD, MBA IT, Executive Director, Stanford University

Purpose/problem statement
With the growing urgency of addressing environmental challenges, the need to embrace sustainability extends beyond individual habits to encompass professional realms. This poster aims to equip CME/CPD professionals with a comprehensive toolkit of best practices and resources, enabling them to infuse sustainability into their activities.

Approach(es)
The poster synthesizes an array of innovative strategies and actionable insights, collating practical guidance for integrating sustainability within the realm of Continuing Medical Education (CME) and Continuing Professional Development (CPD). It draws from diverse sources and real-world cases to offer a multifaceted perspective on sustainable practices.

Findings
The poster highlights the tangible benefits of sustainable integration, ranging from reduced environmental impact to enhanced participant engagement. It outlines approaches such as digital adoption, eco-friendly materials, and responsible event management, showcasing how these strategies can synergize educational goals with ecological responsibility.

Discussion
Through this comprehensive overview, CME/CPD professionals are empowered to navigate the sustainable landscape confidently. By making informed choices and embracing innovative solutions, they can catalyze positive change within their professional domains and contribute meaningfully to broader sustainability efforts.

Barriers/facilitations
While challenges like initial adaptation and resource allocation may arise, the poster underscores the growing alignment between sustainability and professional success. It underscores facilitators like technological advancements and changing societal attitudes, which can help mitigate barriers and foster a seamless transition.

Impact/relevance to the advancement of the field of CME/CPD
Amid an era where sustainability surpasses mere buzzwords, this poster stands poised as a guiding light for CME/CPD professionals, offering a pathway to harmonize their practices with environmental stewardship. Notably, it not only imparts best practices but does so with an artistic flair that promises to be the heart of conference conversations. By merging practicality with creativity, this poster not only equips professionals with sustainable tools but also ensures they become the embodiment of inspired change, leaving an indelible mark on the conference landscape.

6. Balancing Patient Safety and Dignity in Psychiatric Facilities: A Scoping Review to Prevent Patient Self-harm and Suicide

Author(s)

• Sophie Soklaridis, PhD, Scientific Director and Senior Scientist, Centre for Addiction and Mental Health
• Edris Formuli, BSc, Summer Research Student, Centre for Addiction and Mental Health
• Rowen Shier, MA, Research Analyst, Centre for Addiction and Mental Health
• Sophia Lago, Research Practicum Student, Centre for Addiction and Mental Health, University of Toronto
• Jack Morawetz, Lived Experience Expert, Centre for Addiction and Mental Health
• Lara K. Parlatan, BMSc, MD Candidate, Medical Student, University of Toronto, Temerty Faculty of Medicine
• Terri Rodak, MISt, MA, Librarian, Centre for Addiction and Mental Health
• Faisal Islam, PhD, Manager, Education, Evaluation and Quality Improvement, Center for Addiction and Mental Health (CAMH)
• Sanjeev Sockalingam, MD, MHPE, FRCP(C), FACLP, Chief Medical Officer, Vice-President Education, and Senior Scientist, Professor, Department of Psychiatry, CAMH and University of Toronto Department of Psychiatry

Work in progress

Background/context/inquiry question
Navigating the balance between patient safety and dignity is imperative for healthcare professionals, especially in psychiatric environments. Patient self-determination is fundamental to ethical practice; however, this may become overshadowed during situations where safety is at risk. This scoping review explores the multifaceted factors and considerations when balancing patient safety, dignity and recovery during inpatient psychiatry unit design and clinical care. Guided by the research question ‘how can safety and dignity be taken into consideration to reduce the risk of self-harm and suicide in psychiatric hospitals?,’ we examine the ethical considerations related to healthcare practitioners’ duty of nonmaleficence coupled with their duty to respect patient autonomy. We investigate the importance of designing safe and dignified living spaces as enablers for onsite reduction in patient harm and suicide risk while fostering patient recovery. Findings are anticipated to inform psychiatric hospital best practices and policies to safeguard patient safety while promoting respectful and compassionate care.

Reference to current literature/perspective on the topic
Existing evidence reveals that psychiatric inpatient self-harm and suicides can largely be prevented through changes to room design, i.e., ‘suicide-proofing.’ However, while research into patient safety is profuse in the literature and in practice, the intersection with patient dignity is frequently absent. Although factors that lead to self-harm and suicide initiation are manifold, research aimed to inform best practices for psychiatric unit design in view of compassionate and dignified care is critical.

Theoretical framework(s)
To explore the intersection of patient safety and dignity, our study combines a descriptive approach using Arksey & O’Malley’s (2005) six steps to map existing literature with a constructivist lens toward theory generation. This dual-approach allows for the integration of perspectives from different disciplines and lived experience experts.

Methods
A scoping review methodology was chosen to systematically identify and explore relevant information for our research question. We conducted an extensive search across PsycINFO, CINAHL and Medline databases without date restrictions. Our approach considered various study designs and article types. Adhering to evidence reporting and synthesis standards, we employed the PRISMA scoping review extension. To further enhance the scope of this research, we plan to disseminate results using a narrative review format. This study design combines the rigorous nature of a scoping review, while simultaneously enabling researchers to engage in the subjective interpretation of results.

Impact/relevance to the advancement of the field of CME/CPD
Findings will outline clinical and environmental factors related to self-harm and suicide prevention. As it is crucial for healthcare professionals to develop knowledge and competency in this area, this work will identify considerations and evidence-based strategies for recovery-oriented care and the dignified prevention of self-harm in inpatient psychiatric settings. This study has the potential to inform decision-making and quality improvement initiatives related to the delivery of holistic and empathetic psychiatric care. This review also highlights approaches for healthcare practitioners to involve patients in their psychiatric care, and collaborate with patients to promote dignity and self-efficacy in their recovery.

Preliminary Findings
Work is in progress. Currently, we are assessing 137 full-text articles for eligibility after identifying 748 records and screening 558 abstracts after duplicate removal. Comprehensive findings will be available at the time of presentation.

7. Creating Blended Learning in CPD: The Best of Both Worlds

Author

• Gary A. Smith, PhD, Associate Dean for CPD, University of New Mexico, School of Medicine

Purpose/problem statement
Blended learning, including flipped learning, is a well-researched approach in higher education that is underutilized in CPD. Combining asynchronous-online and synchronous-interactive formats incorporates research-based learning principles of spaced learning, adaptive learning, retrieval practice, and elaboration.

Approach(es)
Beginning with one course in 2014, four additional faculty-development workshops were converted from entirely in-person to blended beginning in 2019. A total of 40 CME-earning activities with more than 650 attendances have occurred through 2023. Each offering involves one hour of web-based study through interactive multimedia, text reading, and short assessment prior to 1-2 hours of interactive classroom learning. Online study draws from resources that are accessible to anyone, anytime at the CPD-program website and also become adjunct materials for follow-up use. One annual healthcare-provider course utilizes online modules prepared by a specialty organization as required preparation for in-person skills sessions. In another provider course on the Teach Back method, learners experience a novel design of completing one hour of self-paced multimedia study and assessment and then schedule a brief virtual practice-with-feedback session with a facilitator. Generally, the in-person sessions feature small-group learning, skills practice, discussion in small and large groups, and little or no lecturing. Online multimedia learning typically includes required questions as learning checks, adaptive pathways depending on level of expertise, and, in two cases, submission of assignments for feedback prior to the live session.

Findings
Pre-session preparation levels the varied backgrounds of participants prior to engaging in application activities. Live sessions are now more engaging, are more highly rated by participants, and lead to greater demonstration of competency to implement intended objectives.

Discussion
Participants in blended activities value self-paced learning time, easier scheduling of the resulting shorter live sessions, and their own perception of greater learning. They request more blended offerings. The blended format was particularly advantageous for remote workshops during the COVID-19 pandemic by diminishing the length of Zoom sessions and removing the need for virtual lectures. Notably, all live parts of blended courses returned to in-person learning in fall 2021 at the request of learners.

Barriers/facilitations
So far, almost all blended learning opportunities were created by or in close partnership with the CPD office. Other activity planners desire to implement the approach but the time to create online content and to work with an instructional designer are barriers. To maximize the impact, CPD offices need competent instructional designers and education media creation platforms.

Impact/relevance to the advancement of the field of CME/CPD
Blended learning represents an alternative to traditional enduring-material or live-course activities that match with the potential greater learning-transfer-to-practice known to occur with blended design. Learners respond favorably to the format adding value and visibility to blended CPD offerings. The intention is not to record lectures for online learning but to create engaging online learning experiences that intentionally link to the in-person learning. This requires instructional design expertise, particularly with multimedia learning principles.

