Massachusetts General Hospital Psychiatry Academy: Innovation and Reform in Life-Long Provider Learning
Background and Philosophy
Massachusetts General Hospital Psychiatry has a 30-year tradition of providing postgraduate education to our health care colleagues across the United States and around the globe. Tens of thousands of providers have taken our board examination review courses and continue to participate in a wide range of comprehensive courses in Boston covering diverse topics such as the basic neurosciences and genetics, cognitive behavioral psychotherapy, socio-cultural aspects of symptom expression, natural remedies, medical co-morbidity, child and adult psychopharmacology, and the medical legal aspects of psychiatric practice.
In 2003, we took stock of a number of critical and transformative developments in the field of postgraduate provider education including:
We felt strongly that there were critical shortcomings in the ways in which provider
postgraduate education was evolving. We launched the Massachusetts General Hospital Psychiatry Academy with the hope of building upon and broadening our experience in provider education. We endeavor to be a positive force for education reform, offering outstanding content1 while forging a systematic and data-driven approach to studying the dynamics of the processes underlying provider education and generating validated outcome metrics.Development and Adoption of New Teaching Methods and Technologies
Our qualitative and quantitative market research, conducted with hundreds of multidisciplinary providers across the country, has highlighted the importance of fully incorporating peer-to-peer and faculty-to-peer interactivity as the backbone of our curriculum format. These findings complement research showing that passive learning, in traditional lecture formats, does not necessarily lead to information retention and utilization. Individuals seem to learn best when they are fully engaged in the learning process.
Our foundation of educational tools is not being employed in a scatter-shot fashion. Our website (www.MGHCME.org) has just undergone extensive enhancement aimed at fully integrating all our educational offerings based on these important marketing and educational research findings. The website's enhanced functionality focuses on enriching Academy Member interactivity. The website is your portal to a virtual postgraduate university where you will find a campus life that can enrich your mastery of a given topic area. For example, your experience on our website is meant to be only the first step in a chain of events. Our live webcasts will be followed up with targeted and facilitated web-based colleague and faculty involvement intended to spawn related and meaningful future educational offerings.
Documenting the Effect of Education Programs on Provider Practice and Quality Patient Care
We endeavor to incorporate basic principles of learning methodology into our educational programming. From its inception, every program is conceived with the end in mind. We are exploring a number of new techniques to ensure accurate needs assessment of a provider's fund of knowledge and to identify crucial controversies or gaps that critically affect patient care. Our needs assessments and learning objectives are built around clinically actionable items (e.g., correct dose, when to utilize multimodal therapeutic interventions) that are chosen because they can be longitudinally and quantitatively measured. These evaluation and outcome measures (EOMs) are validated against external standards (evidence-based studies, consensus guidelines and stratified provider bench mark cohorts) to provide the Academy Members with meaningful aggregate (anonymous) performance feedback.
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Figure 1
The cohesiveness and size of the Academy membership, now over 27,000 providers, is an increasingly potent vehicle for generating EOMs. Within this membership, the number of individuals who have agreed to be part of our longitudinal Academy cohort has grown by over 500% during the first semester of our 2006 curriculum, from hundreds to thousands of providers. As demonstrated above (Figure 1) respondents (N=105), canvassed on-line three months after a live symposia event, identified a number of factors that had changed in their subsequent health care practices that they related to their participation in the Psychiatry Academy. Over 65% registered for additional Academy offerings and half of the respondents related making changes in their treatment approach to patients based on their participation.
Concerns about Provider's Reliance on Commercially Supported Education Events
In light of the stated commitment of some companies to continue to support physician education, along with their willingness and need to ensure a complete firewall between their sales and marketing programs, we felt the time was right to explore new models of provider education that included industry support. We believe that our commercial supporters as well as our faculty members who may be actively pursuing research programs sponsored by commercial entities or rendering consulting services to these companies, along with a variety of other content1 development sources, have a valuable contribution to make to the fund of knowledge that will benefit patients.
With enhanced concerns about potential provider conflicts of interests, we are continuingly adapting safeguards aimed at assuring the integrity, independence and non-biased nature of our programs. Our “Information Integrity Initiatives” are meant to be broad based and can be downloaded from our website here: Safeguards Integrity & Initiatives Information. This material details our approach to:
As an added assurance that there is no specific alignment of the content1 with the sales and marketing agenda of a given company, the model we have adopted was based on creating a yearly curriculum, covering multiple therapeutic areas and interventions, independent of and prior to any commitment of support. Additionally, this curriculum is always co-supported by more than one company. As another monitoring measure, all our content1 developers have agreed to routinely include information covering areas such as: toxicology, generic equivalent pharmacotherapy, evidence-based multimodal therapeutic interventions, and preventative health care strategies. We consider these components of content1 development to be important touchstones while striving for a comprehensive therapeutic agenda.
Building Toward the Future
Over the past 30 years, we have had the privilege to form thousands of rewarding professional and personal relationships. Our aim today is to have you become a member of a community of peers, forging lasting collegial relationships that develop core competencies rather than just engaging, in a disjointed array of single educational offerings. Traditional single CME events, although they can serve a vital purpose, cannot create a longitudinal and cohesive community of providers who explore, revise, and document best practice standards.
Massachusetts General Hospital Psychiatry Academy invites you to join us in this exciting new venture. Together, we can strive to discover the best approach to advance our field while preserving our place as guardians of our patients' trust.
