Introduction: Respiratory therapists (RTs) must apply competencies to address the health care needs of the public. Although all competencies are deemed essential, scholarly practice requires that professionals critically assess their practices, integrate evidence-based literature, and enhance the care they deliver to patients. Though scholarly practice is also associated with professional empowerment, role satisfaction, and improved patient care, it is rarely measured. The purpose of this study was to develop, pilot, and generate preliminary validity evidence of a tool designed to measure scholarly practice among RTs. Methods: We used DeVellis' nine-step scale development process and exploratory factor analysis to develop the tool. The results of a scoping review and qualitative study were used to generate an item pool and pilot test it with 81 RTs across Canada. The refined tool was tested on a larger sample (n = 832) and analyzed using exploratory factor analysis. Results: Using principal axis factoring with Promax rotation, we retained 18 items across 4 factors, explaining 56.7% of the variance in the data: (Factor 1) professional development and credibility, (Factor 2) elements supporting scholarly practice, (Factor 3) the perceived impact of scholarly activities on practice, and (Factor 4) scholarly practitioner identity and ability. Internal consistency of the final 18-item scale was suitable overall. Discussion: Our results provide preliminary evidence for a scholarly practice tool that can encourage self-reflection and/or foster peer-based reflection. Using the tool with other health care professionals and conducting confirmatory factor analysis could generate additional validity evidence.

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In health care, cost-effectiveness analysis evaluates changes in health outcomes as a function of costs. The cost-effectiveness of continuing professional development for health care providers has not been historically well characterized despite substantial investment. This literature review identified publications considering the costs and cost-effectiveness of accredited continuing medical education activities. Searches were conducted for English language records in PubMed and the gray literature using a 10-year lookback period from March 10, 2023. Search terms included concepts related to continuing medical education, cost, effect, and utilization. One reviewer conducted title/abstract screening, full-text review, and data extraction, with direction and adjudication of search and screening concepts provided by the lead advisor. Publications were categorized as related to costs of an educational intervention (Concept 1) and/or the impact of education on health care costs (Concept 2). Results were summarized using descriptive statistics. A total of 668 database records were screened, 125 (19%) underwent full-text review, and 25 of 125 (20%) were accepted; 7 of 351 (2%) gray literature sources were accepted for a total of 32 included records. The most common reason for rejection was not being an accredited activity. Of the 32 records, 27 (84%) were related to Concept 1 only, 3 (9%) to Concept 2 only, and 2 (6%) to both Concepts 1 and 2. Approximately half (n = 19, 59%) mentioned costs without supporting data. These findings show that considerations of cost and cost-effectiveness are rare in the accredited continuing medical education literature, which may limit how the value of continuing medical education is characterized.

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Open-ended feedback from learners offers valuable insights for adapting continuing health education to their needs; however, this feedback is burdensome to analyze with qualitative methods. Natural language processing offers a potential solution, but it is unclear which methods provide useful insights. We evaluated natural language processing methods for analyzing open-ended feedback from CPD training at a psychiatric hospital. The data set consisted of survey responses from staff participants, which included two text responses on how participants intended to use the training ("intent to use"; n = 480) and other information they wished to share ("open-ended feedback"; n = 291). We analyzed "intent-to-use" responses with topic modeling, "open-ended feedback" with sentiment analysis, and both responses with (LLM)–based clustering. We examined outputs of each approach to determine their value for deriving insights about the training. Our results indicated that because the "intent-to-use" responses were short and lacked diversity, topic modeling was not useful in differentiating content between the topics. For "open-ended feedback," sentiment scores did not accurately reflect the valence of responses. The LLM-based clustering approach generated meaningful clusters characterized by semantically similar words for both responses. LLMs may be a useful approach for deriving insights from learner feedback because they capture context, making them capable of distinguishing between responses that use similar words to convey different topics. Future directions involve exploring other methods involving LLMs, or examining how these methods fare on other data sets or types of learner feedback.

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Although the Continuing Professional Development (CPD) field has rapidly expanded in scope, breadth, and depth, there is a gap in how we understand CPD leadership and the role of the leader. Previous scholarship indicates that there is neither an agreed on set of competencies for CPD leadership roles nor a distinct pathway towards those roles. This study is aimed at answering the following question: How is leadership described or defined in CPD and what are the contextual issues that are and/or should be shaping its evolution? Seventeen interviews were conducted. There were multiple components identified that were important to CPD leadership, such as being visionary, or having strong collaboration skills with some components, such as adaptability and flexibility appearing more unique to the CPD context. The role of CPD leadership and the pathway to CPD leadership remain highly variable. Attaining a CPD leadership position predominantly involves some degree of "serendipity." While CPD leaders may fundamentally need basic and common leadership skills, an essential attribute of the CPD leader is to effectively respond to the context and the unique needs of the health system. We recommend better articulating and valuing the role of the CPD leader within the health system.

