By Kelly Mantick
Dr. Dave Davis, winner of the 2016 Lifetime Achievement Award, dedicated his career to continuing medical education. Since the early 1970s, Davis has been ahead of his time, putting together interprofessional groups, conducting evidence-based practice, creating a knowledge translation program and much more. Through teamwork, an intense curiosity and a drive to “do it himself,” Davis’ career has ultimately come down to one factor — focusing on the patient.
While he is a current enthusiast and leader in the CME world, he came into the profession, like many CME experts, somewhat by accident. After graduating medicine from a traditional school, he completed an internship followed by two years in pathology. “While I enjoyed pathology very much, for a variety of reasons, I decided I would become a general practitioner to try it out,” Davis says. “However, I didn’t know enough to really practice in the way I wanted to, so I started attending continuing education conferences, thinking that would be a way to increase my learning. But I wasn’t learning in the way that I should to apply the best practices in medicine.” In short, Davis explains that the classes failed him. So, he decided to chair his own committee, which brought in speakers and conducted its own small group learning in family medicine, at his local hospital. After leading this endeavor and obtaining his certification in family medicine over the next three or four years, Davis left to work in Hamilton, Ontario, at a newly formed medical school at McMaster University.
As a nascent medical school, it did not yet have a CME director, and “somebody put my hat in the ring,” Davis says. Serving as a full-time certified family practitioner already, Davis decided to take on this part-time role as well. “I discovered pretty quickly that part time meant you’re expected to work full time but you only got paid part time,” Davis laughs.
Prior to joining McMaster University, Davis became acquainted with the former chief of medicine who had recently stepped down. With a little more time on his hands, the former chief of medicine joined forces with Davis to create an interprofessional CME group, before the term “interprofessional” came into popularity. Calling upon nurses, nursing and service directors, and physical therapists, the group led interprofessional grand rounds, something that had never been done before. Davis says that, while successful, the group had to fight for this initiative. “Surgeons would say, ‘If there’s a nurse in the room, I know I’m not learninganything.’ But we fought and we won and we were, I think, pretty successful,” Davis explains.
When it comes to CME programs, Davis doesn’t necessarily go for the traditional didactic lectures, perhaps harkening back to his earlier days when the outdated classes didn’t teach him what he needed to know about family practice. For example, while at McMaster University, Davis and a group of individuals led by John Premi, MD, adapted the undergraduate, small group, problem-based learning model and applied it to continuing education. The team provided printed materials for the learners to read about a new guideline or disease topic and a case study. In groups of seven or eight, the learners discussed these materials amongst themselves. “That small group learning program grew and matured, and it is now country-wide in Canada, facilitated by the College of Family Physicians of Canada. It truly is a very powerful group learning activity for primary care physicians,” Davis says.
McMaster University, known for educational innovation and evidence-based medicine, provided all the elements that drove Davis further down the CME rabbit hole. Here, he was approached by the dean, who asked him, “Does CME work?” Davis recalls his response, “I said, ‘Yeah, CME works. It brings in revenue to the new medical school, it builds the reputation of the medical school because your faculty are going out in the communities and giving lessons and lectures, and it brings people in so they’ll see the brand new shiny building — it will do all those things.’” But that wasn’t what the dean was looking for, and he clarified his point by asking, “Does it change patient outcomes or healthcare outcomes? If it doesn’t, why are we doing it?” And Davis’ reply? “I’ll provide it.” Looking back, he says, “That created a lifetime interest in analyzing the research of others in a systematic fashion, called systematic reviews, and creating papers around that.”
Davis put this drive for answers and results to good use at the University of Toronto, which, as a larger university in an even larger city, provided a new set of challenges. “It was finding the right way to facilitate continuing education in this very large and complex system. So, we did that with the help of a large committee,” Davis says. Together, the committee developed several deliverables for learners, such as mini med schools to teach patients about their illnesses. Davis was also the founding director of the Knowledge Translation Program, which took continuing education into the healthcare world by developing a robust study program. Using audioconferencing — the video conferencing of the past — Davis helped cultivate several large research grants. Eventually, he moved on to the Association of American Medical Colleges (AAMC), where he was excited to learn more from his American colleagues. Together, they created Education for Quality. “Educating for quality is a consultative process to help CME offices blend, integrate and align their activities to help faculty members become more current in quality improvement. Then, they can develop skills to help disseminate that knowledge about quality improvement of patients,” Davis says.