8. Improving Communication and Compassionate Care Through Wellness

Author(s)

• Sandhya Venugopal, MD, Associate Dean, CME, University of California, Davis Health
• Erik Laurin, MD, Faculty Liaison, University of California, Davis Health
• Glee Van Loon, RD, CDE, Health Professionals Education Specialist/Program Manager, University of California, Davis Health
• Shelley Palumbo, MS, CCC-SLP, Senior Director CME, University of California, Davis Health

Purpose/problem statement
Several factors may impact a physician’s state of wellbeing and the patient experience. Communication skills are essential components of the physician-patient relationship, especially in the areas of empathy and compassion. Recognizing that some providers may not demonstrate these skills enough to fulfill all of their patients’ needs, the UC Davis Health Chief Wellness Officer’s team partnered with the Office of Continuing Medical Education (OCME) to create a program to develop these skills and make a meaningful difference in clinical care.

Approach(es)
The Wellness team and OCME developed a unique, individualized coaching program to improve communication for onboarding physicians and remedial purposes. The program consisted of a foundational Good to Great: Core Communication Strategies educational retreat, followed by individual Coaching for Core Communications Strategies sessions based on the physician’s observed interactions during patient care. The coaching model was designed as an opt-in with an option to opt-out at any time. Beginning with an intake meeting, coaching sessions were then individualized in time and content over the next one-year period. During individual coaching sessions, the physician was shadowed while interacting with their patients. Post-visit, the coach asked the physician questions and for their observations before discussing opportunities for improved physician-patient communication. This approach was vital as the coach determined if the physician was ready to receive the information for it to be impactful, in addition to modeling the skill of curiosity.

Findings
This program improved physicians’ abilities to navigate challenging conversations and physician-patient interactions. Feedback from the physicians was extremely positive, noting heightened awareness of their own verbal and non-verbal communication skills, as well as a new ability to reframe their conversations with patients. Due to the overwhelmingly positive results, the program may become available to all physicians at UC Davis Health.

Discussion
Empathetic and compassionate communication can be challenging at various points of a career, especially with the many stresses that can affect physician well-being. In order to train new physicians and help veteran physicians provide the best care, this program focused on core communication skills with an individualized approach and expert coaching. By providing physicians with customized feedback and discreet improvement strategies, physicians were able to deliver clinical care that was subjectively and objectively more satisfying for both physicians and their patients.

Barriers/facilitations
As with many successful programs, scalability can be problematic. Although highly successful with specific physician groups, expanding the program to all clinicians would require extensive effort. At a minimum, this program sets communication expectations and familiarizes faculty to unique resources available to them at UC Davis Health. Additionally, aggregate objective and subjective anonymized data from the coaching and other wellness programs has been tracked and shared with departmental leadership. Through data sharing, leaders are familiarized with the program and ways to support new and existing faculty.

Impact/relevance to the advancement of the field of CME/CPD
Improvements in physician-patient interactions and satisfaction can occur using a partnership of wellness experts and OCME resources to develop a structured program to optimize communication skills.

9. Addressing Empathy Decline in Physicians Through CME/CPD

Author(s)

• Nasim Gheshlaghi Azar, PhD, Lecturer in Medical Education, Medical Education Dept., School of Medical Education & Learning technologies, Shahid Beheshti University of Medical Sciences
• Shahram Yazdani, MD, Associate professor in Medical Education, Medical Education Department, Shahid Beheshti University of Medical Sciences

Background/purpose/inquiry question
“Being compassionate and empathetic in caring for patients” has been stated as one of the learning objectives for medical education. There is wide consensus that physician empathy has been significantly associated with higher levels of patient satisfaction, adherence to medical recommendations, and improved clinical outcomes, as well as lower burnout and less medical-legal risk of physicians, and higher well-being and clinical competence. Despite its importance there have been distressing reports describing a lack of empathy in patient care. It is therefore incumbent upon medical educators to utilize methods to enhance medical student and physician empathy. Accordingly, the purpose of this study is to investigate the educational strategies for enhancing empathy in physicians.

Theoretical framework(s)
Theoretical framework of this review is based on the Jean Watson’s “Philosophy and Theory of Transpersonal Caring” which mainly concerns caring for patients and how that caring progresses into better plans to promote health and wellness.

Methods
In this narrative review, the search for relevant publications was conducted in the PubMed, Google Scholar, ProQuest and SID databases. Following this orienting search, a second, more in-depth search was conducted that included references of appropriate articles. The focus was on publications that addressed the educational strategies that enhance empathy in medical students and physicians.

Results/findings
Based on the results of this study, the educational interventions to enhance empathy in medical students and physicians are as following: role play, positive role models, experiential learning, medical humanities, mindfulness training, narrative medicine, reflective writing, communication skills training, art-based pedagogy (poem, theater), and various didactics related to spirituality, morality and virtues.

Discussion
While the statistics have reported a significant increase in empathy in medical students following educational interventions, there is limited insight available about long-term efficacy of empathy interventions. Even if medical students’ empathy is enhanced through educational interventions, strategies aimed at enhancing empathy of physicians throughout their career may be more important to ensure that patients consistently receive empathic care. This issue highlights the key role of CME/CPD in enhancing physicians’ empathy at multiple time points throughout their professional career. It is also notable that with self-report measures of empathy, which is the dominant method of assessment of empathy in most of the studies, it can be difficult to say whether interventions increase empathy. Therefore, patient-report measures of empathy should also be taken into account.

Limitations
This study may be subject to the limitation of “publication bias”, that most of the selected studies have reported significantly high incidence of empathy following educational interventions, in comparison to a disproportionately small number of studies with null results. Considering the importance of patient-report measures of empathy, the dominance of selected studies which utilize the “self-report” assessment of empathy by medical students and physicians, is the other limitation of this study.

Impact/relevance to the advancement of the field of CME/CPD
Regarding declining empathy over time and its serious consequences for physicians and their patients, the key role of CME/CPD in enhancing physicians’ empathy seems indispensable. Educational interventions that are mentioned in this study provide a toolbox for CME/CPD to utilize the appropriate method/s to enhance the empathy of physicians.

10. Learner Preference Changes and Organizational Resilience: The Lasting Impact of the Pandemic

Author(s)

• Deborah Samuel, MBA, FSACME, FACEHP, Director, Live Education Activities, American Academy of Pediatrics
• Alisa Nagler, JD, MA, EdD, Assistant Director, Trauma Education Programs, American College of Surgeons
• Suzanne Ziemnik, MEd, Chief Officer, Learning and Educational Research, American Society for Clinical Pathology
• James Morgante, PhD, Associate Director, Qualitative and Survey Research Methods, American Society of Clinical Oncology

Work in Progress

Background/context/inquiry question
The COVID‐19 pandemic catalyzed transformation, including in medicine and medical education across the continuum. Continuing professional development (CPD) organizations, including medical specialty societies (MSS), leveraged this change by providing innovative education, adjusting format, timing, content and anticipated learners. This study identified the disruptive innovation that occurred during this CPD pivot and sought to understand if and how learners’ CPD preferences shifted. Finally, this study analyzed the impact of the pivot on post-COVID CPD offerings and on educators, administrators and staff. Findings will inform CPD’s future and show the resilience of CPD organizations and enduring transformation of CPD and learner engagement.

Reference to current literature/perspective on the topic
CPD organizations responded to the pandemic with innovative education – adjusting format, timing, content, and targeted learners (McMahon 2022). Some strategies are forging a new path, fostering innovations and potentially transforming how medical education is delivered (McMaster, et al 2020). There is much to learn from the last three years when looking to CPD’s future (Price, et al 2020; Ng & Campbell 2020).

Theoretical framework(s)
The disruptive innovation in CPD during the pandemic provided the opportunity to revisit Knowles’ adult learning principles and their application outside of long-standing traditions of education format. The sudden shift to virtual learning led to cognitive dissonance as assumptions about education were challenged (Mezirow’s Transformative Learning Theory). Our study also relied on Social Learning Theory (SLT), as CPD learners were encouraged to reflect on their CPD experiences during the pandemic and preferences going forward.

Methods
The study population included members of the Council of Medical Specialty Societies (CMSS), organizations and membership representing various disciplines. A mixed methods approach was used:

1. Organization survey gathering data on each specialty society’s Annual Meeting–pre-pandemic, in 2020, and post-pandemic.

2. Membership survey of 300 learners from 25 MSS collecting data on learner practices pre-pandemic, in 2020, and post-pandemic.

3. Focus groups (2 with MSS learners early in practice and 3 later in practice) as follow up to survey findings Quantitative and qualitative data from organization and learner surveys and focus groups were analyzed.

Preliminary Findings

Thirty-six CMSS member societies (75%) and 1,078 physicians (12%) responded to the surveys respectively, and 19 physicians participated in focus groups. MSS pivoted due to the pandemic and offered a variety of virtual activities, many continuing today. Learners reported a preference for in-person events primarily for networking and social opportunities, while finding virtual activities to be convenient and effective. Learners expect a choice in education formats. Additional faculty development, staff training, and innovative education formats are necessary to support learner preferences and expectations.

