Continuing Education Requirements Research Articles

Drug-related physician continuing medical education requirements, 2010–2020

IntroductionThe crisis of drug-related harm in the United States continues to worsen. While prescription-related overdoses have fallen dramatically, they are still far above pre-2010 levels. Physicians can reduce the risk of overdose and other drug-related harms by improving opioid prescribing practices and ensuring that patients are able to easily access medications for substance use disorder treatment. Most physicians received little or no training in those subjects in medical school. It is possible that continuing medical education can improve physician knowledge of appropriate prescribing and substance use disorder treatment and patient outcomes. MethodsDescriptive legal review. Laws in all 50 states and the District of Columbia were searched for provisions that require all or most physicians to receive either one-time or continuing medical education regarding controlled substance prescribing, pain management, or substance use disorder treatment. ResultsThere has been a rapid increase in the number of states with relevant requirements, from three states at the end of 2010 to 42 at the end of 2020. The frequency and duration of required education varied substantially across states. In all states, the number of hours required in relevant topics is a small fraction of overall required continuing education, an average of 1 h per year. Despite recent shifts in the substances driving overdose, most requirements remain focused on opioids. ConclusionWhile most states have now adopted continuing education requirements regarding controlled substance prescribing, pain management, or substance use disorder treatment, these requirements comprise a small component of the required post-training education requirements. Research is needed to determine whether this training translates into reductions in drug-related harm.

THE FUNDAMENTAL ISSUE OF CONTINUING EDUCATION IN SPEECH THERAPY

Studies in medicine and sciences are constantly changing with the advancement of research and new discoveries. Continuing education in a field such as speech pathology is crucial for this reason. Most developed countries, like the United States of America and countries in Europe, make education after graduation mandatory and enforce restrictions on licenses in order to encourage people to renew them. Armenia, however, does not. For example, The American Speech-Language-Hearing Association (ASHA) requires all certificate holders (CCC-A and CCC-SLP) to maintain their ASHA Certificates of Clinical Competence and their CCC-SLP by taking additional courses every few years. Countries outside of the United States, such as Canada and Australia, have similar requirements of completing extra hours of practice and education in order to maintain the speech-language pathologist license. 
 Armenia also does not have a higher board or association that legally monitors and audits speech pathologists after graduation, but they should work to establish one in order to encourage and enforce speech pathologists to complete the requirements necessary to continue their practice. Armenia is trying to modernize and change the medical education system in order to advance their professional development and allow for the international mobility of healthcare workers, but they should also work to set requirements like these for the speech therapy field in Armenia. Continuing professional development allows for cardinal information that might have been forgotten over the years after graduating or receiving a license to be reviewed and recollected. With the introduction of new technologies and methods, speech pathologists need to be informed of the new ways of practice through their continuing education requirements. Speech pathologists in Armenia can use the opportunity of continuing education to learn how to use new methods such as Armav and incorporate them into their own practices.

The employment of dental hygienists in European countries: Report of a European Dental Hygienists Federation/European Association of Dental Public Health Survey in 2021.

This survey aimed to investigate a range of topics relating to the employment of dental hygienists in European countries, whose National Dental Hygienists Associations (NDHAs) were members of the EDHF. During 2020/2021, an online questionnaire and participant information leaflet were distributed by email in each of the 24 countries, whose NDHA is a member of the EFDH or to an EADPH member who was likely to respond. The broad term employment of dental hygienists was taken to include current numbers, place of work (public or private clinics and other locations), whether they were currently working as dental hygienists, their pay, any planned changes in their employment and their participation in continuing education. Twenty-four countries (92%) responded. Hungary and Poland reported that fewer than 35% of their qualified dental hygienists were working as dental hygienists. In 10 countries, often for family reasons, over 40% worked part-time. In 14 countries, over 70% worked in private clinics. Average annual pay ranged from €8400 in public clinics in Poland to €106,000 in dental hygienist-owned clinics in Denmark Regular participation in continuing education was mandatory in only nine countries. Dental hygienists play a different role within the oral healthcare system in each European country. There is a wide variation in their education, places of employment, annual pay and continuing education requirements.

Factors associated with continuing education needs in medication administration among school nurses.

