BMJ Learning Product background

ModulesCME

User training

Dr. Kieran WalshBMJ Learning

November 2008

Overview

• Problem• Traditional medical education• BMJ Learning • Resources• Improving practice and decision making • Site demo

Problem

Acute coronary syndromes

• Diagnosis - tests • Local management• Drugs available• Now

Traditional medical education…attendance and non-attendance

We now have 2 problems – coronary syndromes

and traditional medical education • Passive• Variable quality• Variable evidence• Not up to date • Learning things you don’t need to know• Not learning things you need to know• One size fits all• Points driven • No training in team work• No training in communication skills• Training doesn’t change in response to users’ needs• People who really need training are least likely to go for it • People who don’t need training are most likely to go for it • Assessment not fit for purpose

BMJ Learning

Launched as a full service in 2004

• Learning needs assessment/curricula• PDP

• Learning resources

Problem solving: assess your learning needs

• Six different types of assessment tool

• Some involve self assessment, others require input from colleagues and patients

Curriculum-driven learning

• Junior doctors • Vast number of learning needs • Show the curriculum • Learning resources mapped to the

curriculum

Your plan and record

• A rucksack

OR

• Automatically records any learning needs discovered by needs assessment

• Automatically records completed BMJ modules

• Covers non clinical categories as well

• Manual input of traditional CPD events

• Keeps track of learning achieved and deadlines hit

• It is confidential

Charles Dickens – “Hard Times”

• Facts• Think - learning outcomes • Content - - - Outcomes • On completion of the learning I will be able to

competently diagnose and manage patients with acute coronary syndromes

Learning resources

• Interactive case histories• Just in time• Read reflect respond• Multimedia

• Podcasts

Interactive case histories – how much will you remember in one month’s time?

• preview what you are about to learn (P)• ask yourself questions that you would like to find the

answers to (Q)• read the material (R)• recite the material to yourself (S) and • then test yourself by trying to recall the facts that you

have learned (T). • PRETEST - CASES – POSTEST (DECISIONS)

Just in time

• Are you still listening? • Bite sized chunks• Short evidence based review with assessment

questions at the end – available when you need it

Read reflect respond

• Reflective learning

• Ethical and professional issues • Reviews

Multimedia

• Diagnosis • Simulation • C Difficile

Podcasts

• Lectures to a wider audience

• Your questions answered

What makes a good doctor?

• Knowledge, skills, attitudes, behaviours• Must have a combination – blended learning • JIT – knowledge • ICH - skills• RRR – attitudes • Multimedia - behaviours• Podcasts – knowledge and attitudes

Assessment?

• Valid and reliable assessment• Multiple choice question

A 60 year old man

A 60 year old man complains of severe central chest pain. His ECG shows ST elevation in II III and AvF.

What is the likely diagnosis? A. myocarditisB. heart burnC. inferior myocardial infarctionD. chest wall pain

The way to a man’s heart

The way to a man’s heart is through his…?

A. AortaB. Pulmonary veinC. Pulmonary arteryD. Stomach

Assessment questions

A 40 year old man comes to see you with a rash on his abdomen. What is the most likely diagnosis?

A. Mycosis fungoides B. Atopic eczema C. Psoriasis D. Discoid lupus erythematosus

Usage

2005 80 000 modules completed

2006 98 000 modules completed

2007 130 000 + modules completed

Popular

“Excellent learning resource”

“ Great and just in time for me”

“I now realise my knowledge deficits”

“I will change my practice in light of this learning resource”

The evidence - have you learned something?

The pre-test and post-test scores are as follows: • Mean pretest score 66.2 (24.4)

• Mean post-test score 94.3 (4.2)

• Mean improvement in score: 28 (95% confidence interval 25.9 to 30.1, p value < 0.001)

• Doing the module enabled users to improve their knowledge and skills by a statistically significant amount

An academic exercise or has it affected your clinical practice?

• 70-80% have changed their practice or confirmed their correct practice as a result of their learning

• 80% say they will change their practice as a result of their learning

Learning resources

• BMJ Learning – commissioned authors/team• Clinical Evidence • BMJ• Heart • GUT• The EMJ• Journal of Clinical Pathology • Guideline-producer – the National Institute of Clinical

Excellence • The National Patient Safety Agency • National Cancer Screening

This is who you are relying on.

Learning resources – improved care

• Rheumatology – published in WBLPC• Cardiology – published in PMJ• NPSA – modules are now mandatory in some

trusts • C Difficile in association with the Department

of Health – part of induction in some trusts

CPD for doctors – what is the future?

• Excellent learning content • Valid and reliable assessment • Registration • Getting tougher• Learning and clinical practice together

BMJ Learning

• Allows you assess your knowledge• Regularly updated • Changing in response to users needs• Any time, any place, anywhere!• Tangible proof you have learned something• Self-paced (save and exit)• Multimedia• Interactive

What you don’t have to pay for

• Trainer accommodation• Trainer travel and subsistence• Learner accommodation• Learner travel and subsistence• Classrooms• Equipment• Off-the-job time• Print costs

Content is king

BMJ Learning content is

• Reliable• Evidence based • Up to date • Comprehensive

Coronary syndromes

• Find an answer online

Site demo

• All content• Text and image modules• Simulation centre• Diagnosis• Patient safety• Podcast

Thank you