Impact/relevance to the advancement of the field of CME/CPD
A major pivot in education occurred due to the pandemic, with CPD organizations adapting their educational activities and approaches. With exposure to new learning opportunities, learner preferences shifted and will require enduring changes for CPD. To remain resilient, engage learners, and enhance the quality and safety of patient care and health outcomes, CPD organizations must align their educational activity development and delivery methods with learner preferences in format, timing, and content and with their infrastructure and available resources. Further study is needed to assess learning effectiveness.

11. Reflecting on Reflections: Evaluation of a CPD-Led Physician Leadership Development Program

Author(s)

• Matt Orr, PhD, Associate Dean for Continuous Professional Development & Strategic Affairs, University of South Carolina School of Medicine
• Morgan Rhodes, PharmD, Director of Faculty Development, University of South Carolina School of Medicine

Background/context/purpose
The Physician Leadership Institute (PLI) is an organization-sponsored physician leadership development program that is led by the Office of Continuous Professional Development & Strategic Affairs at the University of South Carolina School of Medicine Columbia—Prisma Health Midlands. The program was designed and delivered in partnership with senior clinical and operation leaders in the system to be realistic in time and format – nine Thursday evening-Friday morning dinner/classroom sessions, monthly individual coaching, and an improvement project all over a 10-month period – without sacrificing the necessary intensity to engage participants in meaningful development. The purpose of this project was to evaluate the impact of the program on the 2022 cohort of 11 participants’ leadership skills and practices.

Theoretical framework(s)
Evaluation was informed by Moore’s expanded framework for assessing CME/CPD.

Methods
As a core component of the PLI, participants engage in regular self-reflection activities in which they are prompted to consider the degree to which and why they exercise various evidence-informed leadership skills and practices as well as ways to address any related gaps. While some activities are more personal in nature and intended for self-discovery (e.g., values alignment), others are related to cognitive reasoning, competence and performance related to leadership behaviors and practices, which are not only beneficial for self-assessment but also yield useful information with which to evaluate program impact. At the end of each classroom session participants completed end-of-session reflections designed to identify their key lessons learned and evaluate “Competence” via intention to change statements. Mid- and end-of-program as well as 9-month self-assessments evaluated “Performance” via self-reports of leadership behaviors and practices. Observations by course facilitators and coaches during classroom and coaching sessions yielded opportunities to observe growth (or not) in the way that participants described and discussed problems and solutions. Observations by other leaders and peers of participants’ performances in real-world situations, including the administration of their projects, also aided in further evaluating participant behavior.

Results/findings
PLI participants consistently demonstrated competence and improvements in self-reported performance in self-awareness, self-management, working with and leading others, leading change, and identifying their own learning and performance gaps in their leadership roles. Participants described a much greater sense of confidence in their leadership abilities in leading up the chain as well as with their own followers. Participants also demonstrated greater intentionality in managing biases as well as in engaging in a more deliberate decision-making process.

Discussion
The impact of the PLI is demonstrated by the sustained behavior changes participants report and others observe. As another measure of perceived impact, senior leaders in our system have endorsed their support of the program’s value as they have sponsored the 2023 cohort of the program, which is now underway.

Impact/relevance to the advancement of the field of CME/CPD
Physician leadership development is rapidly becoming a salient issue the CPD community must address, especially now that it is an expected competency for physicians. The PLI has been demonstrated to be a realistic and impactful model to address this learning gap.

12. Engaging Learners to Develop Practice-Based Solutions: Addressing PD-L1 Testing Challenges in the Laboratory

Author(s)

• Melissa Kelly, PhD, Senior Manager, Evaluation, Measurement, and Assessment, American Society for Clinical Pathology
• Joseph Kim, MD, President, Q Synthesis LLC
• Kellie Beumer, MBA., Director, Learning Innovations, American Society for Clinical Pathology
• Patrice Lazure, MSc, Director of Research, AXDEV Group Inc.
• Suzanne Murray, ,CEO and Founder, AXDEV Group Inc.

Purpose/problem statement
Programmed death-ligand 1 (PD-L1) immunohistochemistry (IHC) testing is often used to identify patients with cancer who may be eligible for immunotherapy. However, the complexity around using different assays and platforms often causes confusion, frustration, and reluctance to perform in-house PD-L1 testing, thus potentially weakening the laboratory team’s resolve. Some labs have established a single laboratory developed test (LDT) that may be used across multiple types of tumors, but there is a lack of resources to provide guidance on whether to establish a PD-L1 LDT or how to do it. Laboratory teams need structured guidance to navigate complex institutional issues on establishing an LDT to optimize testing and treatment for patients with cancer.

Approach(es)
Recognizing that operational challenges around PD-L1 testing often contribute to work-related stress for pathologists and laboratory professionals, ASCP, Q Synthesis, and AXDEV Group recruited a dedicated group of 40 pathologists and laboratory professionals to join the ASCP PD-L1 Learning Collaborative to explore ways to improve PD-L1 testing processes. From that group, a smaller subset of 9 participants formed an ad-hoc working group focused on LDTs and reviewed the literature, spoke with labs using LDTs, and developed guidance questions to identify key clinical and operational considerations for establishing an LDT . The working group then developed a guidance document to be disseminated to the broader laboratory community.

Findings
The guidance document identifies and outlines clinical and operational questions around establishing an LDT, including questions related to testing volume and types of cancers, buy-in from oncologists, assay selection and testing platforms, IHC testing processes, interpretation and scoring, validation, and reimbursement. Having a structure for navigating these questions helps strengthen and build resilience as laboratory team members work together to develop practice-based solutions around the knowledge and skills targeted by the program.

Discussion
This program demonstrates how to design an education program to engage learners to collectively develop solutions that address both clinical and operational challenges. For some labs, the investment of time and resources to establish an LDT may be the right solution. For others, the guidance document may help them identify other practice-based solutions. The decision to establish an LDT requires input from multiple stakeholders, so learners also gained resolve and skills to navigate potentially challenging conversations about the pros/cons of an LDT.

Barriers/facilitations
Barriers included the lack of time for healthcare professionals to participate in education. Facilitators included ASCP’s ability as a national society to recruit pathologists and laboratory professionals who were eager to join the learning collaborative and actively participate.

Impact/relevance to the advancement of the field of CME/CPD
Healthcare professionals are at risk of burnout and work-related dissatisfaction, especially when confronted with complex, challenging, and inefficient operational issues that could weaken their team’s resolve. CME/CPD providers can develop programs that provide structured guiding questions designed to engage learners in developing solutions to complex issues. Many challenges require healthcare professionals to demonstrate skillful conversations and provide rationale to support certain operational decisions.

13. Making the Unseen Seen: Teaching Psychiatry Faculty About Identifying and Addressing Unconscious Bias

Author(s)

• Shaheen A. Darani, MD, FRCPC, Director, Faculty Development & Asst Professor, Dept of Psychiatry, Associate Director, PG Wellness, Temerty Faculty of Medicine, University of Toronto
• Amy Gajaria, MD, FRCPC, Assistant Professor & Associate Director, EDI Education and Training, Department of Psychiatry, University of Toronto
• Nikhita Singhal, MD, Psychiatry Resident, University of Toronto
• Certina Ho, BScPhm, MISt, MEd, PhD, Director of Program Evaluation and Scholarship, Dept of Psychiatry, Leslie Dan Faculty of Pharmacy, University of Toronto
• Fiona Rawle, PhD, Professor, Teaching Stream, Dept of Biology, University of Toronto

Background/context/purpose
Creating more equitable settings is an essential area of focus for medical education leaders. To support our Canadian Psychiatry Department’s strategic priority in equity and to address our faculty’s need for knowledge and skills for acknowledging and addressing bias in their academic roles, we delivered an unconscious bias education workshop in collaboration with a grassroots service unit at our University focused on supporting diversity, equity and inclusion (DEI) by offering workshops and resources about unconscious bias, sexism, racism, and other barriers to inclusion and belonging within the institution. Our goal was to not only provide unconscious bias training, but also foster a departmental culture shift — an essential element of advancing equity in academic medicine.

Theoretical framework(s)
Workshop design was informed by the ADDIE (Analyze, Design, Develop, Implement, Evaluate) instructional design process as well as principles of adult and experiential learning. Our evaluation plan was informed by the Kirkpatrick model.

Methods
Workshop design was informed by the ADDIE instructional design process following a literature and internal review to identify gaps and faculty needs. To foster culture change and department-wide uptake, roll-out was initiated at the leadership level. Our evaluation plan was informed by the Kirkpatrick model; participants completed a pre-workshop survey and a post-workshop survey upon session completion.

