1. Copyright restrictions may apply JAMA Pediatrics Journal Club Slides: Principles of Lifelong Learning in Pediatric Medicine Opipari VP, Daniels SR, Wilmott RW, Jacobs RF. Association of Medical School Pediatric Department Chairs principles of lifelong learning in pediatric medicine. JAMA Pediatr. Published online September 19, 2016. doi:10.1001/jamapediatrics.2016.2258.

2. Copyright restrictions may apply Background The practice of pediatrics requires continuous effort to maintain knowledge and competencies. The Association of Medical School Pediatric Department Chairs (AMSPDC) initiated a survey in July 2015 to define principles of lifelong learning in pediatric medicine and determine the approaches and strategies used by chairs to assess knowledge and competence across the care, research, and teaching missions. Introduction

3. Copyright restrictions may apply Study Design –The AMSPDC Education Committee developed 7 principles for lifelong learning that were reviewed and edited by the AMSPDC executive board. The SurveyMonkey online survey site was used by the executive board to draft a survey that would seek endorsement of the principles and query the chairs on strategies used to assess lifelong learning and the role of maintenance of certification (MOC) in the assessment of competence in clinical practice. –The survey contained 20 multiple choice or rating scale questions and 1 open-ended question. There were 145 answer options including 134 quantitative options (yes/no, agree/disagree, and select all that apply) and 11 qualitative options (other: please describe and open-ended). Members were contacted by email 3 times following survey launch to maximize participation. Prior to the close of the survey (October 2015), nonrespondents were contacted by telephone and encouraged to complete the survey. The Kardia Group LLC was retained to perform an independent analysis of the survey data. Methods

4. Copyright restrictions may apply Results Outcomes The AMSPDC Survey on Lifelong Learning and Maintenance of Certification was distributed to 142 chairs of pediatric departments. A total of 101 chairs (71%) completed the survey. Six of 7 proposed principles were endorsed by 84% to 96% of AMSPDC members. The endorsed principles focus areas included (1) individual accountability; (2) individually relevant activities; (3) use of evidence-based guidelines/national standards; (4) focus on gaining cognitive expertise; (5) learning as a continuous effort; and (6) affordability and focus on gaps in individual understanding. A seventh principle mandating lifelong learning was not endorsed. Qualitative comments suggested that the chairs do not support a mandate, as lifelong learning is endemic to the profession of medicine. Importantly, the chairs endorsed a requirement for evidence of lifelong learning, compliance, and demonstrated competence by all faculty members in clinical (n = 89 [88%]), research (n = 63 [62%]), and educational (n = 85 [84%]) practice.

5. Copyright restrictions may apply Results AMSPDC Principles of Lifelong Learning

6. Copyright restrictions may apply Results –In clinical care, 90% of chairs (n = 91) endorsed demonstration of discipline- specific competence being required for all clinicians regardless of the percentage effort spent in clinical activities. –In research practice, most chairs (66%) endorsed an expectation that demonstrating research-specific compliance and competence is required for all pediatric investigators regardless of the percentage of effort devoted to research activities. –The chairs (89%) endorsed that education compliance and competence be demonstrated and required for those engaged in the training of students, residents, and fellows. –Most chairs reported that they rely on existing formal evaluation practices including annual performance reviews, trainee evaluations, measures of professionalism, and institutional credentialing.

7. Copyright restrictions may apply Results Evidence for MOC

8. Copyright restrictions may apply Results Overall Assessment of American Board of Pediatrics/MOC Process

9. Copyright restrictions may apply Comment The AMSPDC initiative on lifelong learning in pediatric medicine represents an important initiative to define core principles of lifelong learning in pediatric clinical practice, research, and education. There was a strong membership response to the survey and member engagement. While the data source was limited to the opinions of chairs, the survey provided improved understanding of how chairs evaluate lifelong learning across missions. The value of the principles of lifelong learning to the individual and demonstrated by the individual was endorsed by most chairs across the missions of clinical care, research, and education. Survey results indicated that most chairs do not rely on MOC to assess clinical competence of their faculty. Additionally, the chairs expressed significant frustration in their quantitative and qualitative responses with the MOC components at the time of the survey launch (July-October 2015). Factors contributing to chair dissatisfaction were perceived lack of evidence, poor alignment with meaningful measures, complexity, time commitment, and cost.

10. Copyright restrictions may apply If you have questions, please contact the corresponding author: −Valerie P. Opipari, MD, Department of Pediatrics and Communicable Diseases, C. S. Mott Children’s Hospital, University of Michigan Health System, 1500 E Medical Center Dr, D3202 MPB SPC 5718, Ann Arbor, MI 48109 (vcastle@umich.edu). Conflict of Interest Disclosures None reported. Contact Information