By Philip A. Dombrowski, MBA, FACEhp, Joseph S. Green, PhD, and Marcia J. Jackson, PhD
Part one of this two-part series described the importance for a specialty society to develop and maintain a relevant education strategy. Such a strategy, consonant with the society’s overall mission and goals, enables the society to remain relevant and responsive to the changing research, clinical practice, political, economic and education environment. The nine goals you see below (and find in full in part one) were proposed to support the attainment of the education vision and mission undergirding a specialty society’s strategic plan and have been presented in a logical order, as each goal is linked to the preceding goal.
Part two in this two-part series presents specific action steps to implement each of these goals.
Selection of Appropriate Goals
An important first step for a society to undertake is for its education leadership to determine which of the above goals are most critical to be accomplished by the society. Each society might select different goals, depending on their organizational realities. Some might only focus on accomplishing one goal; some societies might plan to focus on some or just a few of these goals; but some might hope to accomplish all of the goals within an identified span of time. These decisions might be based on answers made by the society’s leadership to criteria such as these: Is this goal essential to the success of our education program? Will the attainment of this goal impact the society in a positive way? Has the goal been met to date? Do we have the member and staff resources available to accomplish the implementation tasks for the goal? Do we have the financial resources to accomplish the implementation tasks for the goal? Can the goal be accomplished in a reasonable time frame? The society’s leadership might well have other criteria to add to this short list. The society could create a questionnaire designed to measure each criteria on a scale from 1-5, where 1 is “most likely NOT” and 5 indicating “most probably YES” and asking key stakeholders in the education program to complete this questionnaire.
Another process would be for the society to appoint an ad hoc task force, guided by member and staff co-chairs, comprising the most trusted and accomplished staff and member educators to lead the planning of an education strategic plan. As an initial activity, each task force member could be asked to complete this questionnaire and identify any others within the organization who also should be asked to do so. After summarizing all the data, the task force members would select which goals would be the target of the strategic planning effort, the order in which they would be undertaken, over what time frame and at what projected cost. These decisions should also be informed by the implementation tasks essential to accomplish each of the identified goals.
Listed below are some proposed tasks to implement each of the nine goals. These tasks are meant to be suggestive, not comprehensive.
Reconfirm or edit a new education vision and mission, linked to the overall society’s vision, guides, strategic planning and implementation plan.1,2
- Reconfirm consensus on education mission and vision.
- Seek organizational approval as necessary and beneficial.
- Assess annually the extent to which the education program fulfilled the mission; based on this analysis, suggest improvements or changes as necessary to either the education program plan or the mission.
- Assess annually the degree to which the education program contributed to the overall society’s vision and mission.
- Annually review the “education strategic plan” implementation, modifying it as necessary for continuous improvement of the process.
Create and establish a purposeful “backward’ program planning process” that links learning activities to quality of care outcomes.3
- Identify essential elements comprising steps in a backwards program planning process that links educational activities to quality outcomes.
- Develop tools/templates/forms necessary for the successful implementation and assessment of the planning process.
- Create training in this process for all individuals involved in planning or implementation of any learning activity.
- Monitor the implementation of the planning process and the tools/templates/forms, requesting feedback on their utility from users.
- Assess the new planning process, including cost/benefit analysis; create/implement improvements as necessary to increase the annual number and/or percentage of activities based on this more effective planning process.
Identify comprehensive learning needs for all relevant physicians and health professionals and patients with respect to required knowledge, skills and attitudes.4
- Establish a member/staff working group to oversee needs assessment functions.
- Identify data sources for understanding gaps in health professionals’ competence, performance, or clinical care (e.g., journal articles, self-assessment results, activity evaluations, government reports, quasi-government organizations in the quality arena, etc.).
- Identify gaps/needs in each identified competency area of a core curriculum.
- Create needs assessment reports (needs assessment synthesis, gaps in clinical care) for each identified topic area in a core curriculum.
- Create a comprehensive annual needs assessment summary report for each competency-based topic area in a core curriculum; create a centralized repository of all identified learning needs.
- Disseminate centralized learning needs summary report to all relevant planning committees.
