Lifelong learning, faculty development and conflict of interest

 
From the September 2006 issue of the Journal of General Internal Medicine: [subscription required for last two years; 1997-2004, and January 2006 Supplement available free online]

Hojat M, Veloski J, Nasca TJ, Erdmann JB, Gonnella JS. Assessing physicians’ orientation toward lifelong learning. J Gen Intern Med 2006; 21(9):931-936.

Abstract: Despite the importance of lifelong learning as an element of professionalism, no psychometrically sound instrument is available for its assessment among physicians. To assess the validity and reliability of an instrument developed to measure physicians’ orientation toward lifelong learning. Mail survey. Seven hundred and twenty-one physicians, of whom 444 (62%) responded. The Jefferson Scale of Physician Lifelong Learning (JSPLL), which includes 19 items answered on a 4-point Likert scale, was used with additional questions about respondents’ professional activities related to continuous learning. Factor analysis of the JSPLL yielded 4 subscales entitled: “professional learning beliefs and motivation,””scholarly activities,””attention to learning opportunities,” and “technical skills in seeking information,” which are consistent with widely recognized features of lifelong learning. The validity of the scale and its subscales was supported by significant correlations with a set of criterion measures that presumably require continuous learning. The internal consistency reliability (coefficient alpha) of the JSPLL was 0.89, and the test-retest reliability was 0.91. Empirical evidence supports the validity and reliability of the JSPLL.
PubMed Record    Earlier Study by the same authors [full text] 

Sullivan AM, Lakoma MD, Billings JA, Peters AS, Block SD. Creating enduring change: demonstrating the long-term impact of a faculty development program in palliative care. J Gen Intern Med 2006; 21(9):907-914.

Abstract: Improved educational and evaluation methods are needed in continuing professional development programs. To evaluate the long-term impact of a faculty development program in palliative care education and practice. Longitudinal self-report surveys administered from April 2000 to April 2005. Physician and nurse educators from North America and Europe. All program graduates (n=156) were invited to participate. Two-week program offered annually (2000 to 2003) with 2 on-site sessions and 6-month distance-learning period. Learner-centered training addressed teaching methods, clinical skill development, and organizational and professional development. Self-administered survey items assessing behaviors and attitudes related to palliative care teaching, clinical care, and organizational and professional development at pre-, postprogram, and long-term (6, 12, or 18 months) follow-up. Response rates: 96% (n=149) preprogram, 73% (n=114) follow-up. Participants reported increases in: time spent in palliative care practice (38% preprogram, 47% follow-up, P<.01); use of learner-centered teaching approaches (sum of 8 approaches used “a lot”: preprogram 0.7+/-1.1, follow-up 3.1+/-2.0, P<.0001); and palliative care topics taught (sum of 11 topics taught “a lot”: preprogram 1.6+/-2.0, follow-up 4.9+/-2.9, P<.0001). Reported clinical practices in psychosocial dimensions of care improved (e.g., assessed psychosocial needs of patient who most recently died: 68% preprogram, 85% follow-up, P=.01). Nearly all (90%) reported launching palliative care initiatives, and attributed their success to program participation. Respondents reported major improvements in confidence, commitment to palliative care, and enthusiasm for teaching. Eighty-two percent reported the experience as “transformative.” This evidence of enduring change provides support for the potential of this educational model to have measurable impact on practices and professional development of physician and nurse educators.
PubMed Record 

Weinfurt KP, Friedman JY, Allsbrook JS, Dinan MA, Hall MA, Sugarman J. Views of potential research participants on financial conflicts of interest: barriers and opportunities for effective disclosure. J Gen Intern Med 2006; 21(9):901-906.

Abstract: There is little guidance regarding how to disclose researchers’ financial interests to potential research participants. To determine what potential research participants want to know about financial interests, their capacity to understand disclosed information and its implications, and the reactions of potential research participants to a proposed disclosure statement. Sixteen focus groups in 3 cities, including 6 groups of healthy adults, 6 groups of adults with mild chronic illness, 1 group of parents of healthy children, 1 group of parents of children with leukemia or brain tumor, 1 group of adults with heart failure, and 1 group of adults with cancer. Focus group discussions covered a range of topics including financial relationships in clinical research, whether people should be told about them, and how they should be told. Audio-recordings of focus groups were transcribed, verified, and coded for analysis. Participants wanted to know about financial interests, whether or not those interests would affect their participation. However, they varied in their desire and ability to understand the nature and implications of financial interests. Whether disclosure was deemed important depended upon the risk of the research. Trust in clinicians was also related to views regarding disclosure. If given the opportunity to ask questions during the consent process, some participants would not have known what to ask; however, after the focus group sessions, participants could identify information they would want to know. Financial interests are important to potential research participants, but obstacles to effective disclosure exist.
PubMed Record 

Journal of General Internal Medicine