Column Editors: Eleftherios F. Soleas, PhD and Helen Mawdsley, EdD This column speaks to practice innovations, emerging trends, and practical high-impact tools as well as what these mean for CME/CPD.
So, Change is Scary
This year the theme of our 2022 SACME Annual Meeting is ‘Navigating Through Uncertain Times’. Let’s set the stage here by discussing change and how we organize for change. As motivation researcher, I can tell you that change is to one extent or another scary. If you are nervous about the change afoot in the world of CPD, you’re not being a luddite or a laggard, you’re being human. I’ll be human too, I’ll use my circumstance at Queen’s as a case study.
Change, what change?
We like to group things together and this gives us comfort, so let’s talk about two groups of changes and act like they are terminally unique. There are changes occurring outside of CPD organizations and changes occurring within our CPD organizations. We are focusing in this article on the changes within CPD organizations. The fact is, these within organization changes may or may not be occurring to you, but I promise you they are true for either you or someone you know and perhaps like. Funnily enough, the changes occurring in CPD organizations are being driven by forces from within and from outside the CPD organization.
The call is coming from INSIDE the house
I like to think that I am a sensitive team lead for the CPD team of the office where I live. Even if I weren’t, I would be able to tell that people are stressed. That they are stressed is not surprising, WHY they are stressed is. Our staffs (and us) are feeling overworked, because they are working outside their comfort zone, and perhaps on topics and in ways where they do not feel expert, and it shows. We had people tobogganing, and now they are doing skeleton. You might end up at the bottom of the hill, but the way down is terrifying for folks whose livelihoods depend on appearing professional, poised, and one-step ahead of the folks who they serve. Simply put, the expertise of our pre-pandemic staff is being challenged as an integral part of the office. Much of the CPD provider crowd’s expertise was predicated on in-person programming that will NEVER be as common or as used as it was before (you heard that here 1st or perhaps 51st). Simply put, our hard-fought proficiency in skills for in-person no longer single-handedly qualify us as all-around experts in CPD. My team is still reeling from this, maybe yours is as well.
What got you here as a high-achieving, productive CPD creator, seemingly doesn’t matter as much as it used to. We’re not being hyperbolic if we call this a form of grief. It’s a type of grief where we miss the past, where what we were good at mattered and got us through the day and must accept that we have to wade into an uncertain present and future, where we are learning how to do what we need to do to survive. We are essentially learning the textbook the night before we take the stage and teach everyone else.
Circumstances of the pandemic have required CPD organization to [synonym for pivot] (because I’m sick of that word) as demonstrated through the change of modalities for programs, as well as some CPD organizations accepting that they must become unwillingly leaner versus becoming leaner by choice. There are also COVID restrictions that have changed the social nature of in-person programming, depriving many of necessary human interactions. There has certainly been a loss of funding, which drives other losses. We also have changed retraining needs to contend with. Oh, and we have to deliver engaging programs virtually, and determine the best way to evaluate all of these changes to ensure we are meeting the spirit of accreditation standards
Organization and re-organization
At Queen’s, (Kingston, Ontario; it’s beautiful, come visit), we are a staff-heavy office which means that the vast majority of the leadership and function of the office is performed by staff rather than faculty. In fact, the only conventional faculty member in the whole building runs the joint. I can see pros and cons of this build. We have tons of doers, but exceptionally few clinicians on retainer. We are almost entirely reliant on our planning committees for the healthcare knowledge and proficiency. That said, a staff-heavy build benefits from stability and consistency that you can only really get from CPD being your full-time job. For clinician-faculty, CPD is more often than not, their SECOND job. Is this consultation-reliant build of office more agile and able to respond to the changing needs of CPD learners through partnerships? Maybe. If the CPD office (or pieces of it) went ‘poof’ and disappeared because of restructuring or insufficient cost-recovery, staff lose their livelihoods. This will probably matter more to staff reading this than it would to faculty. If the Faculty member lost their CPD hat would say ‘drat’ and I suppose see more patients. We’re talking about two different scales of calamity. This is why, in my perspective, staff, in the aggregate, feel and fear the changes more that faculty who have the security of knowing that there is a safety net for their gainful employment, treating patients. Agree with me or not, for CPD staff, there is much more for them at stake. Trust me, I’m one of them.
As I have slowly learned, not all CPD organizations have the same core funding. At Queen’s, we have university responsibilities in teaching, service, program organization which means we have a tranche of core funding that essentially pays for our building, our dean, and 2.75 full-time-equivalency of our admin staff members. The rest is on a cost-recovery mandate. Some organizations will have more, and some will have less depending on their circumstances. The pandemic did not magically increase our funding, yet it increased our expenses. We have a job to do and mostly our favourite tool (in-person) was conspicuously unavailable. We had to move on, willingly and unwillingly to try to do things differently.
This reality underpins the decision making on the types of program topics that a provider can offer. An office that needs more financial lift from cost-recovery to stay afloat simply doesn’t have the same resources to cover equally important, but less audience-garnering topics like Equity, Diversity, Inclusion, and Indigeneity (EDII).For this to change, funding structures needs to change. Perhaps, offering baseline funding for these under-discussed topics is a way to revamp the system and make sure that learning about these topics is consistently accessible, consistently encouraged, and consistently reinforced.
Tips, Recommendations, and Next Steps
- Think about how you are interacting with change. Are you processing, developing a response, refusing to engage, and/or embracing change? How are you meeting this change?
- With so much uncertainty, this is an excellent time to do some soul-searching. Decide what type of organization your organization wants to be. How would you find out?
- Unity of the CPD profession. We’re uncertain if there is a right response to the changes we are facing, but we’re positive a wrong answer is to try and respond alone. High-impact practices are meant to be shared and SACME is almost certainly a great place to do it.
To this end, I recognize this woefully short treatise on change in CPD is incomplete. Here are our emails (email@example.com and firstname.lastname@example.org) where you can tell us how much you (dis)liked this perspective and every perceived and unperceived factor that we missed. We’ll read every single response and listen.
Yours in Solidarity,
Terry & Helen
Eleftherios F. Soleas, PhD is Director of Continuing Professional Development, Professional Development & Educational Scholarship, Faculty of Health Sciences, Queen’s University and Adjunct Professor, Faculty of Education, Queen’s University, Kingston, Ontario
Helen Mawdsley, EdD is Director of Research, Office of Continuing Competency and Assessment , Assistant Professor, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada