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July 2004


The ABCs of Continuing Ed

By Melissa S. Cohn, OTR/L
Therapists and other health care professionals spend countless hours helping restore, maintain, and promote the overall health of individuals through practice and treatment in specially equipped hospitals, clinics, private offices, homes, and schools. The nature of the work—evaluating, treating, and educating patients; consulting with a variety of other professionals; and navigating the elements of a professional practice—requires that therapists manage their time effectively by making quick and informed decisions. But, as the patient population becomes more diverse and developments in medicine frequently occur, therapists are also expected to continue their professional development by participating in continuing education (CE) courses and workshops.

For therapists and other health care professionals, maintaining an effective practice means collecting, interpreting, and applying research and collegial information. The approach and integration of this information at the very least depend on course content, venue, and learning style. There are currently myriad learning opportunities available: classroom courses, online courses, or a “blended” approach that combines both live and online components. These learning systems conveniently allow physical therapists, occupational therapists, speech-language pathologists, and other health care professionals to earn continuing education credit, and meet licensure and certification requirements.

In considering the available CE and professional development options, “why” becomes as important to the decision as “what,” “how,” and “when.” The importance of maintaining licensure and certification is familiar to almost every therapist and health care professional, as is the complexity of satisfying the requirements of licensure and/or certification. One area of confusion among therapists and health care professionals is that licensure is a state- and discipline-specific designation.

CONTINUING EDUCATION IN REHAB
Some states require licensure for certain forms of health care delivery and others do not. Further confusing matters is that each state that requires licensure may or may not have a CE requirement for renewal. The various allied health professional associations, such as AOTA, ASHA, and APTA, also define their own set of strict guidelines for accomplishment of CEUs. Determining which learning options satisfy which requirements can be a difficult process for the therapist.

The professional associations have eased some of this burden by offering guidelines about CE programs. The recommendations tend to be more general and cautionary than specific. Health care professionals are advised to consider whether the intended program at least has a defined rationale, title, and statement of content and outcomes; an identifiable target audience and instructional level; an easily identified source and number of CEUs; information about instructor qualifications; and details about fees and provider contact information.1,2 Establishing individual educational and professional goals and needs is also of importance prior to enrolling in a CE program.

Although the task of fulfilling these requirements can be complicated and at times frustrating, there are numerous avenues available by which to satisfy them. Today, state licensing boards and professional associations offer practitioners continuing education credit through an array of articles, manuals and assessments, and courses.

While learning style is specific to each person, certain learning options tend to work more effectively than others. Courses that cover “core” information work ideally in an online environment. E-learning, the online or electronic form of distance education, is powered by the flexibility and accessibility of the Internet, telecommunications, and multimedia resources. Yet, some individuals remain apprehensive about breaking away from traditional learning experiences and taking advantage of e-learning opportunities. E-learning is now part of the professional conscience and is fundamental to gaining skills for providing comprehensive care. Research has shown that most health care professionals can increase their skills far beyond required levels—and more efficiently—when given the access and time to build skills through e-learning.

Overall, the appropriate choice for CE in health care is contingent on a number of factors. The shape of learning and continuing education in the rehab industry, combined with individual learning styles, figures prominently into making informed decisions about CE and professional development planning. Understanding related trends and practices enables rehab providers to make purposeful decisions regarding the utility and implementation of a personalized CE program.

EVIDENCE- AND COMPETENCY-BASED CONTENT
Whether one is working clinically or administratively, judgment calls and decision-making situations are part and parcel of any professional practice. These judgments and decisions are made based on how, where, and what type of information is collected and interpreted. You may be familiar with two broad types of information, or content: evidence-based and competency-based.

Evidence-based content approaches decision making by taking the “best evidence available, in consultation with the patient, to decide upon the option which suits that patient best.”3 Using evidence-based content for learning means that therapists acquire scholarly research about procedures, often from an instructor, and incorporate that information into daily practices. This time-specific approach is consistent with the type of learning experienced at a traditional, “brick-and-mortar” institution and supported by professional associations. However, evidence-based content discounts learning based on personal experience or ideas gathered from collegial interaction.

The competency-based content method is, conversely, learner-centric. This self-paced learning method is grounded in the learner’s ability to demonstrate accomplishment of clinical skills under certain conditions. Competency-based content is used in a system where the “focus is on outcome, which is the application of the knowledge, and the process is learner centered with input from a mentor.”4 Given sufficient time and appropriate training, a learner ought to be able to grasp the intended knowledge and skills. Attainment of skills is set against identifiable standards and the skills theoretically develop into competencies.

Academicians and practitioners will argue both for and against each of these content approaches. Yet, it is not necessary to be exclusive when considering how best to implement these methods into your CE and professional development plan. In fact, you have to take into account types of learning venues available to therapists and the learning styles of therapists themselves.

CONSIDERING THE VENUE
A variety of learning and professional development opportunities exist outside and inside the therapist’s workplace. The CE prospects available at regional and national conferences can easily become costly in both time and money for the practitioner and for the employer. Traditional in-house programs have typically incorporated large group, instructor-led classes taught by internal staff or external consultants, and can range from 2-hour workshops to 2-day symposia. While these classes can be highly interactive and customized, the objective is often to deliver a broad amount of information to a group of people. This educational standard, while effective, is at the mercy of the facilitator from instructional, time, and resource perspectives.