To investigate the continuing education requirements and factors influencing school nurses' needs in relation to medication administration on school campuses. A total of 391 school nurses working in K-12 schools in Taiwan were invited to participate in an online questionnaire survey. This cross-sectional study employed a probability proportionate to size technique along with a random sampling method. Data were collected from February to April 2023. School nurses reported a significant demand for continuing education and perceived moderate levels of stress and government support related to medication administration. Among the various dimensions, the highest demand was observed for 'definition of campus medication errors' and 'regulations for campus medical orders.' Moreover, the 'identifying drug interactions' and 'adverse drug effects and referrals' dimensions were identified as the most stressful aspects. Notably, perceived stress emerged as the sole predictive factor for continuing education demand, accounting for 16.1% of the variance. The study found that there was a significant demand for and moderate stress related to continuing education among school nurses. Therefore, it is crucial for the government and school nursing organizations to develop targeted programs focusing on medication administration. These initiatives should be designed to enhance nurses' capabilities and reduce their stress, thereby ensuring safe medication administration on campuses. Continuing education enables school nurses to acquire up-to-date knowledge and improve the workflow in their practice. This study highlights a strong need for education in medication administration with a focus on 'campus medication error definitions' and 'campus medical order regulations.' The government and relevant school nursing organizations should prioritize the development and implementation of continuing education programs to decrease the school nurses' stress related to medication administration. No patient or public contribution. This study adhered to the relevant cross-sectional EQUATOR STROBE guidelines.

Eating Disorder Specialist Views on Gender Competency and Education for Treating Gender Minority Patients.

Studies exploring patient experience with eating disorder specialists have reported poor gender competency among clinicians, as revealed through patient-clinician interactions. Through interviews with eating disorder specialists, the authors sought to (1) clarify how and why current practice and clinical training may not meet the needs of transgender and gender-diverse patients, (2) assess where and how clinicians received education on gender identity, and (3) how changes can be made to meet educational and patient needs. Specialists were recruited, and semi-structured interviews were conducted. Narratives were coded by two independent coders, using thematic analysis. Four key themes emerged from 19 completed interviews: Training and education received, importance of receiving training or education, self-education, and improvements recommended by clinicians. Only ~ 16% (n = 3) of clinicians reported sufficient training both in graduate school and through their place of employment. Most with sufficient education received it at their clinic/practice. Despite lacking formal training, all clinicians engaged in some form of self-education on gender. These findings support the need for standardized and comprehensive graduate curricula, in-service training, and continuing education requirements. Advocacy is required to encourage accrediting organizations to mandate training on gender among mental health clinicians.

Can US Medical Schools Teach About Structural Racism?

Since the beginning of COVID-19 and the rise of social justice movements sparked by the murders of George Floyd and Breonna Taylor in the summer of 2020, many medical schools have made public statements committing themselves to become antiracist institutions. The notions that US society generally, and medicine, are rife with structural racism no longer seems as controversial in the academic community. Challenges remain, however, in how this basic understanding gets translated into medical education practice. Understanding where the profession must go should start with understanding where we currently are. Prior to the events of 2020, in the spring of 2018, we conducted nine key informant interviews to learn about the challenges and best practices from schools deemed to be positive deviants in teaching about structural racism. Our interviews showed that even those schools deemed positive deviants in the amount of teaching done about structural racism faced significant barriers in providing a robust education. Significant structural change, perhaps far beyond what most schools consider themselves willing and able to engage in, will be necessary if future US physicians are to fully understand and address structural racism as it affects their profession, their practice, and their patients.

An Examination of Assisted Living Facility Administrator Qualifications Across States

ABSTRACT Resident acuity, Medicaid’s increased role in funding assisted living, and the COVID-19 pandemic have brought increased attention to the regulatory environment of assisted living facilities (ALFs) and the responsibilities of ALF administrators (ALFAs) are growing increasingly complex. This study explores, describes, and compares the education (degree and assisted living-specific training), experience, exam (competency), and continuing education requirements for ALFAs across all states, and how states’ requirements compare to national assisted living associations’ suggested standards for entry-level and ongoing practice. Wide variation in ALFA qualifications are identified, with some states found to have extremely low qualification requirements.

Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare.

Nurses suffering in silence: Addressing the stigma of mental health in nursing and healthcare.

A modified Delphi study to establish consensus on continuing education requirements for pharmacists' relicensing in Saudi Arabia.