Results/findings
To date, our unconscious bias education program has reached a total of 554 faculty members through the delivery of 13 sessions held between April 2021 and October 2022. The workshops were extremely well-received [ie. reaction/satisfaction]; participants reported an increase in understanding of various DEI concepts [i.e., knowledge], comfort discussing DEI-related issues, and strategies for how to address DEI-related issues [i.e., skills]. Thematic analysis was applied to open-ended responses about what participants valued most, suggestions for improvement, as well as anticipated barriers, facilitators, and departmental support required to execute sustainable knowledge translation post-workshop attendance.

Discussion
This intervention demonstrates how equity leaders and medical educators can design, implement, and evaluate, an equity focused workshop for faculty in a large department. Key aspects of success included early engagement and endorsement of leadership, use of integrated, didactic and interactive learning, and content that was easily accessible and grounded in scientific literature. We anticipate these results will help guide future directions to build capacity and empower faculty to effect positive cultural change. Take Home Messages A DEI CPD program with early institutional and leadership support, that incorporates best practices in faculty development/CPD, can facilitate engagement and behavioural change as well as advance equity within a University department.

Impact/relevance to the advancement of the field of CME/CPD
To our knowledge, this is the first example of implementation of a large-scale department-wide DEI faculty development initiative. This initiative could inform the development and delivery of future CPD in DEI in academic institutions.

14. Reflections on our Webinar Series ‘Addressing Health Disparities: Clinical Perspectives on Race and Social Justice

Author(s)

Purpose/problem statement
Historically, content for HMS CE programs has been driven by faculty from our affiliated hospitals. Although our office had made efforts to encourage discussion of race and social justice issues in affiliate courses, we recognized that our department could (and should) do more to ensure thorough coverage of topics related to the multiple biological, social, financial and cultural aspects that influence patients’ health-oriented behaviors. Following the successful launch of a COVID-19 related webinar series in Spring 2020, HMS’ CE team launched the “Addressing Health Disparities: Clinical Insights on Race and Social Justice” webinar in Summer 2020. Starting as a weekly one-hour webinar, the program has continued as a monthly inter-professional program multidisciplinary program examining the intersections of race and ethnicity, racism, sexual orientation, social justice and health to better understand the myriad ways these important factors lead to health care disparities in our communities

Methods/Approach(es)
Originally when discussions of equity arose within our office, the focus was on ensuring representation within our course planners and faculty. However, in light of the increased attention in the lay and medical press to structural racism in the aftermath of the high-profile deaths of African-Americans at the hands of the criminal justice system in Spring 2020, we recognized that there was also a role to be played by utilizing expertise within our system to develop and offer content focusing on the underlying factors that create health disparities. From there, we began offering a weekly one-hour webinar series, which has continued as a monthly offering through the Fall 2023.

Findings
The activity was offered as a free webinar series as well as a recorded enduring activity. Because of that it is somewhat difficult to draw conclusions on the overall impact of the program on addressing health disparities. However, the overall success of the program in attracting an audience (including many international participants) demonstrates the value of including content related to health disparities within existing activities.

Discussion
Overall, the webinar series demonstrates that there is an audience for content focused on the intersections of race and ethnicity, racism, sexual orientation, social justice and health. This can help other providers emphasize the value of these topic areas to faculty who may be reluctant to include them in their talks/programs.

Barriers/facilitations
As noted above, it is difficult to evaluate the overall program impact. While we have self-reported attendee data on changes in performance and competence as a result of the activity, given the size and diversity of the attendees it is nearly impossible to track the “on the ground” impact of our program on patients and communities.

Impact/relevance to the advancement of the field of CME/CPD
There is also a lesson to be learned by providers on addressing big-picture, systemic issues. Our webinar series was a fairly simple intervention to a hugely complex problem. Still, it enabled us to reach a huge audience of health professionals relatively inexpensively. As educators, the solutions we offer don’t have to be perfect to be impactful, just timely and relevant to our audience.

15. Artificial Intelligence in Paediatric Postgraduate Medical Education: A Scoping Review

Author(s)

• Ajantha Nadarajah, MD, Department of Medicine, University of Toronto, Canada
• Ghazal Malekzadeh, Undergraduate Student, Department of Biology, York University, Canada
• Savithiri Ratnapalan, MBBS, PhD, Professor, University of Toronto, Hospital for Sick Children

Background/purpose/inquiry question
Artificial intelligence (AI) encompasses a wide range of technologies that enables computers to mimic human intellect. AI includes several domains, including machine learning, natural language processing, text and speech synthesis, computer vision, robotics, planning, and expert systems. The integration of AI in healthcare has caused changes in the way postgraduate medical education is conceived and delivered. Our objective was to explore the use of AI in pediatric postgraduate medical education programs, highlighting its potential to revolutionize the learning experience and enhance the competence of future pediatricians.

Theoretical framework(s)
A scoping review following PRISMA-ScR guidelines was conducted.

Methods/ Approach(es)
MEDLINE, EMBASE, and ERIC databases were searched between January 2000 and June 2023 using a comprehensive search strategy developed with the assistance of a research librarian. All studies that discussed AI in postgraduate paediatric education were included. Studies that exclusively addressed AI in undergraduate medical education were excluded. Titles and abstracts were screened for relevant studies independently by two reviewers, and full text reviews were conducted independently. Disagreements were reconciled by the third reviewer. Information about the participants, study type, AI interventions used, and outcomes were abstracted from included studies and synthesized using a narrative approach.

Results/findings
The search yielded 983 unique publications. Full text reviews of 63 publications were conducted and 13 studies that met inclusion criteria were analyzed. . The included studies investigated the use of AI in General Paediatrics, Paediatric Radiology, Paediatric Oncology, Paediatric Otolaryngology, and Paediatric Emergency Medicine programs. Two studies investigated machine learning models, two studies used Bayesian-based tools, eight studies specifically explored deep learning models, and one study examined AI generally. Ten studies explored AI as a clinical decision support tool in pediatric residency training, including four showing improved diagnostic accuracy and six showing better radiographic interpretation with AI-based training amongst residents. Two studies used AI models to assess competency of residents. One qualitative study assessed the experiences of AI amongst young pediatricians and found that only 5% of participants received AI training, while 87% considered implementation of such training to be necessary in postgraduate programs.

Discussion
Overall, the studies included in this review demonstrated that AI tools improved residents’ workflow, diagnostic accuracy, and clinical confidence. However, studies raised concerns about the ethical and societal issues linked with the implementation of AI in residency training.

Limitations
Other databases, conference abstracts and gray literature were not searched. This could have resulted in missing some of the newer studies.

Impact/relevance to the advancement of the field of CME/CPD
There is currently no uniform AI curriculum included in pediatric postgraduate medical training. The integration of AI in healthcare appears to be inevitable, and this scoping review shows that AI is largely used as a clinical decision support tool in current pediatric postgraduate medical education. Data from this review can be used to shape future integration and diversification of AI teaching in pediatric postgraduate programs, including professional development programs to address faculty and learners’ needs and concerns.

16. Innovations in Mentorship: Implementation of a Comprehensive Mentorship Program for Faculty in a large Psychiatry Department

Authors

• Shaheen A. Darani, MD, FRCPC, Director, Faculty Development & Asst Professor, Dept of Psychiatry, Associate Director, PG Wellness, Temerty Faculty of Medicine, University of Toronto
• Mary Jane Esplen, PhD, Vice Chair Mentorship, Dept of Psychiatry, University of Toronto
• John Teshima, MD, FRCPC, Associate Professor, Department of Psychiatry, University of Toronto
• Certina Ho, BScPhm, MISt, MEd, PhD, Director of Program Evaluation and Scholarship, Dept of Psychiatry, Leslie Dan Faculty of Pharmacy, University of Toronto
• Krista Lanctot, PhD, Vice Chair, Basic Sciences, Department of Psychiatry, University of Toronto
• Jiahui Wong, PhD, Assistant Professor, Department of Psychiatry, University of Toronto
• Danica Kwong, MSc, Strategic Planning Coordinator, Department of Psychiatry, University of Toronto

Background/context/purpose
Mentorship supports professional development, academic outcomes, and wellness. Effective mentorship can develop careers of faculty through greater access, and equity, diversity, and inclusion (EDI). At a Department of Psychiatry in Canada, a recent need assessment survey showed more than 60% faculty were without mentors and would like to have one; and 75% mentors received no training to support mentorship. A comprehensive mentorship Program was implemented department wide to facilitate sharing of expertise, self-reflection, and career development.

Theoretical framework(s)
The theoretical frameworks used in the design of the mentorship workshops included the principles of adult learning and experiential learning.