- Annually assess value of needs assessment report to the planning process and suggest necessary improvements in the summary reports.
- Repeat this process on an annual basis.
Create content based on the identified competencies in a core curriculum and learning gaps of physicians and health professionals and referring physicians and patients.
- Identify competencies and learning gaps.
- Identify resources to provide a framework for competency delineation (e.g., alignment with re-certification requirements).
- Delineate competencies for the identified knowledge domains within a core curriculum.
- Make the following planning decisions for each proposed learning activity, based on what is most likely to meet the identified learning needs of the target audience(s): intended outcomes, objectives, content, faculty, format, methods, sequence, assessment of outcomes.
- Implement this process incrementally over time, based on valid and reliable data and continually improve it by evaluating its effectiveness each year.
Meet the individual and group learning needs of all physicians and health professionals providing care to patients and to referring physicians and patients worldwide through an education program and learning activities aligned with the society’s education vision and mission.
- Identify all health professionals involved in the global care of relevant patients.
- Rate each of the above groups’ roles against the following criteria: criticality of that role to quality care, ease of access to the community of professionals, individual professionals or patients; cost of entry to that community, role education has in improving care by that community, competencies, and cost/benefit analysis.
- Analyze the amount of current programming directed to each professional role and to patients.
- Determine the extent of revised or new programming needed for professional audiences or patients of highest priority based on ratings.
- Develop selected international member/speakers on country-specific, cultural sensitivity.
- Pilot the implementation of new activities to any top priority, new audience of professionals/patients.
- Evaluate annually the alignment of society learning activities with professional audiences and patients based on priority and modify as necessary or desirable.
- Identify top priority countries for education programs (market potential, size of market, number of member health professionals to population, number of care centers to population, level of experience/expertise, need/interest in assistance from society, etc.)
- Develop and implement country-specific cultural sensitivity training for US faculty.
- Assess current relationships with foreign national societies and explore feasibility of cooperative scenarios, e.g., create a national affiliates, access to society education program, etc.
- Consider establishing a society international speakers’ bureau and create criteria for faculty selection into the bureau.
Disseminate knowledge using innovative formats (including live and web- and technology based learning) and methods consistent with the learning needs of the specified target audience(s) and learning activity objectives.
- Evaluate and prioritize available educational formats and methods and suggest which to implement within this overall education strategic planning process. Evaluation criteria for selection of formats and methods should include feasibility, available faculty champion and experience, cost/benefit, ease of implementation, fit with other activities, etc.
- Evaluate and rank each of the following formats and methods and select and pilot test multiple evaluation and dissemination methods for a specific topic, given agreed-upon evaluation criteria: a) self-assessment item bank, b) case study library, c) competency-based evaluation instruments, d) online module template, e) a subset of content from scientific sessions (e.g., regional meetings, foundational material for self-assessment items, case studies, on-line modules), f) member self-assessment products.
- Appoint a working group of young faculty to disseminate content from scientific sessions and other sources using methods consistent with their medical school training (e.g., use of technology, problem-based, current work environment).
- Develop and implement evaluation criteria to determine the success of this format and method selection process.
Evaluate educational activities with respect to higher-level outcomes including learning, professional competence, performance and/or patient care outcomes.
- Measure all current education learning activities against outcome levels.5
- Make overall recommendations for improvements and enhancements to the evaluation process.
- Identify, prepare or modify evaluation tools (e.g., commitment to change, three-month follow-up with intent to change, practice self-study, M&M/registry data, MACRA/MIPS, case studies, other outcome measures).
- Enhance the use of appropriate evaluation tools and collect outcomes data for each learning activity.
- Initiate the use of a logic model to link CME activity evaluations to higher level outcomes and organizational strategic priorities.
- Analyze data, prepare evaluation summary reports and distribute to relevant planning committees so as to facilitate improvement of the future planning processes.
- Consider creating criteria to audit the annual meeting and other courses from planning through implementation to outcomes, to include: a) interactivity, b) member experience, c) moderator role and performance, d) formats used, e) faculty slides, f) learning levels achieved, g) link between learner practice setting needs and curriculum, etc.
