Blogs and Listservs in Medical Education

blog.jpg  If you are interested in keeping up with what people are talking about in medical education, here is a selection of blogs and listservs to which you may wish to subscribe:

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CME as a Bridge to Quality: Leadership, Learning, and Change within the ACCME® System

CME as a Bridge to Quality: Leadership, Learning, and Change within the ACCME® System is a booklet published by the ACCME in January 2008.

From the ACCME Web site:

The booklet is a resource to accompany the plenary session presentation of ACCME Chief Executive, Dr. Murray Kopelow, [see p. 68] at the 34th [sic]  Annual Meeting of the Alliance for CME in Orlando. The 22-page booklet encapsulates the essential philosophy and practice of the ACCME in its mission to ensure that continuing medication education (CME) is a strategic asset that improves US healthcare. Dr. Kopelow remarks, “we intend for this booklet to be an essential resource that our nationally-accredited providers, state-accredited providers, and volunteers can use to help their stakeholders understand the importance of CME to an organization’s healthcare mission.” Dr. Kopelow’s plenary presentation and the booklet are the most recent examples in the ACCME’s continuing commitment to support the role of the CME system in improving patient care.

Excerpt from the booklet:

It is a critical time for continuing medical education (CME) to address the competence and performance gaps of physicians that underlie deficits in the quality of US healthcare.
 
Accredited CME is an essential component of continuing physician professional development in the eyes of the US organizations of medicine that comprise the ACCME member organizations. For almost 30 years, the ACCME system for accredited continuing medical education has provided standards, criteria, and policies that define what it means to be a provider of CME.

The ACCME recognizes that US healthcare is at a crossroads, and that accredited continuing medical education is being asked to provide solutions to bridge healthcare quality gaps. The ACCME system is an essential link between the lifelong learning of physicians and State and Federal requirements for physician licensure and Maintenance of CertificationTM. Accredited CME connects current practice to best practice. Your stakeholders need to understand just how important this role of CME is to the healthcare mission of your organization.

This booklet has been designed to help you take action to demonstrate the value of accredited continuing medical education to your stakeholders—so that we can work together to improve patient care.
 

Chiropractors and the risk of stroke: new research from Spine

bjd.gif  On January 19, 2008, the following article was published in the Globe and Mail:
Alphonso, C. Chiropractors don’t raise stroke risk, study says. Globe and Mail; January 19, 2009. The article begins:
A Canadian study indicates there is no increased risk related to chiropractic treatment in the heated debate about whether neck adjustments can trigger a rare type of stroke.

Researchers say patients are no more likely to suffer a stroke following a visit to a chiropractor than they would after stepping into their family doctor’s office.

The findings, published today in the journal Spine, help shed light on earlier studies that had cast a cloud on the chiropractic profession and suggested that their actions resulted in some patients suffering a stroke after treatment.

This article was referring to one of the studies published in the special Spine supplement entitled Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders:

Cassidy JD, Boyle E, Cote P, He Y, Hogg-Johnson S, Silver F, Bondy SJ. Risk of vertebrobasilar stroke and chiropractic care: Results of a population-based case-control and case-crossover study. Spine 2008; 33 (4S):S176-S183.
The study concludes: VBA stroke is a very rare event in the population. The increased risks of VBA stroke associated with chiropractic and PCP visits is likely due to patients with headache and neck pain from VBA dissection seeking care before their stroke. We found no evidence of excess risk of VBA stroke associated chiropractic care compared to primary care.

Here is a related study, published in the same issue:

Boyle E, Cote P, Grier AR, Cassidy JD. Examining vertebrobasilar artery stroke in two Canadian provinces. Spine 2008; 33 (4S):S170-S175.
The study concludes: In Saskatchewan, we observed a dramatic increase in the incidence rate in 2000 and there was a corresponding relatively small increase in chiropractic utilization. In Ontario, there was a small increase in the incidence rate; however, chiropractic utilization decreased. At the ecological level, the increase in VBA stroke does not seem to be associated with an increase in the rate of chiropractic utilization.

Evidence-Informed Management of Chronic Low Back Pain (CLBP) Without Surgery

sj.gif   The January-February 2008 issue of The Spine Journal is devoted to the evidence-informed management of chronic low back pain [subscription required]. See the editors’ preface at the bottom of this page.  Journal link    PubMed Records

Introduction:

Link to the articles below from this page, until the DOIs are created. (As of April 3, 2008, the links below do not yet work.)

Intervention review articles:

Editors’ preface: The management of chronic low back pain (CLBP) has proven very challenging in North America, as evidenced by its mounting socioeconomic burden. Choosing amongst available nonsurgical therapies can be overwhelming for many stakeholders, including patients, health providers, policy makers, and third-party payers. Although all parties share a common goal and wish to use limited health-care resources to support interventions most likely to result in clinically meaningful improvements, there is often uncertainty about the most appropriate intervention for a particular patient.