Continuing education is a key priority for pharmacy workforce development and the achievement of the nation's health goals. The current study was conducted to evaluate continuing medical education requirements for pharmacists' re-registration in Saudi Arabia. It also aimed at establishing a continuous professional development (CPD) system that fills the gaps in the current continuing medical education (CME) system. A modified Delphi method was utilized. Data extraction and statement development (review of key documents) was initially conducted by benchmarking the current CME requirements for pharmacists' re-registration in Saudi Arabia to continuing professional development models from 3 countries: the UK, Ireland, and Australia. This stage identified the gaps in the current model and was used in developing the data collection tool (11 statements). A 3-round Delphi, with 15 expert panel members, was used to reach consensus and to establish a suggested guideline document for a national CPD model for pharmacists' re-registration in Saudi Arabia. A CPD model for pharmacists' re-registration was developed. Panel members reached consensus on the need to shift the current CME system to a CPD model and individualize CPD plans according to the pharmacists' identified knowledge gaps and areas of practice. They agreed on the incorporation of unplanned activities and non-accredited CPD activities into the new model if they improve pharmacists' practice. They also noted that the current biennial re-registration is appropriate, considering pharmacists' busy work schedules. This study used the modified Delphi technique to develop a suggested CPD model for pharmacists' re-registration in Saudi Arabia. Expert panel members reached consensus on shifting from a CME model to a CPD model, increasing CPD credits to 40 per annum and incorporating unplanned CPD activities, while keeping re-registration to every two years.

Process Alpha: How to Construct and Manage Optimized Venture Portfolios

The author provides a specific strategy to design and manage an optimal venture investment strategy, regardless of the venture thesis. The author first discusses the contributing factors that have contributed to the consistent underperformance of the median venture capital fund performance and highlights the recent research findings and actions taken by Sequoia Capital to frame the direction of the innovation in the venture fund model. He then offers specific examples of how an optimal fund would be structured and managed, presuming there is proper reporting and analytics available on the individual portfolio companies. Last, the author makes a case for professionalizing the venture industry with recognized training, curriculum, and a certification and continuing education requirements to parallel other recognized professions.

Clinical Social Work Practice in Canada: A Critical Examination of Regulation

Purpose: The most common form of social work (SW) practice in Canada is clinical which requires specialized knowledge and advanced clinical skills. The SW profession is more than 100 years old, but regulation is new to Canada and presently most jurisdictions have regulatory bodies to advance safe, competent, and ethical practices. Regulatory bodies establish admission requirements, standards of practice, ethical guidelines, supervision, continuing education requirements, and measures for complaints and discipline. Methods: This article examines regulation of SW practice in Canada with a focus on registration requirements, clinical SW designation, use of controlled acts such as psychotherapy and diagnosis, supervision, continuing education, technology, private practice, and how regulatory bodies address diversity, equity, reconciliation, racism, and discrimination. Results: This critical examination of clinical SW practice found inconsistent standards across the country. Conclusions: It is important to harmonize the three pillars including education, association, and regulation to strengthen clinical SW practice in Canada.

Mandated Continuing Education Requirements for Health Care Professional State Licensure: The Texas Model

ABSTRACT It is well acknowledged that persons who have experienced human trafficking and persons at risk for victimization often present for health care services. It is also extensively documented in scientific literature that awareness of trafficking among clinical providers remains relatively low. Well-intentioned but poorly executed trainings spread misinformation, aid propulsion of stigma and bias, and often neglect to provide individualized and practically actionable messages for specific clinical audiences. Widespread adoption of standards to ensure evidence-based, patient-centered, trauma-informed, and culturally responsive care is lacking. The state of Texas recently passed legislation requiring direct health care providers to complete one hour of continuing education on human trafficking to qualify for licensure renewal. Advocates guided the implementation of this law based on lessons of previously enacted legislation in other states. Texas can serve as a regulatory policy model for adhering to evidence-based standards in human trafficking educational state or federal mandates.

Conceptual approaches to the development of continuing medical education for general practitioners in Moscow

The article is devoted to the current state of continuing medical education for general practitioners in the city of Moscow and is based on a survey of general practitioners working in Moscow. Results demonstrate a lack of satisfaction with the organisation and content of training in its previous format, the absence of significant changes in the learning objectives following education reform and an ambiguous attitude towards this reform. The minimum continuing education requirements for general practitioners working in the city of Moscow were shown to consist of day release, short-term training, theoretical and practical orientation and the application of contemporary educational technologies. Conceptual approaches to the development of continuing medical education in the field of general medical practice in Moscow were formulated. These comprised organisation of training, setting of learning objectives, selection of forms and methods of training, determination of interactive training content, application of a competency-based approach and individualisation of the educational path.