Methods/Approach(es)
A mentorship working group was formed. The mentorship program development was informed by a literature review and created using a design process employing co-design with person-centered and service design approaches (Slattery et al. 2020). Co-design involves meaningful end-user engagement occurring at all stages of the process (Slattery et al 2020). Thus, strong efforts were placed on ongoing engagement, communication and advocacy with key stakeholders, leaders, users, and partners from the very conception of the project. Several activities supported engagement and included workshops and presentations with opportunity for feedback and the sharing of documents outlining the design of the program. Core to the program is a traditional primary mentor-mentee relationship that is further supported by mentorship groups focused on academic roles, scholarship interests, or social identity. The program offers an online mentor/mentee matching process, based on faculty academic interests, roles, and social identity preferences. PRISM (Practical, Robust, Implementation and Sustainability Model) is applied with continued implementation to assess predetermined contextual factors (e.g., mentee/ mentors characteristics, academic roles, organizational perspectives; infrastructure support). This iterative component of program feedback will be used to further refine the program (addressing barriers, gaps; applying facilitating factors and help address sustainability). A logic model informs a three-year evaluation plan with participants completing evaluations at enrolment and annually. Focus groups explore perception and concepts, such as intersectionality, wellness, and DEI.

Results/findings
The program was launched in 2021 with virtual workshops offering best practices and reflection on challenges encountered during mentorship. Thirty-six faculty mentors and 84 faculty mentees attended the workshops. Trainings have been provided on DEI and mentorship, best practices, and content supporting academic roles. Feedback has been positive with 93% of participants indicating the workshops met learning objectives; 80% rated the workshops as excellent. Eighty-seven percent of mentor participants reported increased awareness of best practices in mentorship. Group programs have been well-received and associated with high levels of satisfaction.

Discussion
Accessibility of mentorship is a challenge, with many faculty having received limited education or access. Preliminary feedback demonstrates increased access to 1:1 and group mentorship and workshops are an effective mode of enhancing knowledge, skills, and work satisfaction. We anticipate the implementation of our mentorship program could be adapted to other academic settings.

Impact/relevance to the advancement of the field of CME/CPD
The presentation has direct relevance and implications for future CPD in mentorship and program implementation for academic physicians in other academic institutions.

17. Predictors of Factors of Lifelong Learning in Physicians Referred for Remediation

Author(s)

• Miranda A. McDaniel, Research Assistant, Professional Renewal Center
• Dillon Welindt, Doctoral Student, University of Oregon
• Betsy W. Williams, PhD, MPH, FSACME, Clinical Program Director, Professional Renewal Center

Background/purpose/inquiry question
Lifelong learning is a professional responsibility and component of professionalism. With continuous advances in medical technology, changes in the healthcare landscape, and changing societal/cultural norms, it is important for individuals in the healthcare field to engage in this process.1 Motivation and self-directed learning are necessary to effectively engage in lifelong learning. 2 Intrinsically motivated individuals often find inherent satisfaction in the activity they are performing. This is associated with a lower risk for depression, decreased burnout, and other overall health benefits. 3 Establishing lifelong learning practices as early as possible is beneficial for continuing medical education. 2 However, in order to effectively inculcate skills and attitudes needed for lifelong learning, educators must understand the factors that influence an individual to engage in lifelong learning activities. The aim of the present study is to identify those factors.

Theoretical framework(s)
The responses employed in this study are drawn from a sample of physicians and trainees (n=415) referred to a midwestern center for assessment/remediation secondary to professionalism lapses. Measures used in this study include the Jefferson Lifelong Learning Scale, General Self-Efficacy Scale, DSM scales of anger, sleep, and anxiety, and demographic information. These data are collected as part of the assessment/remediation process. Western IRB has opined that this study is exempt. The core of this study is to use a clustering method to analyze clusters of learning styles, and a logistic regression framework to predict cluster membership. Other analyses include factor analysis and item response theory analysis to make these data more parsimonious and improve measurement validity.

Methods
N/A

Results/findings
These findings demonstrate a relationship between understanding lifelong learning as an aspect of professional identity. While lifelong learning as an element of professional identity is a strong predictor of engaging in activities of lifelong learning, the relationship is complex 4. These findings also support the importance of health and well-being as being associated with the decision to engage in professional development activities.

Discussion
N/A

Limitations
N/A

Impact/relevance to the advancement of the field of CME/CPD
These findings support past works indicating a relationship among professionalism, well-being and socio-cognitive factors. 5 Professional identity in physicians with regard to lifelong learning is highlighted as both an aim and indicator of successful medical training. However, medical educators would be well-advised that the complex nature of choice suggests a tailored approach to CME that assesses knowledge, but also learner readiness and wellbeing. Impediments to self-directed learning and suggestions for practice will be discussed. Due to word limit references are available upon request.

18. Improving Healthcare Delivery for Vulnerable Populations: Lessons from Best Practices in Addressing Complex Care Needs in Under-Resourced Settings, with a Focus on Migrant and Asylum-Seeking Communities

Author(s)

• Paulina Castleberry, Lead Clinical Assistant, UCSD
• Nancy Carballo, MD, Assistant Medical Director, UCSD
• Linda Hill, MD, Medical Director, UCSD

Purpose/problem statement
Enhancing healthcare for vulnerable populations, asylum seekers globally seek refuge in the United States. The University of California San Diego and NGOs collaborate, operating shelters offering essentials and travel aid to migrant families awaiting immigration hearings. UCSD’s daily medical services at these shelters proactively screen for public health risks, stabilize through acute care, and facilitate referrals, improving healthcare delivery for

Approach(es)
The research used qualitative methods, such as interviews and participant observations, to gather insights from healthcare professionals, patients, and the NGOs involved with UCSD’s asylum seekers clinics. Using health screening surveys, daily tracking of findings over two years were collected and analyzed for this study. 1. Review of UCSD’s Asylum Seekers Clinics: Conducted an in-depth analysis of UCSD’s asylum seekers clinics, examining their structure, services offered, patient demographics, and partnerships. 2. Case Studies of Successful Interventions: Investigated case studies and success stories from various global and local healthcare initiatives that effectively provide care to migrant and asylum-seeking individuals. 3. Identifying Best Practices: Synthesized the findings from UCSD’s asylum seekers clinics and other case studies to identify standard best practices contributing to successful healthcare delivery in under-resourced settings. 4. Recommendations for Replication and Expansion: Developed recommendations for healthcare practitioners, policymakers, and organizations interested in replicating or expanding successful interventions.

Findings
Approximately 20% of asylum seekers require acute care, including stabilization of hypertension (0.76%) or diabetes (0.4%); addressing medical needs of pregnant patients (1.9%); or mitigation of the spread of infectious diseases (covid, gastroenteritis, influenza-like illness, malaria, scabies, tuberculosis, or varicella). Incorporating carefully planned orientation and workflow processes for screeners, clinical assistants, nurses, and providers raised confidence levels among staff (92.5% among screeners) and also reduces the over-utilization of emergency departments (0.4% ED referral rate).

Discussion
The development of detailed processes and workflows helps ensure the standardization of best practices. With the help of specialists, patients with congenital conditions such as Tetralogy of Fallot can receive the proper care for safe travel. Use of language translation services, cultural competency, and daily communication with NGOs enhances the successful allocation of legal, medical, and financial resources. Using best practices and continual quality improvement checks leads to other shelters’ desire to adopt and standardize operations for similar success.

Barriers/facilitations
Some challenges and barriers encountered in providing healthcare to vulnerable populations include language barriers, cultural differences, legal restrictions, navigation of the healthcare system, and financial constraints that hinder access to care and effective treatment. The clinics have mitigated these issues through in-depth orientation/OTJ training for new hires, standardized clinic protocols, partnerships with local hospitals and clinics, translation lines, and open communication and collaboration with the involved NGOs.

Impact/relevance to the advancement of the field of CME/CPD
This innovative research contributes valuable new insights to the field of healthcare delivery for vulnerable migrant and asylum-seeking populations. By analyzing successful strategies employed by UCSD’s asylum seekers clinics in California and other initiatives, the study informs the development of evidence-based approaches that can guide healthcare providers, organizations, and policymakers to improve the quality, accessibility, and equity of healthcare services for vulnerable migrant and asylum-seeking communities across the United States.

19. Perceived Importance of Transition to Practice Competencies by Psychiatry Residents in Canada: Implications to Continuing Professional Development

Author(s)

• Certina Ho, BScPhm, MISt, MEd, PhD, Director of Program Evaluation and Scholarship, Dept of Psychiatry, Leslie Dan Faculty of Pharmacy, University of Toronto
• Justin Lee, PharmD Student, PharmD Student, University of Toronto
• Anna Nguyen, PharmD Student, PharmD Student, University of Toronto
• Eulaine Ma, BSc, PharmD, Pharmacy Resident, University of Toronto
• Michael Mak, MD, FRCPC, FCPA, Assistant Professor, University of Toronto
• Sanjeev Sockalingam, MD, MHPE, FRCP(C), FACLP, Chief Medical Officer, Vice-President Education, and Senior Scientist, Centre for Addiction and Mental Health and University of Toronto Department of Psychiatry

Work in Progress

Background/context/inquiry question
As Canadian psychiatry residency programs transitioned to the competency-based model, the Royal College of Physicians and Surgeons of Canada released a list of Transition-to-Practice (TTP) competencies. These competencies include the integration of skills directed towards life-long learning and management of clinical, administrative, and financial aspects of practice. In the context of implementing competency-based medical education in residency training, there is also an implication to continuing professional development (CPD) needs from early career psychiatrists (ECPs). Our project is aimed to determine which skills/proficiencies are perceived as the most valuable to psychiatry residents during their transition to practice.

