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Special Communication | Journal Club

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

Valerie P. Opipari, MD1; Stephen R. Daniels, MD, PhD2; Robert W. Wilmott, MD3,4; Richard F. Jacobs, MD5,6,7
[+] Author Affiliations
1Department of Pediatrics and Communicable Diseases, C. S. Mott Children’s Hospital, University of Michigan Health System, Ann Arbor
2Department of Pediatrics, University of Colorado School of Medicine, Children’s Hospital Colorado, Aurora
3Department of Pediatrics, School of Medicine, Saint Louis University, St Louis, Missouri
4SSM Health Cardinal Glennon Children’s Hospital, St Louis, Missouri
5Department of Pediatrics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock
6Pediatric Infectious Diseases Section, College of Medicine, Arkansas Children’s Hospital, University of Arkansas for Medical Sciences, Little Rock
7Arkansas Children’s Hospital Research Institute, Little Rock
JAMA Pediatr. Published online September 19, 2016. doi:10.1001/jamapediatrics.2016.2258
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Pediatric general and subspecialty care requires continuous effort to maintain knowledge and competencies in clinical practice. Equally important are efforts by investigators and educators to maintain knowledge and competencies in the conduct of research and training. The Association of Medical School Pediatric Department Chairs initiated a survey in July 2015 to define principles of lifelong learning in pediatric medicine and determine the approaches and strategies used by chairs to assess knowledge and competence across the care, research, and teaching missions. A total of 101 of 142 chairs (71%) completed the survey. Six of 7 proposed principles were endorsed by 84% to 96% of Association of Medical School Pediatric Department Chairs members. The focus areas included individual accountability, individually relevant activities, use of evidence-based guidelines/national standards, gaining cognitive expertise, learning as a continuous effort, affordability, and focus on individual understanding. The chairs endorsed a requirement for evidence of lifelong learning, competence, and compliance by all faculty members in clinical (n = 89 [88%]), research (n = 63 [62%]), and educational (n = 85 [84%]) practice. The survey identified the strategies to assess lifelong learning and faculty competence and compliance in clinical, research, and educational roles. Across missions, chairs endorsed an expectation for individual responsibility supplemented by formal evaluation practices and institutional and regulatory office oversight. While chairs endorsed an important role for the American Board of Pediatrics in assessing and verifying lifelong learning, knowledge, and competence in general and specialty certification, most (n = 91 [90%]) endorsed a need to revise current board requirements to better emphasize closing gaps in knowledge and using approaches that are evidence-based. This study provides the perspectives of pediatric department chairs on principles for lifelong learning and strategies and approaches used to assess faculty competence and commitment to lifelong learning across missions.

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Figure 1.
Strategies for Assessment of Lifelong Learning in Clinical Practice by Pediatric Department Chairs

Participants were asked the following: “Please indicate which of the following activities you use in evaluating lifelong learning in clinical practice and faculty performance in your department: (check all that apply).” N = 95 responses. MOC indicates maintenance of certification; M&M, morbidity and mortality.

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Figure 2.
Strategies for Verification of Competence and Compliance in Research by Pediatric Department Chairs

Participants were asked the following: “Verifying research-specific compliance and competence is the responsibility of: (check all that apply).” N = 93 responses.

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Figure 3.
Strategies for Verification of Competence and Compliance in Education by Pediatric Department Chairs

Participants were asked the following: “Verifying education/teaching compliance and competence is the responsibility of: (check all that apply).” N = 93 responses. ACGME indicates Accreditation Council for Graduate Medical Education.

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Figure 4.
Evidence for Maintenance of Certification

Participants were asked the following: “Is there sufficient evidence to support current requirements for [maintenance of certification] activities being necessary to verify understanding in principles of lifelong learning, knowledge, and performance in clinical practice?” N = 93 responses. The numbers in parentheses indicate the number of faculty members.

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Figure 5.
Overall Assessment of American Board of Pediatrics/Maintenance of Certification Process

Participants were asked to indicate the following: “General assessments/recommendations of the [American Board of Pediatrics/Maintenance of Certification] process (check all recommended to be considered).” N = 93 responses.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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