Development and implementation of a novel Web-based gaming application to enhance emergency medical technician knowledge in low- and middle-income countries.

Increasing access to high-quality emergency and prehospital care is an important priority in low- and middle-income countries (LMICs). However, ensuring that emergency medical technicians (EMTs) maintain their clinical knowledge and proficiency with procedural skills is challenging, as continuing education requirements are still being introduced, and clinical instructional efforts need strengthening. We describe the development and implementation of an innovative asynchronous learning tool for EMTs in the form of a Web-based trivia game. Over 500 case-based multiple-choice questions (covering 10 essential prehospital content areas) were created by experts in prehospital education, piloted with EMT educators from LMICs, and delivered to EMTs through a Web-based quiz game platform over a 12-week period. We enrolled 252 participants from nine countries. Thirty-two participants (12.7%) completed the entire 12-week game. Participants who completed the game were administered a survey with a 100% response rate. Ninety-three percent of participants used their mobile phone to access the game. Overall, participants reported that the interface was easy to use (93.8% agreed or strongly agreed), the game improved their knowledge (100% agreed or strongly agreed), and they felt better prepared for their jobs (100% agreed or strongly agreed). The primary motivators for participation were improving patient care (37.5%) and being recognized on the game's leaderboard (31.3%). All participants reported that they would engage in the game again (43.8% agreed and 56.3% strongly agreed) and would recommend the game to their colleagues (34.4% agreed and 65.6% strongly agreed). In conclusion, a quiz game targeting EMT learners from LMICs was viewed as accessible and effective by participants. Future efforts should focus on increasing retention and trialing languages in addition to English.

Air pollution and neurological development in children.

Pregnancy and early childhood are periods with high plasticity in neurological development. Environmental perturbations during these sensitive windows can have lifelong developmental consequences. This review summarizes key findings relevant to the effects of air pollution on neurological development. Mounting evidence suggests that exposure to air pollution, both during pregnancy and childhood, is associated with childhood developmental outcomes ranging from changes in brain structures to subclinical deficits in developmental test scores, and, ultimately, developmental disorders such as attention-deficit/hyperactivity disorders or autism spectrum disorders. Although the biological mechanisms of effects remain to be elucidated, multiple pathways are probably involved and include oxidative stress, inflammation, and/or endocrine disruption. Given the alarming global increase in developmental disorders in recent years, and increased human exposures to pollution, it is critical to reduce personal and community-level exposures through tight collaboration of interdisciplinary and multi-level bodies including community partners, physicians, industry partners, policy makers, public health practitioners, and researchers. WHAT THIS PAPER ADDS: Exposure to air pollution is associated with a range of childhood developmental complications. Biological mechanisms may include oxidative stress, inflammation, and endocrine disruption.

Making Psychotherapy Available in the United States: Implementation Challenges and Solutions.

About 46.6 million Americans have mental illnesses, yet profound treatment gaps exist in this country. Among those receiving treatment, most are treated solely with medication, even though >50% prefer to include psychotherapy in treatment. Other countries have changed policies to enhance access to evidence-based psychotherapy, resulting in availability and utilization reflective of patient preferences. To improve access to these treatments, the U.S. health care system would need to seek agreement among stakeholders regarding what constitutes effective treatment; enhance training, credentialing, and continuing education requirements; implement quality measures; integrate services into nontraditional venues; and incentivize best practices.

Continuing Education for Prehospital Healthcare Providers in India - A Novel Course and Concept.

