The paths to continuing education credits (CEs) -- also known in various healthcare disciplines as continuing education units, competency education, or credential maintenance points, among other variations, appear to be as plentiful as lines on a roadmap.
The most succinct and direct route can be found via online CE courses, such as those offered to nurses, nurse practitioners and physician assistants, and lab professionals through ADVANCE. It's an easy on-ramp: Courses are on-demand, allowing clinicians to study at a time of their choosing, take the accompanying test, and collect CEs - all for a small toll ($10 for an online-credit course, or $34.99 for a full year of unlimited courses).
The variety of topics offered online through a multiplicity of organizations is nearly endless, and includes emerging areas of concern as well as state-mandated education topic options.
"Sometimes you'd have to wonder why anyone would do anything else to get CEs," remarked Carole Eldridge, DNP, RN, CNE, NEA-BC, vice president, post-licensure programs, Chamberlain College of Nursing, St. Louis, Mo. "Going online, paying a small fee, and getting credits is so convenient."
Flipping the Paradigm
Yet Eldridge noted that education -- in all of its phases -- is morphing. "Lectern teaching is the antithesis of good education these days," she commented. "The days of 'the sage on the stage' are over. The interactive 'flipped' classroom -- wherein students act and interact, do things in simulation, engage in knowledge -- is the objective today."
That thinking has also spread to the world of CEs. The Association of American Medical Colleges and the American Association of Colleges of Nurses pointed the way in their 2010 conference report, "Lifelong Learning in Medicine and Nursing." While the report underscored the continuing value of didactic education, it also expanded the outlook for CE to encompass more active participation, inter-professional learning, and greater workplace involvement.
A statement from the boards of the sponsoring associations said, "We envision a continuum of health professional education from admission into a health professional program to retirement that values, exemplifies, and assesses lifelong learning skills; emphasizes inter-professional and team-based education and practice; employs tested, outcomes-based continuing education methods; and links health professional education and delivery of care within the workplace. To achieve this vision, we encourage an understanding of and support for the need for change."
Pharmacist specialist Sally Rafie, PharmD, BCPS, is assistant clinical professor of health sciences at the University of California San Diego's Skaggs School of Pharmacy and Pharmaceutical Sciences. She used the interest in participatory and inter-professional undertakings to her own advantage -- and earned CE credits.
"I volunteered to facilitate inter-professional (medical, nursing, pharmacy) student simulations," Rafie explained. "The students worked up patient cases based on information they gathered from actors." Indeed, most healthcare disciplines have taken up the call to allow CE credits for activities outside of the classroom or the computer screen.
Heidi Herbst-Paakkonen, MPA, is continuing competency manager at the Federation of State Boards of Physical Therapy (FSBPT), a membership organization consisting of 53 jurisdictions (each state, plus Washington D.C., Puerto Rico, and the U.S. Virgin Islands).
"Since at least 2000, FSBPT members have engaged in ongoing discussions around continuing competency and the challenges that jurisdictions maintain to assure that PTs are fully competent to practice," said Herbst-Paakkonen.
Following up on this concern, FSBPT launched an initiative in 2007 to create tools and services, with an eye to suggesting evidence-based and quality credit-worthy conduits to continuing competency, including courses, conferences and "alternative activities." Using its own certification process with standards tied to evidence-based best practices, FSBPT gives its stamp of approval to the best continuing competency opportunities available.
"These are recommendations from the federation; each jurisdiction has the option to adopt these suggestions or not," said Herbst-Paakkonen. As such, some jurisdictions use all of them, some employ some of them, and indeed some jurisdictions eschew them altogether.
"Our approach 'weights' the alternative activities on the basis of the level of learning, the demands it exacts on participants, and the PT's level of engagement," explained Herbst-Paakkonen, noting that FSBPT's continuing competence model recommends that higher-engagement activities earn a greater number of continuing competency credits.
For example, credits still may be received via online education. However, because this is a passive undertaking, it carries a lower credit value. On the other hand, "A conference offering a lecture with a lab component or a role-playing component would be more engaging and would deliver more credits," said Herbst-Paakkonen. "When participants really synthesize and use information - not just regurgitate answers back on a quiz -- we feel they are better-prepared, more competent practitioners."
While it could be a daunting task for providers to figure out where the green lights signal a "go" for CE credits, FSBPT offers a tool as useful as a kindly crossing guard; there's no concern about which way to go. Physical therapists can learn which activities will satisfy continuing competency model points, where they can participate in them, how much they will cost, and what the credit values will be via a free online management system called aPTitude, housed on the federation's website.
Visitors can see at a glance which continuing competency options are approved by each state or jurisdiction, which license requirement each one pertains to, and more. In short, it displays a menu of alternative, as well as traditional, competency activities to drive practitioner engagement and assure professional competence.
The 'Write' Stuff
Such alternative activities show up in literature from other healthcare disciplines as well. For example, laboratory professionals certified by the American Society of Clinical Pathologists (ASCP) Board of Certification may be required (depending on the original date of their licensure) to participate in a Credential Maintenance Program (CMP).
Information provided by CMP assures participants that they can receive CMP points via a wide variety of experiences: "Some of the qualifying activities include employer-offered coursework, writing journal articles, serving on committees or boards, competence assessment by your employer, and participating in formal continuing education courses."
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While CMP offers five points for a journal article, lab professionals with the requisite skills may want to aim for writing an entire book -- an activity worth 21 points in the view of CMP.
The American Nurses Credentialing Center (ANCC), in its 2015 certification renewal requirements, allows professional development requirements to be met via traditional continuing education courses and academic credits, as well as through efforts in research and publishing, educational presentations, and precepting.
Additionally, nurses may complete two or more years of volunteer service during a certification period with an international, national, state or local healthcare-related organization in which the nurse's certification specialty expertise is required. While traveling to a Third World country is not required -- serving on a local task force or an editorial board will suffice -- it would certainly qualify. Documentation of volunteer service is necessary, keeping in mind the impact of the service on specific professional development.
However, that required documentation and tracking of activities may be one stumbling block to undertaking volunteer services in exchange for credits. Some 15 years ago, Eldridge traveled to an African clinic in hopes of helping people in Zambia slow the spread of HIV.
"When I returned home [to Texas] at that time, I could have written up my experiences and explained all the things I learned about tropical diseases, infectious diseases, cultural insights etc., and applied for alternative credits through the state of Texas," she said. "They could have determined if that experience would have been acceptable for CEs. But here's the barrier to doing that: It is so easy to get CEs now. Very few people get too creative about it. Why jump through the hoops? Even for me, who had done the field work, it was easier to go online, pay my $10 and get a CE. Done. But is it possible to get credits for your efforts? Certainly -- if you have the will to do it."
Valerie Neff Newitt is on staff at ADVANCE. Contact: firstname.lastname@example.org