To help understand and evaluate the various commonly used nonsurgical approaches to CLBP, the North American Spine Society has sponsored this special focus issue of The Spine Journal, titled Evidence-Informed Management of Chronic Low Back Pain Without Surgery. Articles in this special focus issue were contributed by leading spine practitioners and researchers, who were invited to summarize the best available evidence for a particular intervention and encouraged to make this information accessible to nonexperts.

Each of the articles contains five sections (description, theory, evidence of efficacy, harms, and summary) with common subheadings to facilitate comparison across the 24 different interventions profiled in this special focus issue, blending narrative and systematic review methodology as deemed appropriate by the authors. It is hoped that articles in this special focus issue will be informative and aid in decision making for the many stakeholders evaluating nonsurgical interventions for CLBP.

Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders

bjd.gif  The February 15, 2008 supplement of Spine is a special issue on the findings of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders [subscription required].   PubMed records

Read the executive summary:
The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: Executive Summary by Scott Haldeman, DC, MD, PhD; Linda Carroll, PhD; J David Cassidy, DC, PhD, DrMedSc; Jon Schubert, CMA; Åke Nygren, DDS, MD, DrMedSc
Open Access Version!

Contents:

  • Preface: Neck Pain and the Decade of the Bone and Joint 2000-2010 (S1)
  • Editorial Preface: The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders (S3)
  • The Empowerment of People With Neck Pain: Introduction (S8)
  • A New Conceptual Model of Neck Pain: Linking Onset, Course, and Care (s14)
  • Self-Study of Values, Beliefs, and Conflict of Interest (s24)
  • Methods for the Best Evidence Synthesis on Neck Pain and Its Associated Disorders (s33)
  • The Burden and Determinants of Neck Pain in the General Population (S39)
  • The Burden and Determinants of Neck Pain in Whiplash-Associated Disorders After Traffic Collisions (S52)
  • The Burden and Determinants of Neck Pain in Workers (S60)
  • Course and Prognostic Factors for Neck Pain in the General Population (S75)
  • Course and Prognostic Factors for Neck Pain in Whiplash-Associated Disorders (WAD) (S83)
  • Course and Prognostic Factors for Neck Pain in Workers (S93)
  • Assessment of Neck Pain and Its Associated Disorders (S101)
  • Treatment of Neck Pain: Noninvasive Interventions (S123)
  • Treatment of Neck Pain: Injections and Surgical Interventions (S153)
  • Identifying the Best Treatment Among Common Nonsurgical Neck Pain Treatments: A Decision Analysis (S184)
  • The Prevalence and Incidence of Work Absenteeism Involving Neck Pain: A Cohort of Ontario Lost-Time Claimants (S192)
  • Clinical Practice Implications of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: From Concepts and Findings to Recommendations (S199)
  • Research Priorities and Methodological Implications (S214)

Continuing Education in the Health Professions: Improving Healthcare Through Lifelong Learning (Macy Foundation)

Final Report   In November 2007 the Josiah Macy, Jr. Foundation convened a conference to address complex issues concerning continuing education in the health professions. Participants developed the set of conclusions and recommendations found at the end of this Executive Summary:
Chairman’s Summary of the Conference on Continuing Education in the Health Professions: Improving Healthcare through Lifelong Learning
Proceedings of the Conference Chaired by Suzanne W. Fletcher, M.D., M.Sc.
Published by the Josiah Macy, Jr. Foundation, 2008.

The final report is available as of May 16, 2008:
Continuing Education in the Health Professions: Improving Healthcare Through Lifelong Learning. A Conference Sponsored by the Josiah Macy, Jr. Foundation. Chaired by Suzanne W. Fletcher, M.D., M.Sc. Bermuda,  November 2007. Edited by Mary Hager, Sue Russell, and Suzanne W. Fletcher, M.D., M.Sc. New York: Josiah Macy, Jr. Foundation, 2008.

What people are saying about the Chairman’s Summary [updated June 18, 2008]:

Participants developed the set of conclusions and recommendations found at the end of the executive summary, released January 10, 2008.  A more detailed account of the proceedings, along with the background papers, will be included in a monograph to be published by the Macy Foundation late in 2008.

Excerpt: Continuing education (CE) of health professionals is essential to the health of all Americans.With accelerating advances in health information and technology, physicians, nurses and other health professionals must maintain and improve their knowledge and skills throughout their careers in order to provide safe,effective and high quality health care for their patients.

Yet continuing education in the health professions is in disarray. Over the past decade, both professional and lay reports have identified multiple problems. CE, as currently practiced,does not focus adequately on improving clinician performance and patient health. There is too much emphasis on lectures and too little emphasis on helping health professionals enhance their competence and performance in their daily practice. With Internet technology, health professionals can find answers to clinical questions even as they care for patients, but CE does not encourage its use or emphasize its importance. And, while studies show that inter-professional collaboration,teamwork and improved systems are key to high quality care, accrediting organizations have not found ways to promote teamwork or align CE with efforts to improve the quality of health systems.