Performance Data Advocacy for Continuing Professional Development in Health Professions

Abstract

Efforts to optimize continuing professional development (CPD) are ongoing and include advocacy for the use of clinician performance data. Several educational and quality-based frameworks support the use of performance data to achieve intended improvement outcomes. Although intuitively appealing, the role of performance data for CPD has been uncertain and its utility mainly assumed. In this Scholarly Perspective, the authors briefly review and trace arguments that have led to the conclusion that performance data are essential for CPD. In addition, they summarize and synthesize a recent and ongoing research program exploring the relationship physicians have with performance data. They draw on Collins, Onwuegbuzie, and Johnson’s legitimacy model and Dixon-Woods’ integrative approach to generate inferences and ways of moving forward. This interpretive approach encourages questioning or raising of assumptions about related concepts and draws on the perspectives (i.e., interpretive work) of the research team to identify the most salient points to guide future work. The authors identify 6 stimuli for future programs of research intended to support broader and better integration of performance data for CPD. Their aims are to contribute to the discourse on data advocacy for CPD by linking conceptual, methodologic, and analytic processes and to stimulate discussion on how to proceed on the issue of performance data for CPD purposes. They hope to move the field from a discussion on the utility of data for CPD to deeper integration of relevant conceptual frameworks.

Recasting Assessment in Continuing Professional Development as a Person-Focused Activity

“…17,38,58,59 Assessment has to be made personal for it to be used beyond the CPD event. 60 Aspects for the person, such as trust, 24,37 authenticity, 38 alignment with practice, 38,61,62 and acknowledgement of personal beliefs about their practices 38,62 are factors that may bridge the gap between goals of external systems and the person being assessed.…”

“…68 Thus, assessment offers an intentional space for the external expert to meet alongside the health professional-as-a-person to actively and meaningfully co-construct alignment, acknowledge gaps, and reconcile misalignment between the purposes, meanings, and uses of assessment findings. 24,37…”

“…68 Thus, assessment offers an intentional space for the external expert to meet alongside the health professional-as-a-person to actively and meaningfully co-construct alignment, acknowledge gaps, and reconcile misalignment between the purposes, meanings, and uses of assessment findings. 24,37 Nevertheless, subjectification does not imply that the person has the agency to do whatever they want regarding assessment. Biesta 71 reminds us that the possibilities afforded through subjectification are always constrained by our responsibility to live in and with the natural and social world (or in the case of health professionals, constrained by our relationship with and responsibility to society).…”

“…For instance, when Sargeant (2013) provides clarification on what CPD is-as encompassing multiple formal and informal "educational and developmental activities which health professionals undertake to maintain and enhance their knowledge, skills, performance, and relationships in the provision of health care," assessment is an assumed part of CPD's conceptualization. 23 Furthermore, assessment of the person in CPD is often conflated with program evaluation findings 17 and performance data 24,25 causing confusion when a person's assessment data are used to substantiate the effectiveness of the education activity, 22,26,27 or of the qualification program. 17,28 When we focus on persons in assessment, their inability to accurately self-assess 29 or how they engage with feedback 7,8 becomes the focus, instead of intentionally examining the link between assessment and the person.…”

Conceptual Advances in Continuing Professional Development in the Health Professions

“…A contemporary issue has been the integration of electronic records in CPD. [18][19][20][21] After a comprehensive review of the literature and consultations with experts in the field, Pizzuti et al 22 offer insightful and detailed arguments that provide new directions for the community to consider on the use of health records for CPD. Their work challenges existing assumptions and beliefs, such as the correlation between health recorddriven performance enhancements and actual practice or health outcomes.…”