Reference to current literature/perspective on the topic
A Canadian study of 16 psychiatry training programs identified gaps in resident self-perceived skills in physician-manager training areas such as program planning, career development, and innovation – indicating a demand for TTP competencies to align with the needs of psychiatry residents. Similarly, when designing CPD for ECPs, the learning objectives should also match with the needs of ECPs.

Theoretical framework(s)
We adopt Kern’s six-step approach to curriculum development to identify skills or proficiencies that were perceived to be the most valuable to psychiatry residents during their transition to practice.

Methods
An online questionnaire was sent to all senior psychiatry residents (PGY4 and above) in Canada via the Coordinators of Psychiatric Education (COPE) from January to March 2023. Residents were asked to rank the Royal College TTP competencies based on perceived levels of importance. Rankings were converted into quantitative data with 1 = Least Important and 5 = Most Important. Additionally, residents were given the opportunity to include open-ended comments addressing other aspects of training they felt were important but not captured in existing TTP competencies.

Impact/relevance to the advancement of the field of CME/CPD
Insights gained from this project provide an opportunity to not only refine the PGY5 TTP curriculum in psychiatry residency training, but also contribute to CPD. Educators and CPD curriculum designers may focus on prioritized TTP competencies perceived by residents. Furthermore, areas determined by residents as valuable but not captured by the Royal College TTP competencies reflect unmet needs in psychiatry residency training where development of CPD resources may be needed going forward.

Preliminary Findings
We received 72 responses (57% PGY4 and 42% PGY5) from 15 of 17 Canadian medical schools. The top 3 TTP competencies were management of adverse events, practice management, and business aspects of practice. The TTP competencies ranked as least important were evaluating costs of patient treatment in different settings, quality improvement initiative, and social media training. Areas not captured by the Royal College TTP competencies that residents perceived as important included managing practice-related finances, and how/where to apply for jobs.

20. Standardizing Virtual Interactive Cases for Pharmacist Prescribing for Minor Ailments

Author(s)

• Certina Ho, BScPhm, MISt, MEd, PhD, Director of Program Evaluation and Scholarship, Dept of Psychiatry, Leslie Dan Faculty of Pharmacy, University of Toronto
• Autumn Chen, BSc, PharmD, Pharmacy Resident, University of Toronto
• Danya Nguyen, BSc, PharmD, Pharmacist, University of Toronto
• Eulaine Ma, BSc, PharmD, Pharmacy Resident, University of Toronto
• Neil Patel, BSc, PharmD, Pharmacist, University of Toronto
• Gordon Tait, PhD, Assistant Professor, University of Toronto

Purpose/problem statement
Virtual cases are associated with increased learner satisfaction and provide learning opportunities that simulate practice. We created a series of pharmacist prescribing for minor ailment (PPMA) cases, via the Virtual Interactive Case (VIC) System, to facilitate PPMA engagement. Following a usability study of three pilot cases, users requested an enhanced feedback mechanism in VIC to better inform individual knowledge gaps in PPMA patient assessments. Our project is aimed to develop and standardize the scoring/feedback mechanism of PPMA VIC cases to reflect community pharmacy practice and provide case-specific feedback to users more accurately.

Approach(es)
A preliminary scoring table was created incorporating feedback from the usability study of three PPMA VIC cases and by consulting the curricular resources on PPMA. Three independent pharmacy-student assessors then applied the scoring table on three VIC cases and regrouped to reach a consensus on the final scoring table. The final scoring table was then applied to the entire series of 14 PPMA VIC cases by four independent reviewers, followed by consensus generation.

Findings
The final scoring table was separated into five “point” levels: 50, 25, 15, 5, and 0. If a PPMA VIC user asks all 50-point questions, then they have completed a core patient assessment of the respective minor ailment. If the user also asks the 25-point questions, then they will be able to recommend patient-specific interventions. For the 15-point questions, they represent best practices for general patient-centered care. The 5-point questions are unrelated to the specific minor ailment, but present opportunities for health promotion. Finally, 0-point questions are irrelevant/unnecessary PPMA patient-assessment questions.

Discussion
Through an iterative/consensus-generating process, we developed and standardized the feedback mechanism of a series of 14 PPMA VIC cases. With this enhanced scoring method, pharmacists may better engage in the VIC learning experience and reflect on their strengths and weaknesses in PPMA patient assessments.

Barriers/facilitations
If more standard setters could be involved, we could further refine our consensus-generating process. Once the feedback mechanism is standardized, it can be applied to all PPMA VIC cases across the board.

Impact/relevance to the advancement of the field of CME/CPD
CPD programming with a built-in feedback mechanism is always preferred by learners. A standardized scoring/feedback mechanism of PPMA VIC cases will not only better reflect real-life pharmacy practice, but also provide case-specific feedback to learners, a win-win advancement in CME/CPD.

21. Bite-sized Educational Resources and a Virtual Community of Practice to Engage Healthcare Professionals and Students in Quality Improvement

Author(s)

• Certina Ho, BScPhm, MISt, MEd, PhD, Director of Program Evaluation and Scholarship, Dept of Psychiatry, Leslie Dan Faculty of Pharmacy, University of Toronto
• Eulaine Ma, BSc, PharmD, Pharmacy Resident, University of Toronto
• Annie Yao, BSc, PharmD, PharmD/MBA Student, University of Toronto
• Wei Wei, BSc, PharmD, Pharmacy Resident, University of Toronto
• Pamela Molina, PharmD Student, PharmD Student, University of Toronto

Purpose/problem statement
Bite-sized educational content (e.g., infographics, podcasts, video microlessons) about quality improvement (QI) can be shared online and tailored to diverse learning styles of healthcare professionals (HCPs) and students. A virtual community of practice (CoP) facilitates knowledge exchange/translation of QI initiatives among HCPs/students. We aimed 1) to develop and evaluate educational resources for HCPs about QI concepts using infographics (Online Pocket Guide to QI; PGQI), video microlessons, and provide real-world examples of QI/leadership (Leading with Quality Podcast; LQP); 2) to engage HCPs/students by featuring the content in a virtual QI CoP.

Approach(es)
Development of educational resources involved consulting national/international resources for training HCPs on QI (PGQI, video microlessons) and interviewing guest speakers (e.g., faculty members, clinical directors) about their experiences with QI/leadership (LQP). Resources were featured on a QI CoP for pharmacists hosted on QID. The PGQI and LQP were individually pilot-tested to a convenience sample of Canadian pharmacy professionals/students through online surveys based on Kirkpatrick’s four-level training evaluation. We asked about perceived value, relevance, and knowledge gain after reviewing the PGQI or LQP.

Findings
The PGQI, video microlessons, LQP and QI CoP have been developed. Survey respondents for both PGQI (n = 20) and LQP (n = 20) found the materials to be relevant and easy to understand, indicated improved knowledge on QI and/or leadership, and recommended the resources to other HCPs/students. PGQI respondents suggested more external resources, QI examples, and case scenarios, while LQP respondents suggested improving clarity by explaining concepts and jargon at the beginning of the episode, and to divide some episodes into two sessions for greater elaboration of subject matter.

Discussion
Our bite-sized content (PGQI and LQP) will serve as resources to support a virtual QI CoP for HCPs/students for knowledge exchange, personal and professional development, and fostering HCP/student leadership in QI.

Barriers/facilitations
HCPs/students may have different prior learning experience on QI and related aspects. It might be challenging to accommodate the various learning styles and learner needs, despite various modalities of teaching strategies were used in the QI CoP. Bite-sized educational content and/or microlearning are likely the solution going forward.

Impact/relevance to the advancement of the field of CME/CPD
CPD curriculum developers may consider adopting microlearning or bite-sized CME content to accommodate the current learning environment where HCPs/students are often overwhelmed by digital information from social media and/or the internet. Microlearning provides learners with spaced learning of small chunks of new/refreshed content, enhancing overall knowledge retention. 72. Piloting Reflective Discussion as RSS Learner Evaluation

Author: Marci Fjelstad, MPH, MBA, CHCP, CME Director, University of Utah

Purpose/problem statement
For our Regularly Scheduled Series (RSS), we do an annual evaluation with learners, trying to assess what they’ve learned and put into practice over the past year of the series. Typically, this is in a survey format and our response rate is very low. Learners report survey fatigue, lack of time, and frustrations over completing the survey multiple times for the different series they participate in. Directors get the survey results, but sometimes express confusion over a specific response or wish they could find out more. Learners complete the survey in a silo, reflecting only on their own experiences, perhaps forgetting about specific topics covered and definitely missing the team approach to reflective feedback. We wondered: could we improve this experience for our learners and still collect the important individual learner feedback about changes they made in their practice?