E-learning, on the other hand, is more closely formatted to consider the practitioner in the workplace. Practitioners seeking CE units have clinical experience and are likely maintaining a practice. Thus, they increasingly pursue learning opportunities that cater to their individual areas of expertise and that accommodate their individual schedules.5 E-learning permits professional development and CE studies to be completed by therapists who, for example, prefer limited or no campus attendance.

LEARNING STYLES
According to noted researcher and author Howard Gardner, “students possess different kinds of minds and therefore learn, remember, perform, and understand in different ways.”6 Gardner’s Theory of Multiple Intelligences holds that individuals form several different types of learning, or intelligences, as a result of biological and cultural elements. The strength of these intelligences—visual-spatial, bodily-kinesthetic, musical, interpersonal, intrapersonal, linguistic, and logical-mathematical—exists in varying degrees in each person. This is why customized education, such as e-learning, is so appealing to an array of practitioners seeking to fulfill CE and professional development.

Rating the strength of these intelligences can help individual practitioners choose an optimal form of CE and professional development. Each of these intelligences can be thought of as a type of learner. Visual-spatial learners find it most advantageous to use drawings, imagery, models, charts, photographs, and video during learning experiences. Bodily-kinesthetic learners optimize movement and touch to grasp concepts. Musical learners are inclined to turn to lyrics, rhythmic speech, musical instruments, music, radio, and similar forms of multimedia when learning. Interpersonal learners learn best through interaction in group activities, seminars, dialogues over the telephone, audio conferencing, working with an instructor, video conferencing, and email. Intrapersonal learners enjoy learning through independent study and introspection. Linguistic learners, who thrive on using words effectively, learn well from computers, games, multimedia, books, and lectures that require them to distinguish and articulate words. Logical-mathematical learners can use logic games, for example, to reason and calculate by perceiving and investigating patterns and relationships. Clearly, a number of these intelligences can be taught to, especially given the abundance of electronic media and easily accessible learning opportunities.

Obviously, people exhibit each of these intelligences in varying amounts. Careful research of available CE and professional development opportunities will aid the practitioner in choosing the opportunity that is a best-fit. As individual learning styles are better understood, it becomes more apparent why a variety of multimedia is appealing and effective. One of the benefits of exploring and choosing e-learning is that it, by definition, satisfies the myriad types of learning preferences evidenced by health care practitioners. Practitioners can thereby effectively create variety in their CE and professional development. Another advantage of e-learning is that practitioners can share with others methods and means of learning that they have found to be personally successful.

TRENDS & TACTICS
Ultimately, practitioners and their employers need to see the value and responsibility in ensuring supportive pathways for CE and professional development. Individual states are beginning direct licensure requirements in a way that would better “level the field.” In trying to ensure competencies, CEU requirements to maintain licensure will likely be standardized throughout a given health care profession, regardless of the location of a person’s practice. As these changes come, the astute professional will assess learning style now to be ready for later. Choosing an accommodating avenue of professional development is increasingly easy. In fact, the difficult part may be choosing which form of learning is optimal.

The novelty, flexibility, and availability of modern learning options can be exciting, while overwhelming, and can make for difficult decisions. Research on decision-making informs that people generally misunderstand the policies and procedures they use in making decisions.7 As individuals think, perceive, conceptualize, and experience when making decisions, the information must be organized in a structured manner if learning is to occur. Learning, then, occurs not only from daily relationships, but also from individual discovery. Consequently, it is your responsibility as a learner-practitioner to try different venues to become accustomed to what works for you.

Online content, live seminars, laboratory presentations, and teleconferences are only a handful of the learning strategies available today. As detailed in a previous Rehab Management article (“An E-Learning Primer,” June 2003), certain forms of learning have become more popular and have been proven more effective than others, but may not necessarily solve all of your problems. Proper assessment of individual learning style, where the learning will take place, employer support for the learning process, and the purpose and requirements of the learning will guide the best-fit decision for professional development planning.

Melissa S. Cohn, OTR/L, is the president/CEO of Dynamic Group, Oldsmar, Fla. She may be reached at Melissa S. Cohn, or visit Dynamic Group.

REFERENCES
  1. American Physical Therapy Association. Guidelines for evaluating continuing education programs. Available at: APTA. Accessed April 13, 2004.
  2. American Occupational Therapy Association. AOTA Approved Provider Program: Criteria & Guidelines. Bethesda, Md: AOTA; 2004.
  3. Gray, JAM. Evidence-based Healthcare: How to Make Health Policy and Management Decisions. London: Churchill Livingstone; 1997.
  4. Carraccio C, Englander R, Wolfsthal S, Martin C, Ferentz K. Educating the pediatrician of the 21st century: defining and implementing a competency-based system. Pediatrics. 2004;113:252-258.
  5. Coyne C. Electronic education and distance learning: pioneer t-DPT programs report. PT: Magazine of Physical Therapy. 2002;10:40-45.
  6. Gardner H. The Unschooled Mind: How Children Think and How Schools Should Teach. New York: Basic Books; 1991.
  7. Ross L, Nisbett RE. The Person and the Situation. New York: McGraw-Hill; 1991.

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