Despite intensive attempts to create scholarship equity at academic medical centers, clinician educators continue to face a challenging professional promotion environment that puts them at risk for burnout, stalled career advancement, and abandonment of academic medicine altogether. Coaching, which has a wealth of supportive evidence from outside of medicine, is distinguished by (1) being driven by the agentic coachee that is inherently capable, creative, and resourceful, (2) not requiring the coach and coachee to have shared content expertise, and (3) not being centered around transfer of expertise from the more knowledgeable or experienced party to the recipient. Initial evidence from within medicine indicates that coaching reduces burnout and improves learner self-reflection, teaching effectiveness, goal setting, reflective capacity, professional identity formation, career planning, and development of adaptive expertise. In this article, faculty coaching is presented as a powerful means to help clinician educators overcome the myriad challenges to professional advancement and career fulfillment. The current evidence in support of coaching—both within and outside of medicine—is reviewed. Finally, a conceptual model is provided, as are guidelines demonstrating specific roles, behaviors, and responsibilities for faculty coaches and coachee.

The Canadian Medical Protective Association (CMPA)'s Commitment to Change in Test-Results Follow-Up (CTC-TRFU) program aims to provide physicians with resources to enhance their test results follow-up systems for improved patient safety. Framed around the Transtheoretical Model, the program involves a 6-month multimodal educational intervention involving individual and group coaching sessions, action planning, and reflection surveys. This study evaluates the program's impact by analyzing survey responses and course documents, focusing on three main outcomes: physicians' perceived barriers and challenges, changes in their confidence and commitment, and implemented practice changes with perceived impact on patient safety. Participants were Canadian physicians who enrolled through the CMPA's open-access registration, with a particular emphasis on those facing challenges in test result follow-up. Physicians who participated in the CTC-TRFU program reported meaningful practice changes, which we believe underscores the value of comprehensive, longitudinal continuing patient safety CPD initiatives. These findings indicate the potential for future studies to explore the long-term impact of similar programs and their scalability.

We suggest a conceptual change of emphasis in designing CPD to better align it with the goals of improving health care value for patients through the dynamic incorporation of five distinct domains to be included in learning activities. We identify these domains as: (1) identifying, appraising, and learning new information [New Knowledge]; (2) ongoing practicing of newly or previously acquired skills to maintain expertise [New Skills and Maintenance]; (3) sharing and transfer of new learning for the health care team which changes their practice [Teams]; (4) analyzing data to identify problems and drive change resulting in improvements in the health care system and patient outcomes [Quality Improvement]; and (5) promoting population health and prevention of disease [Prevention]. We describe how these five domains can be integrated into a comprehensive conceptual framework of CPD, supported by appropriate learning theories that align with the goals of the health care delivery system. Drawing on these distinct but interrelated areas of CPD will help organizers and directors of learning events to develop their activities to meet the goals of learners and the health care system. Click here to access the abstract.

The rapid rise of artificial intelligence (AI) is transforming society; yet, the education of health care providers in this field is lagging. In health care, where AI promises to facilitate diagnostic accuracy, and allow for personalized treatment, bridging the knowledge and skill gaps for providers becomes vital. This article explores the challenges of AI education, such as the emergence of self-proclaimed experts during the pandemic, and the need for comprehensive training in AI language, mechanics, and ethics. It advocates for a new breed of health care professionals who are both practitioners and informaticians, who are capable through initial training or through continuing professional development of harnessing AI's potential. Interdisciplinary collaboration, ongoing education, and incentives are proposed to ensure health care benefits from AI's trajectory. This perspective article explores the hurdles and the imperative of creating educational programming designed specifically to help health care professionals augment their practice with AI.

What are the mechanisms by which our CPD interventions create our outcomes? Despite ever growing evidence regarding the effectiveness of continuing professional development (CPD), there are ongoing debates about CPD's utility in improving health professional behavior and patient health. Evaluations of CPD demonstrate substantial variability in efficacy, the causes of which remain largely unclear in part because CPD programs are conventionally evaluated as "black boxes." Namely, evaluations typically account for program inputs, outputs, and outcomes, but they do not explicitly evaluate the mechanisms driving intended outcome changes. This emphasis on outcomes without considering that the processes underlying them can lead to obscuring or misinterpreting causal relationships and to missing unintended program effects. Our questions about CPD effectiveness are incomplete: our focus must shift from the 2 dimensions of whether CPD works or does not work to the multidimensions of how, why, and in what contexts it works or does not work.. Click here to access the abstract.

Project Extension for Community Healthcare Outcomes (ECHO) is a teleconsultation model that leverages technology to sustain specialized interventions in underresourced settings. We present the application of the ECHO model to longitudinal training and consultation for community behavioral health providers learning to deliver cognitive behavioral therapy for psychosis, an evidence-based psychotherapy for individuals with psychotic disorders that has poorly penetrated the US mental health system. Our evaluation suggests that the ECHO model supports continuous professional development for practitioners, most of whom had indicated inadequate preparation for their role. We observed improved learner and select patient outcomes.