Approach(es)
We asked our learners and directors for feedback, surveyed our peers, and scoured ACCME’s SACME’s CE Educator’s Toolkit. Eventually, we decided to try a discussion-based semi-structured group interview option for RSS learners. At the beginning of our annual evaluation RSS period, we offered the option for RSS to opt-in to this exciting new method of collecting learner feedback. For those series that expressed interest, we then followed up to confirm a date that they would include the feedback discussion in their upcoming series. For the series that confirmed a date and engagement in the new methodology, we provided a very short interview guide with four questions to ask during the feedback collection.

Findings
Of the 125 RSS that completed our annual evaluation for the 2022-2023 academic year, 37 (30%) opted in for trying the discussion-based semi-structured interview. Of the 37 that initially expressed willingness, 24 (65%) ultimately completed the interview and provided us with learner feedback notes.

Discussion
Overall, we found the discussion-based semi-structured interview an excellent tool for collecting learner feedback from our RSS. Directors felt the feedback was richer and more team-based. Learners reported the process much more helpful to their engagement and education. The interview guide we provided included four questions, aimed at assessing what learners had changed in their practice. So outcome measures centered around that. Learners noted everything from improved engagement in team meetings to improvements in clinical diagnoses and treatments to improvements to total patient care approaches. Ultimately, we gained information about learners’ changes to practice through this useful reflective tool that helps inform the successes of our program overall.

Barriers/facilitations
We did not give enough notice to our RSS that we would offer this option and several series coordinators indicated they would like to participate next year. We asked series directors to facilitate the semi-structured interviews, using a guide we provided. This may have limited negative feedback or engagement from learners who didn’t have positive experiences with the series.

Impact/relevance to the advancement of the field of CME/CPD
There are so many creative options to collecting learner feedback. We were happy to try out something new this year. It was fun for us, fun for our learners, and fun for our activity planners! 

22. Who You Are and Where You Live Matters: Differentiating Latino and Rural Communities’ Health Disparities

Author(s)

• Cindie Garza, BBA, Senior CME Conference Coordinator, UT Health San Antonio
• Leticia Z. Bresnahan, MBA,CHCP, Director, UT Health San Antonio
• Anand Prasad, MD, Professor of Medicine, Division of Cardiology, UT Health San Antonio
• Shweta Bansal, MD, Professor of Medicine, Division of Nephrology, UT Health San Antonio

Purpose/problem statement
Latinos and rural communities are less likely to receive appropriate care causing higher morbidity and mortality within their communities.

Approach(es)
The Cardiorenal Connection CME Conference specifically focused a plenary focusing on health inequity and Cardio-renometabolic risks. Latino Health and Rural Communities were highlighted.

Findings
Latinos are 10% less likely to have and 30% less likely to die from coronary heart disease than non-Latino whites … but suffer risk factors related to diabetes, including overweight/obesity. 33% of American adults are at risk for kidney disease, and Latinos are 1.3x more likely to have kidney failure compared to White Americans. Approximately 1 in 3 U.S. adults have metabolic syndrome, Latinos — especially Latinas — appear to be at the greatest risk of developing metabolic syndrome. The reasons for this are not entirely clear. 1 in 4 Americans has fatty liver disease for Latino adults, that rate is drastically higher, and it is also rising in Latino children. Rural Communities – racial diversity increased in nonmetropolitan America over the past decade, through the population remains 76% non-Hispanic White. Diversity increased in rural America, even as the rural population declined. The rural child population is more diverse than the adult population. Growing rural diversity presents both challenges and opportunities for rural communities, people, and institutions.

Discussion
Experts outlined the culture of Latinos, i.e., intergroup contact, peer modeling, and awareness-provoking interventions. This can improve social cohesion and confidence for individual and collective action for change. They also outlined rural communities by building networks, community health needs assessment, implementation strategy, and implementation & evaluation.

Barriers/facilitations
Latinos have higher rates and are at risk for obesity, diabetes, cancer, Alzheimer’s, and Covid. Rural Communities: older, lower education, more food insecure, economically challenged; have a higher burden of behavioral risk factors; higher burden of metabolic risk factors; lower access to health care; and lower access to internet and transportation.

Impact/relevance to the advancement of the field of CME/CPD
With the epidemic of diabetes and aging of the United States Latino population, physicians will continue to face a growing number of patients with renal and cardiovascular disease. This CME program will serve to help foster education and discussion about the intersection of these two pathophysiologic systems. The Rural Community areas for consideration are becoming more racially diverse, thus analyzing the environment, engaging with the potential partners, developing a collective strategy, and reviewing requirements and seeking technical assistance is paramount.

23. Maternal Morbidity and Mortality in Women at Risk with CV Disease: A CME Program to Address the Issue

Author(s)

• Cindie Garza, BBA, Senior CME Conference Coordinator, UT Health San Antonio
• Leticia Z. Bresnahan, MBA,CHCP, Director, UT Health San Antonio
• Ildiko Agoston, MD, Professor of Medicine, Division of Cardiology, UT Health San Antonio

Purpose/problem statement
Cardiovascular disease is one of the highest causes of maternal morbidity and mortality In Texas the maternal mortality rate per 100,000 live births in Texas more than doubled from 10.3 in 1999 to 21.9 in 2019, above the national average. Pregnancy places a large cardiovascular stress on even a young healthy woman. For many women it is often their first interaction with a health care system, and previously undiagnosed cardiac conditions are discovered for the first time. For other women, new unexpected cardiovascular conditions arise, often in a catastrophic fashion.

Approach(es)
Nationally recognized speakers presented the most up to date information on the Epidemiology of cardiovascular disorders make pregnancy high risk and can be transmitted genetically to the fetus. Proper pregnancy counseling and team management for either pregnancy avoidance when appropriate, or making the planned pregnancy as low risk as possible were presented. Presentations on which symptoms and findings should be referred for higher care discussing best practices for treatment of these conditions during pregnancy. Management strategies for following these pregnancies closely and planning for all stages, including labor, delivery and postpartum were presented. Correct best practices for treatment of unexpected cardiovascular emergencies during pregnancy were presented . Lastly, the need for long term monitoring and management of newly recognized conditions, long term impact of these newly recognized conditions on the woman’s health, and any future pregnancies were presented.

Findings
100+ health care professional learners attended this CME Meeting and findings indicated that new knowledge was gained such as collaboration between services in complex patients is key, medical ethics regarding abortion to include a better understanding of Texas law, new hypertension guidelines, and disparities with maternal pregnancy and CV diseases as it relates to demographic/social determinants of maternal death.

Discussion
Experts outlined the epidemiology and pathophysiology of newly recognized or newly developed cardiovascular conditions during pregnancy.

Barriers/facilitations
Epidemiology and pathophysiology of preexisting cardiovascular conditions are known to have an adverse impact during pregnancy. New cardiovascular symptoms in young pregnant women with no known prior medical disease is underappreciated. Many women and their physicians do not appreciate the need for continuing monitoring and treatment of their newly recognized condition and then later represent with advanced problems.

Impact/relevance to the advancement of the field of CME/CPD
This CME program is designed to help primary care providers better recognize and refer to women with cardiovascular conditions before pregnancy; and for all providers who encounter pregnant women with cardiovascular disease to better manage them for safer outcomes.

24. Publish, Perish, and Precarity: a Qualitative Study of Medical Scholars’ Experiences of Academic Productivity During the COVID-19 Pandemic

Author(s)

• Sophie Soklaridis, PhD, Scientific Director and Senior Scientist, Centre for Addiction and Mental Health
• Georgia Black, BA, Research Analyst, Centre for Addiction and Mental Health (CAMH)
• Anna MacLeod, PhD, Professor and Director of Education Research, Dalhousie University
• Kinnon R. MacKinnon, MSW, PhD, Assistant Professor, York University
• Constance H. LeBlanc, MD, FCFP(EM), MAEd, CCPE, MBA, Professor, Department of Emergency Medicine, Dalhousie University
• Christine Chambers, PhD, Professor, Dalhousie University
• Vicky Stergiopoulos, MD, Professor, University of Toronto, Centre for Addiction and Mental Health
• Fiona Clement, PhD, Department Head, University of Calgary
• Brett Schrewe, MDCM, MA, PhD, FRCPC, Assistant Professor, Division of General Pediatrics, Faculty of Medicine, University of British Columbia
• Jayna Holroyd-Leduc, MD FRCPC, Department Head, University of Calgary
• Valerie Taylor, MD, PhD, Department Head, University of Calgary
• Ayelet Kuper, MD, DPhil,FRCPC, University of Toronto

Background/purpose/inquiry question
The COVID-19 pandemic exacerbated and exposed existing inequities in academic medicine. In particular, the pandemic highlighted the precarity of academic labor where some faculty experienced a disproportionate reduction in the time they had available to dedicate to activities that are often linked to career progression. Early analyses focused on the impact of pandemic restrictions on the academic productivity of women scholars. However, there was a lack of literature exploring the experiences of scholars from a broader range of equity-deserving groups and how scholars’ various intersecting identities interacted with wider structural systems related to productivity during this time. To address this gap, we conducted a qualitative study with the aim of exploring medical scholars’ intersectional experiences of managing their academic activities during the COVID-19 pandemic.