BackgroundEmergency medical services (EMS) in India face enormous challenges in providing care to a geographically expansive and diverse patient population. Over the last decade, the public–private-partnership GVK EMRI (Emergency Management and Research Institute) has trained over 100,000 emergency medical technicians (EMTs), with greater than 21,000 currently practicing, to address this critical gap in the healthcare workforce. With the rapid development and expansion of EMS, certain aspects of specialty development have lagged behind, including continuing education requirements. To date, there have been no substantial continuing education EMT skills and training efforts. We report lessons learned during development and implementation of a continuing education course (CEC) for EMTs in India.MethodsFrom 2014 to 2017, we employed an iterative process to design and launch a novel CEC focused on five core emergency competency areas (medicine and cardiology, obstetrics, trauma, pediatrics, and leadership and communication). Indian EMT instructors and providers partnered in design and content, and instructors were trained to independently deliver the CEC. Many challenges had to be overcome: scale (>21,000 EMTs), standardization (highly variable skill levels among providers and instructors), culture (educational emphasis on rote memorization rather than practical application), and translation (22 major languages and a few hundred local dialects spoken nationwide).Lessons LearnedDuring the assessment and development phases, we identified five key strategies for success: (1) use icon-based video instruction to ensure consistent quality and allow voice-over for easy translation; (2) incorporate workbooks during didactic videos and (3) employ low-cost simulation and case discussions to emphasize active learning; (4) focus on non-technical skills; (5) integrate a formal training-of-trainers prior to delivery of materials.ConclusionThese key strategies can be combined with innovation and flexibility to address unique challenges of language, system resources, and cultural differences when developing impactful continuing educational initiatives in bourgeoning prehospital care systems in low- and middle-income countries.

P72 Examining Perceptions of Obesity-Related Training Opportunities and Needs for Head Start Health/Nutrition Managers

<h3>Background</h3> Head Start (HS) health/nutrition managers have identified obesity as the top health concern for their preschool children. However, little information exists related to perceived training needs and professional development (PD) training opportunities available for HS managers around obesity and related measurements. <h3>Objective</h3> To examine perceptions of obesity-related PD training needs and opportunities reported by Ohio Head Start health/nutrition program managers. <h3>Study Design, Setting, Participants</h3> Phenomenology was utilized for this research study. Semi-structured, in-depth telephone interviews (n = 13) were conducted with HS Health and Nutrition Managers across Ohio who were recruited via emails distributed by the HS Director of Professional Development. <h3>Outcome Measure/Analysis</h3> Interviews were audio-recorded and transcribed. Open coding of transcripts was conducted by trained qualitative researchers. Significant statements were coded, defined, and organized into themes. Themes enabled the description of the types of opportunities and needs (the "what" and "how") of the phenomenon. <h3>Results</h3> Researchers identified 5 themes. Themes around professional development opportunities included attending professional health conferences (eg nursing/nutrition/early childhood/health) as part of the professional continuing education requirements; online food and nutrition-focused trainings (eg, webinars) through state and national resources, such as USDA; health-related trainings as part of professional development days organized by Head Start programs; and networking as informal education from internal staff, RD consultants, and partnerships with local universities and WIC. Participants identified a lack of knowledge and training specific to the understanding of BMI, BMI-for-age growth charts, and skills around BMI measurement. <h3>Conclusions</h3> There are a number of general nutrition, food, and health-related trainings from a variety of sources (professional organizations, USDA, Head Start), but there is a need identified for training to improve knowledge and skills specific to BMI and its measurement (height/weight) in preschoolers, and the interpretation of BMI-for-age growth charts.

Antibiotic use in goats: role of experience and education of Missouri veterinarians

BackgroundIn a previous study, we found that rates of antibiotic residues in goat carcasses in Missouri were three times the published national average, warranting further research in this area.MethodsWe conducted...

U.S. Re-Licensure Opioid/Pain Management Continuing Education Requirements in Dentistry, Dental Hygiene, and Medicine.

Drug-induced deaths have been accelerating over the last two decades. The aim of this study was to determine if states with high opioid-induced deaths and overall drug-induced deaths were more likely to have continuing education (CE) requirements related to opioid use/pain management than states with fewer opioid-induced deaths. Almost 200 state dental and medical law boards' websites were examined for CE requirements, license renewal periods, and CE requirements for opioid use/pain management in December 2018 and January 2019. Drug-induced death data were obtained from the Centers for Disease Control and Prevention online database. States were categorized into quartiles of opioid-induced deaths per 100,000 population. A similar categorization was created for all drug-induced deaths. The results showed that states in the second, third, and fourth quartiles of opioid-induced deaths were more likely to have dental boards requiring opioid use/pain management CE than states in the first quartile in dentistry. This pattern was not the case with the medical boards' requirements. Dentists and physicians in states with higher all drug-induced deaths per 100,000 population were as likely to be required to attend opioid use/pain management CE as dentists and physicians in states with lower opioid-induced deaths. Although many licensing boards require opioid use/pain management CE in relation to their opioid-induced death rates, there is a need for policies to increase education in substance use disorders to reduce the number of drug-induced deaths.