- Conduct a baseline audit of the current scientific sessions, using pre-defined criteria and report findings and suggested improvements to relevant planning committees.
- Re-audit future scientific sessions to assess extent to which the original audit informed and improved the next meetings; report findings and suggested improvements to planning committee.
- Make suggestions about better integration of all aspects of the annual meeting (pre-meeting course, leadership process, annual meeting sessions, and ancillary programs.)
Ensure that members and staff have the leadership, learning skills and organizational knowledge to implement successfully the strategic plan and succeed in the educational roles they are asked to play within the organization.
- Identify education member leaders and staff who will be trained on the strategic plan goals, implementation and commitment.
- Develop training goals, objectives and materials for a staff/member leader education program and/or an “emerging faculty” program, then deliver the education.
- Provide training for self-assessment item writers.
- Create a career ladder for faculty development opportunities — faculty education, course chair education, mentorship training and educational leadership and identify possible collaborators.
- Delineate education leadership competencies, chair competencies, faculty competencies, and develop an overall faculty development plan with associated budget.
- Establish evaluation criteria to determine the effectiveness of this effort to enhance member/faculty/staff educational skills and their impact on the outcomes of educational activities.
Establish an organizational infrastructure that supports the successful implementation of the education strategic plan.
- Insure that the society (staff, members, contractors, collaborators) has access to the important skill sets required to implement the education strategic plan, including clinical expertise (needs assessment, content development, planning processes, faculty support); instructional design; evaluation including experience with research, data gathering, analysis, summary/synthesis, reporting; program and project management; leadership/“sales” to interface with members, international organizations.
- Implement enhancements to or modification of current infrastructure as needed and financially feasible.
Setting Organizational Priorities
After the society has determined the relevant goals and corresponding implementation tasks to be accomplished, a final step is to create a plan for evaluating the degree to which the tasks and resultant goals are being accomplished, and assessing both the positive and negative consequences of those changes within the society. This should be an annual evaluation and assessment so that changes, deletions or enhancements can be put in place to increase the chances for success. The following value propositions support undertaking this education strategic planning process, as an education strategic plan:
- increases the chances of obtaining critical healthcare data on all educational activities that are designed to improve physician and patient outcomes;
- increases the number of society members who are knowledgeable about and supportive of the value of outcomes-based CPD vs traditional content-based CME;
- helps society members better understand practice-based gaps in their knowledge, competence and performance;
- increases internal and external resources for the invaluable role that education can play in improving healthcare in demonstrable ways;
- increases the number of members who are more meaningfully involved in the learning opportunities offered by the society;
- gathers data for the ACCME self-study and thereby be more successful in obtaining Accreditation with Commendation;
- provides guidance to better advertise and market the value of membership to those outside of the society who could benefit in their professional life; and
- increases the meaningfulness of work-life realities for the society staff.
Developing and implementing an education strategic plan supports the society in becoming an invaluable organization that identifies and meets the professional learning needs of its members in the changing landscape of today’s healthcare.
References and Further Reading
- Green JS, Grosswald, SJ, Suter E, and Walthall DB III (Editors). Continuing Education for the Health Professions: Developing, Managing, and Evaluating Programs for Maximum Impact on Patient Care. San Francisco: Jossey-Bass Publishing Co., 1984.
- Moore DL, Green JS, and Gallis H. Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities”, J Cont Educ Health Prof. 2009; 29:1-15.
- Green JS, “Program evaluation,” in Knox,A.B.,Conceicao,S.C.O. and Martin, S.G., eds, Mapping the Field of Adult and Continuing Education; An International Compendium, Vol. 4, Co-Published with AAACE and Stylus Publishing, LLC, 2017.
- Green JS and Leist JC, “Determining needs from the perspective of institutions or organizations providing CME,” in Davis, D., Barnes, B., Fox, R. eds., The Continuing Professional Development of Physicians: From Research to Practice: AMA Press, 2003.
- Davis DA, Turco MG, Rayburn, W. Continuing Professional Development in Medicine and Healthcare: Better Education, Better Patient Outcomes. Wolters Kluwer, 2017.