Theoretical framework(s)
We conducted this work through a constructivist grounded theory (CGT) lens. CGT is a qualitative approach which focuses on generating novel theories to explain social phenomena. To conceptualize our research problem, we used the neoliberalization of academic institutions as a ‘sensitizing concept’; working towards a theoretical understanding of how participants’ experiences during the pandemic interacted with meritocracy, performativity, and individualism in academic medicine.

Methods
We conducted semi-structured virtual interviews with 24 medical scholars from across Canada, exploring their experiences of navigating productivity during the pandemic. We aimed to interview participants who held varying levels of institutional power and who also identified as members of equity-deserving groups. Interview transcripts were iteratively analyzed using a CGT approach.

Results/findings
A core overarching theme was the interplay between participants’ experiences during the pandemic and broader social movements, including the increased demand to implement equity, diversity, and inclusivity measures. With this as a foundational concept, we constructed three major themes: 1) “Fixing” the problem; 2) Why change feels (im)possible; and 3) The breakdown of the neoliberal promise. In our analysis, we explored how these themes interacted to produce a sense of disillusionment amongst some scholars, altering their understanding and relationship to the concept of productivity.

Discussion
Our findings provide insight into how medical scholar’s relationship to current working norms in academia may have shifted in the wake of the pandemic. We discuss how this shift may have ruptured some scholar’s relationship with precarious neoliberal systems in academia that are reliant on individual competition. Overall, our work speaks to how these ruptures may provide an opportunity to move towards more collective and collaborative models of science.

Limitations
Although we aimed to recruit as diverse a sample as possible, it should be noted that this was somewhat impacted; in part due to additional time constraints on scholars from equity-deserving groups during the pandemic. This will be explored more closely as part of this presentation.

Impact/relevance to the advancement of the field of CME/CPD
Faculty from equity deserving groups – including CME/CPD educators and scholars – experienced disproportionate interruptions to their work during the pandemic, potentially impacting future career progression. This could widen the existing equity gap in academic medicine and by extension the field of CME/CPD where diverse leadership is crucial to working towards fairer and more equitable systems of medical education and healthcare.

25. Getting to the Heart of Prostate Cancer: Expanding Options to Improve Outcomes for Men of Color

Author(s)

• Michael J. Burk, BS, Senior Program Operations Manager, Projects, Boston University Chobanian & Avedisian School of Medicine, CCE
• Mark Katz, MD, Assistant Professor of Urology, Boston University School of Medicine
• Alicia Morgans, MD, Genitourinary Medical Oncologist, Medical Director of Survivorship Program, Dana Farber Cancer Institute
• Jasmine Patel, PharmD, BCOP, Clinical Pharmacy Specialist – Hematology/Oncology, Boston Medical Center

Background/context/purpose
The approach to metastatic prostate cancer has evolved immensely since 2014. Most treatment agents used in these settings are novel, hormonal-based agents that are given in combination with androgen deprivation therapy (ADT). As a backbone of therapy, ADT is given indefinitely in most men with metastatic disease. ADT therapy is not without risk- long-term use has been associated with an increased risk of cardiovascular events. This risk may be compounded in Black men, where the incidence of cardiovascular disease is higher. Hence, it is imperative to minimize or reduce the risk of cardiovascular complications. This CME initiative highlighted the multidisciplinary approach to ensure appropriate care for patients and bring awareness to the under-recognized risks of ADT. It provided targeted education to multidisciplinary prostate cancer providers, including urologists, medical oncologists, and advanced practice providers.

Theoretical framework(s)
Diversity, Equity and Inclusion (DEI) framework

Methods
Webinar Series: A series of six, 1-hour CME/CNE/CPE live webinars for community-based oncology clinicians. For each webinar, two clinicians presented cases with analysis. Outcomes included polling questions, a knowledge posttest, and evaluation. Enduring activity: A stand-alone, 1.25-hour CME/CNE/CPE module hosted by myCME, and PowerPak. Outcomes included polling questions, a knowledge pretest/posttest, an evaluation, and Follow-up survey on practice changes.

Results/findings
Webinar Series: 146 learners attended the 6 webinars. It received a 4.39 rating on a scale of 1-5. 71% of participants felt that the learning objectives were fully met and that 44% of respondents made commitments to change their practice. Online Digital Enduring activity: Had 4,221 unique visitors, 1,966 awarded certificates. It received a rating of 4.45 on a scale 1-5. There was a 178% improvement in the posttest knowledge scores. 64% of respondents made commitments to change their practice and 67% of follow-up survey respondents were able to implement changes in practice. 77% of participants felt that their ability to work effectively with interprofessional team members was improved.

Discussion
The high satisfaction ratings, along with a 178% improvement in posttest scores for the online activity, represent a significant impact on the participants’ knowledge. 64% of respondents also made commitments to change their practice. Specific changes that were planned to be implemented include: “Be aware of the risks that people of color face with prostate cancer” “I now feel when I cover the prostate service, I will have a better understanding of the medications and potential side effects.” “Increase education and awareness of prostate cancer in black men.” “Make changes in how I communicate with/educate my patients and/or their caregivers.”

Impact/relevance to the advancement of the field of CME/CPD
Increased the participant’s awareness of the health disparities for Black men with prostate cancer and understand the prevalence of prostate cancer amongst Black men and improved their patient communication skills. And integrated a multidisciplinary approach into treatment decisions for patients initiating ADT and novel antiandrogens for prostate cancer. This is exemplified by 77% of participants feeling that they are now better able to work effectively with interprofessional team members to enhance care and that 80% of participants felt that they were better able to understand the abilities of the team members.

26. Continuing Professional Development Credits – Pharmacy Education’s New Continuing Education Credit Approach to Content Implementation

Author(s)

• Glen Baumgart, PhD, Director of the Center for Continuing Professional Development, The University of Texas at Austin, College of Pharmacy
• Logan Murry, PharmD, PhD, Assistant Director of the Continuing Pharmacy Education Accreditation Program, Accreditation Council for Pharmacy Education (ACPE)

Purpose/problem statement
In January 2023, the ACPE Board of Directors approved criteria for organizations to develop a Continuing Professional Development Program (CPD). In addition, A Model for Continuing Professional Development Credit was approved. Implementation of the CPD criteria and credit framework is planned for January 2024. During this session, attendees will receive updates on CPD policies and procedures and participate in a discussion on how CPD Credits could be implemented to help with existing programs from dissemination through implementation.

Approach(es)
ACPE along with a variety of professionals in pharmacy and other professions have been working to introduce CPD into the process of re-licensure for pharmacists. The ACPE CPD committee was tasked with developing a proposal for how to best implement CPD. In the fall of 2022, the committee submitted a proposal that integrates CPD into the existing systems for CPE existing structures with an emphasis on continuous learning and implementation of CE content into practice.

Findings
This is not a research project, but a major national policy change in regards to the integration of CPD. Multiple research groups are currently being founded to study the impact of this major CPD policy advancement in a major healthcare profession.

Discussion
ACPE has been working on criteria and credit framework with a goal of launching the process in January 2024. CPD Credits are proposed to be equivalent to at CPE hour, but are awarded to pharmacists who follow the CPD cycle of self-guided learning. Providers would have authority to award CPD credits when a pharmacist is able to provide documentation meeting CPD standards. This process would allow individual pharmacists and organizations to conduct training useful for specific practice resulting in significantly improved process for continuing education.

Barriers/facilitations
Starting in January 2024, organizations may apply to become CPD Providers, a separate providership from CPE Provider status. The initial stage will also include policy changes among state boards of pharmacy in order to recognize CPD Credits in the same way CPE hours are for pharmacists re-licensure. The goal is to see how the various providers will implement CPD training, and make adjustments as needed. This process allows for flexibility and review, however, it is a new process where problems are likely to occur.

Impact/relevance to the advancement of the field of CME/CPD
The CPD Credit process in pharmacy is a major shift in how CPD can be implemented in healthcare continuing education. Here, the traditional CE standards are in a way flipped where the pharmacist is in charge of meeting the standards and design for their own learning. The CPD process is used by the professional to implement knowledge and skills into practice, reflect, report, and shift as needed. This implementation process is the first approach in healthcare CE where credit is awarded for the actual implementation of CE.