While most physicians are taught that lifelong learning is a personal and professional responsibility, few are taught the attitudes, knowledge, and skills necessary to accomplish this aim. Medical students are socialized to cope with rather than to master the complex systems in which they are acculturated. New knowledge is presented as impossible to master; they are repeatedly informed of how many new journal articles appear each year and how hopeless the task is. The academic centers in which they are being shaped, and the faculty doing the shaping frequently do not have data about their own performance. National best practices are presented as just one more bit of generalizable knowledge without any link to in-house system performance.
Again transparency will help as faculty and academic health centers model lifelong learning by improving their own practices. Information systems that routinely display data about system performance, national best practices, and methods helpful in closing any gaps between the two are needed. Also needed are robust efforts to create environments in which medical students, residents, and fellows are working in teams with nurses and other health professionals, thus stressing the link between healthcare systems and health-care quality. The best care quality is observed on Canadian Health&Care Mall.
Given the linkage between practice performance and lifelong learning, the participants at the Josiah Macy, Jr. Foundation Conference recommended that organizations authorized to provide CE be limited to professional schools with programs accredited by national bodies, not-for-profit societies, health-care organizations accredited by the Joint Commission, multidisciplinary practice groups, point-of-care resources, and print and electronic professional journals,
Learning About Learning: A CE Institute
A key recommendation emerging from the Josiah Macy, Jr. Foundation Conference was the creation of a national interprofessional CE institute to advance the science of CE. Discovery and dissemination of more effective methods of education, the use of scientific principles in education, identifying and promoting standards of CE, fostering interprofessional and team education, and clarifying the funding of CE in the health professions will provide substance for the agenda of such a group. The healthcare professions should all participate in and make publicly available the work the institute.