Looking back, Davis notes how lucky he is to have a career in continuing education that has lasted over 40 years. “I’m very grateful for the Lifetime Achievement Award and verygrateful to the Alliance for this opportunity to share a career with many Alliance members,” Davis says.
With all of the knowledge Davis has gained throughout his career, he has some wisdom to share with fellow continuing education professionals. First, he bids that CME professionals always remember and prioritize the patient. “No matter our level of education or our personal experiences, we have all at some point been patients or had family members who were patients.”
To that end, Davis says that it’s important to remember the doctor-patient interaction, or the health professional-patient interaction. He explains that in every interaction, the CME provider is an invisible presence in the room. “What does the doctor know, how is he or she listening to the patient?” Davis says, “What level of knowledge does he bring, or skill does he bring? Does he know about the most recent guideline? Is he prepared to push himself in a way that extends himself to the patient or to the problem that the patient presents? And if he does, or she does, then CME has played a really important role.”
Finally, Davis expresses the need to think of CME as a valuable profession. “Value CME in the healthcare system, rather than looking at it as, ‘Well, we had 500 registrants at this last conference and we made a little bit of profit’ — that’s not the true value of CME. The true value of CME is in that patient encounter and that patient outcome.” In other words, there’s so much more to CME than merely being a provider of activities or events.
And these unique qualities are what have kept Davis excited and passionate about the profession, ever since he created his own programs to continue his education in family practice. Helping people, meeting people, learning from people all drive Davis to continually pursue new and better options for CME. Whether its relationships with team members, patients, mentors or learners, for Davis, his interactions with the people around him have made his career what it is: fun. “Working with other people to create projects like this and seeing outcomes improve make it fun,” Davis says. “We’re doing something that is fun, and it’s also meaningful.”
Leading from Behind
Dr. Dave Davis has led a number of teams and has gained a wealth of leadership know-how throughout these experiences. He shares some of his top advice:
- Create the vision. Davis points out that, in CME, this more often than not revolves around the patient.
- Choose the people. You need the right people around the table, Davis says. He uses the example of his Knowledge Translation Program — without the right teammates, it would never have come into fruition.
- Be enthusiastic. “It’s hard not to get excited about creating a program to reduce patient error,” Davis attests. Keep your enthusiasm high, and others won’t be able to stop themselves from following suit.
- Lead from behind. Davis explains that he doesn’t like being a typical “boss,” portioning out tasks to the group. Instead, he recommends facilitating the group process. For example, if there are five things that need to get done and five people around the table, Davis is the first one to volunteer to complete one of these assignments. He emphasizes the importance of allowing everyone to “jump in” to the project and apply their skills, rather than the leader only using his or her own thoughts.
Enhance Your CME Powers
Dr. Dave Davis attributes much of his success to a few different factors:
- Seeking out the literature in continuing education. Ask your colleagues, go online, subscribe to a journal – do your research! Davis explains that not everyone needs to become a researcher, but all continuing educational professionals need to be informed about what’s best in lecturing, what works, how to utilize interactivity, what small group learning is and more, so that when they talk to practitioners, clinicians and learners, they are knowledgeable and can create thoughtful programs.
- Finding mentorship relationships. “I can’t tell you the values that I place in the mentor relationship,” Davis says. While these mentorships haven’t necessarily been traditional or formal, he explains the importance of learning from other people to gain new skills. “There isn’t anybody on the planet who wouldn’t say yes if you sat down with them and said, ‘I really value your expertise, I wonder if I could learn from you. Could I have 15 minutes of your time now and could I buy you a cup of coffee next week?’”
- Getting involved in a team. By joining a team, Davis says, you are getting the benefit of learning from more than one mentor, whether it’s a formal team working on a program or an informal team in your personal life. Davis sites his Knowledge Translation Program, which included graphic designers, clinical engineers, information technologists and more. With more than 20 disciplines represented, Davis learned information from many different industries.
Currently, Dr. Dave Davis is a senior consultant to medical education at the Association of American Medical Colleges. He is also a senior consultant to the Mohammed Bin Rashid University of Medicine and Health Sciences in Dubai, UAE, while serving as a professor at the University of Toronto.