Healthcare is not delivered in silos. You rarely bypass the nurses’ station when you go to your primary care physician. Hospitals are filled with specialists of every sort who frequently have to consult with each other on both routine and complicated cases. Then there are the pharmacists who dispense medications and counsel patients, the social workers who help navigate insurance issues, and countless other professionals who all have a role in overall patient health. In the new era of the empowered patient, it is vital that the entire healthcare team communicate effectively and efficiently to maximize the effectiveness of care.
Through multidisciplinary education, continuing medical education professionals can play a key role in bringing these groups together to open doors and build bridges for better communication and patient care. In recent years, we at the Institute for Continuing Healthcare Education (an accredited provider of CME/CNE/CPE for physicians, nurses, pharmacists, and other healthcare professionals) have become adept at planning and designing multidisciplinary education.
Needless to say, it’s more than just slapping multiple
certifications on an activity and hoping that the target audiences participate. Among other components, effective multidisciplinary education takes careful planning, selection of appropriate topics, development of realistic educational objectives, and, in some cases, a customized learning assessment and outcomes design that captures role-specific
knowledge, competence, and behavior change.
Without question, there are specific nuances educational providers need to be mindful of that, if not addressed from the outset, can sink multidisciplinary education. Here are some tips on how to do it right.
Step 1: Choose the Right Topic
Naturally, not every topic is going to be appropriate for a multidisciplinary audience. To help identify topics that relate to multiple learner types, use a comprehensive gap analysis process to pinpoint specific educational gaps in a given therapeutic area. Carefully review performance indicators for each learner type to ensure that the gaps are indicative of multidisciplinary educational needs. Interviewing a multidisciplinary cohort representing each discipline surrounding preliminary educational gaps is a great way to get insight into how these audiences truly interact in day-to-day clinical care.
For example, we are currently developing an initiative centered on the need for earlier identification of rheumatoid arthritis (and hence, earlier treatment, which has been shown to lead to better long-term patient outcomes). Initially, we thought this would largely be an issue for rheumatologists, but our preliminary analysis showed that a large part of the problem is the lack of communication and trust between primary care and rheumatology practices. This served as the launching point for a more comprehensive needs assessment, which went on to pinpoint additional areas needing multidisciplinary education for primary care, nursing, and specialist audiences.
Finding these types of gaps that point to an obvious need for multidisciplinary education isn’t always so easy. However, your medical team should have a good sense of topics that would be applicable to specific audiences and provide guidance when the question of the need for multidisciplinary education is broached.
Step 2: Develop the Right Educational Objectives
Accredited providers need to ensure that all of their programs are designed based on measurable educational objectives. Developing one set of educational objectives that match the disciplines of the entire audience can be complicated when designing multidisciplinary education, because some learning objectives that are clearly appropriate for a physician audience based on the proposed educational content may not be appropriate for nurse or pharmacist learners. It isn’t possible to measure behavioral change if a learner’s role on the healthcare team does not match the spirit of each learning objective. It is often wise to develop individualized learning objectives for each target audience; the only time that one set of educational objectives is acceptable is when an activity centers around imparting general knowledge (i.e., review of updated patient care guidelines where education is not dependent on role).
Step 3: Choose the Right
We can’t emphasize this enough—if your faculty doesn’t understand the need for and believe in the multidisciplinary approach to education, your initiative is going to fail. Some faculty enjoy the opportunity to work across professional walls; others may be more resistant and put up barriers to successful education.
At our company, we are big believers in “like educating like.” For physician-specific activities, we only use physicians as faculty; for nursing-specific activities, we use nurses; and for pharmacy-specific activities, we use pharmacists. Our learner audiences tend to be more receptive to education delivered by their peers who can relate to their day-to-day challenges.
This approach carries over to multidisciplinary activities. It is important, as well as required by many accrediting bodies, to make sure that the voice of each targeted audience is represented on the activity’s faculty. It is also important that faculty members involved in helping develop multidisciplinary education receive instructions from the beginning of the initiative (and ideally, when they are being invited to participate) that they think broadly when developing content that will be relevant to the entire audience.
Step 4: Develop the Right Learning Assessment and Outcomes Questions
As with the development of educational objectives, the development of an appropriate learning assessment and outcomes methodology for multidisciplinary education can be tricky. Different accrediting bodies require different sorts of learning assessments. The Accreditation Council for Pharmacy Education, for instance, mandates that, for application-based activities, learning assessments should center on case vignettes (this does not apply to knowledge-based activities for pharmacists).
While time-consuming, it is often worth developing different content-related post-tests for each target audience. You can even go the extra mile and develop individualized activity evaluation forms—this may even be necessary if you have created different learning objectives for each of your audiences. Taking this sort of approach allows you to segment your audiences and evaluate the impact of the education on each one, giving you an extra layer of data to report on and to use for the planning of future activities.
Integrated Care, Integrated CE
When done right, multidisciplinary education can be among the most valuable initiatives for your learners to help them enhance their knowledge and professional competence. It allows for more viewpoints and voices within your activities, improving the chances that your learners will have that “aha!” moment that spurs them to change their overall performance.
It’s vital that providers proactively identify the unique components of multidisciplinary education—having to make adjustments midway through an activity when you realize that your education is mistargeted can be an expensive mistake in terms of manpower, dollars, and quality of the overall education.
As healthcare moves toward more and more integration of care across the whole medical team, continuing medical education will need to move with it. This means we have to learn how to plan, develop, and implement multidisciplinary education the right way with the right learner mix in mind and the right focus on effectively and efficiently maximizing the effectiveness of care.
Scott Kober, CCMEP (email@example.com), is the director of content development and Karen Thomas, CCMEP (firstname.lastname@example.org), is the associate director of compliance and accreditation at the Institute for Continuing Healthcare Education in Philadelphia, PA. Follow them on Twitter @InstituteCME.
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