From numbers to intelligence Insights from 2010 National Physician Survey about CME/CPD in physicians’ lives

We have no conflicts of interest to disclose … except our personal interest in competent physicians. We need data to support that interest.

Numbers… numbers… noise But every number tells a story Numbers… numbers… noise But every number tells a story

How much of the story do you know? 1. How many hours per week do MDs spend on CPD/CME? a)1 hour or less b)2-3 hours c)3-5 hours d)Over 5 hours 2. From this list, what is the most significant barrier to MDs’ participation in CPD/CME? a)Time away from practice family b)Lack of locum relief c)Cost of travel d)Lack of opportunity e)Lack of relevance

How much of the story do you know? 3. From this list, what is the CPD/CME method that has the most impact on MDs’ practice? a)Accredited conferences b)Unaccredited conferences c)Peer-reviewed journals d)Self-assessment e)Simulation 4. What is the CPD/CME method that MDs use >1/month? a)Accredited conferences b)Unaccredited conferences c)Peer-reviewed journals d)Self-assessment e)Simulation

Objectives 1.Describe the types of CPD activities in which FPs and SPs participate and their deemed level of impact on practice. 2.Identify potential types of CPD activities that will have significant impact on practice 3.Discuss types of CPD activities will will increase significant attendance and participation 4.Identify barriers to MDs’ participation in CME/CPD 5.Identify how much time MDs report spending on CME/CPD 6.Discuss potential new areas of NPS research into CME/CPD

National Physicians Survey (NPS) 101 Respected Canadian source of reliable information about the profession of medicine and issues in health care. Conducted jointly by: –Canadian Medical Association –College of Family Physicians of Canada –Royal College of Physicians and Surgeons of Canada

NPS 101- continued 3 completed cycles: 2004, 2007 and 2010 Next cycles: 2012, 2013 and 2014 Data on current and future Canadian physicians Questionnaires developed with broad input Data used widely in health care planning and research

Time spent on CME/CPD Average physician work week was 51.4 hours, excl. call 2010 average time on CPD/CME was 3.2 hours/week Time spent by Family Physicians increasing since Variability in other specialties

Types of CPD/CME Conferences (accredited / unaccredited) Journals (peer-reviewed / non peer-reviewed) Evidence-based resources (CPGs, etc) Electronic education (online / offline) Small group activities (hospital rounds etc.) Self-assessment Practice audits Simulation

Types of CPD by % of physicians using

Types of CPD by % of physicians using once/month or more

Live Accredited Conferences 98% of physicians attend at least one a year 33% attend one at least once a month Has highest ranking of “very significant impact on practice” at 31% –By comparison only 11% said that unaccredited conferences have a “very significant impact ”

Peer-reviewed journals Easiest method to access and most frequently used 74% of physicians read these at least once a month < FP/GPs report significant impact on practice compared to other specialists overall (57% vs. 65%) –> impact among Rheumatol (79%), Rad Onc (77%), Nephrol (77%) and Microbiol/ID (77%) –< impact among Diag Rad (52%), Otolaryng (52%) and Plastic Surg (51%)

Small group activities 83% of physicians participate in small group activities (e.g. hospital rounds) –< frequent among FP/GPs (39% do 1/month) vs other specialists (64% do 1/month) –48% FP/GPs and 57% other specialists deem impact on practice as significant (> variability among other specialists) Radiation Oncologists (81%) Neurosurgeons (79%) Ophthalmologists (48%) Public Health / Preventative Med (30%)

Evidence-based learning Use of evidence-based resources on a monthly basis: 63% FP/GPs: 52% other specialists) – 31% of physicians rate the impact of these resources as “very significant” – equalling the impact of live conferences. Geriatric Medicine Specialists (75%) Microbiology & Infectious Diseases (75%) Diagnostic Radiologists (29%) Plastic Surgeons (19%)

Computer-based CPD/CME Neither online or offline computer CPD/CME methods receive high assessment of impact. 80% of physicians use online electronic CPD/CME tools and 70% use offline versions. Impact of these tools rated as significant by 26% of physicians for offline methods and by 35% for online. Online methods are used at least monthly by 38%, and offline by 21%.

Other CPD/CME methods While 20% of physicians use self-assessment at least monthly, only 26% rate its impact as significant. Practice audits are used by less than half of physicians (48%) with only 15% reporting a significant impact on practice Simulation registers as the CPD method with least impact – only 11% report it had a significant one. It is only used by 35% of all physicians.

How much of the story did you know when we started? 1.How many hours per week do MDs spend on CPD/CME? Between 3 and 5 (3.2) 2.From this list, what is the most significant barrier to MDs’ participation in CPD/CME? Time away from practice 3.From this list, what is the CPD/CME method that has the most impact on MDs’ practice? Accredited live events 4.What is the CPD/CME method that MDs use >1/month? Peer reviewed journals

Some takeaways from this story Much available and relevant CME/CPD content Live accredited events: most used and deemed most impactful –Associated with most barriers (time and money) Peer-reviewed journals: frequently used and deemed impactful E-based resources: frequently used but deemed of limited impact Self-assessment: used by 7 of 10 but few deem impactful on practice

Some takeaways from this story No single strategy fits all –Great variability by type, specialty –and practice setting Need to complete the storyline so more research and analysis is needed.

National Physician Survey 2013 Next NPS: spring 2013 –Watch for it –Complete it –Use it Become a part of the story

Contact us Danielle Fréchette - Executive Director, Office of Health Policy and Communications, Royal College of Physicians and Surgeons of Canada. Artem Safarov – National Physician Survey Project Manager, College of Family Physicians of Canada.