The Use of Simulation in Continuing Professional Development: A Comparison of Family Physicians’ Awareness in Mersin and in Ann-Arbor

Öz

Introduction: With the intent to promote using simulation in Continued Professional Development (CPD) in Turkey, we examined Turkish Family Medicines (FM) in Mersin and United States FMs in Ann-Arbor attitudes toward simulation and resources used in CPD programs to identify preferred teaching methods and subject areas that might benefit from the use of simulation for training.  Method: A survey-based needs assessment was disseminated via email to FM Associations in Mersin (MAHDER) and in Ann-Arbor (AFMRD). Participants completed the 2-part survey that included demographics and 10 items across three domains (reasons for CPD, preferred resources, learning modalities) rated on 5-point rating scales (5=highest). Top factors and rating differences across participants’ country, gender, stage in career, were evaluated using a many-facet Rasch model.  Results: Two-hundred, seventy-three FMs completed the survey. Top reason for participation in CPD was “Willingness to try new things” for both FMs in Mersin and Ann-Arbor. FMs in Mersin indicated “Simulation-based training” had higher importance as a learning modality than FMs in Ann-Arbor, but reported less use of simulation for CPD. Other detailed findings and their implications are discussed.  Conclusions: Findings suggest that FMs in Mersin feel that simulation is an important educational modality for CPD but it is not widely employed. This suggests that there are opportunities for the development of novel, simulation-based CPD curricula targeted to FM physicians in Mersin. with potential expansion to other developing countries.

Giriş: Türkiye’de, Sürekli Mesleki Gelişim (SMG) de simülasyon kullanımını teşvik etmek amacıyla, Türkiye’nin Mersin ilindeki aile hekimleri ile Amerika’nın Ann-Arbor bölgesindeki aile hekimlerinin eğitimlerinde simülasyon kullanımının, hangi eğitim metodlarında ve konu alanlarında fayda sağlayabileceğini belirlemek için SMG programlarında simülasyon ve kaynak kullanım alışkanlıkları araştırıldı. Yöntem: Mersin (MAHDER) ve Ann-Arbor (AFMRD) aile hekimleri derneklerine mail yoluyla değerlendirme anketleri gönderildi. Katılımcıların tamamladıkları anket, demografik verileri ve üç alanı kapsayan (SMG sebepleri, tercih edilen kaynaklar, öğrenim modaliteleri) 5 lik skalada değerlendirilen (5= en yüksek) 10 soruluk 2 kısımdan oluşmuştu. Katılımcıların ülke, cinsiyet, ve kariyerlerine göre temel faktörler ve puanlama farklılıkları many-facet Rasch tekniği kullanılarak değerlendirildi. Bulgular: 273 aile hekimi anketi tamamladı. Mersin ve Ann-Arbor daki aile hekimlerinin herikisi için de, SMG’ye katılımda en önemli faktör “yeni şeyleri denemeye isteklilik’’ idi. “Simulasyon temelli eğitimi’’ bir öğrenme şekli olarak, Mersin’deki aile hekimleri, “Ann-Arbor’’ daki aile hekimlerine göre daha önemli bulduklarını, ancak SMG’de daha az kullandıklarını belirttiler. Diğer sonuçlar ve uygulamalar tartışıldı. Sonuç: Bu bulgular, Mersin’deki aile hekimlerinin SMG’de simulasyon kullanımının önemli bir eğitim şekli olduğunun farkında olduklarını ancak yaygın olarak kullanmadıklarını göstermiştir. Bu durum Mersin’deki ve diğer gelişmekte olan ülkelerdeki aile hekimlerine yönelik yeni, simülasyona dayalı SMG müfredatının geliştirilmesi için fırsatlar olduğunu önermektedir.

Anahtar Kelimeler

• simulation,CPD,family medicine

Kaynakça

1. 1. Motola I, Devine LA, Chung HS, Sullivan JE, Issenberg SB. Simulation in healthcare education: a best evidence practical guide. Med Teach 2013;35(10):1511-1530.
2. 2. Kurdak H, Altintas D, Doran F. Medical education in Turkey: past to future. Med Teach 2008;30(8): 768-773.
3. 3. World Federation for Medical Education (WFME) and For Advancement of International Medical Education and Research (FAIMER). https://search.wdoms.org/. Accessed September 23, 2015.
4. 4. Description of simulators for medical learners. Acıbadem University. http://case.acibadem.edu.tr/tr-tr/Sayfalar/Mezuniyet-Oncesi.aspx. Accessed September 23, 2015.
5. 5. Center of Advanced Simulation and Education (CASE). Acıbadem University. http://case.acibadem.edu.tr/tr-tr/Sayfalar/Mezuniyet-Sonrasi.aspx. Accessed September 23, 2015.
6. 6. Adult Basic and Advanced Life Support Applications. http://birincibasamak.org/yazarlarimizdanhandanbirbicereristemileriyasdesApr2015tr.php. Accessed September 23, 2015.
7. 7. MacCarrick GR. A practical guide to using the World Federation for Medical Education (WFME) standards. WFME 1: mission and objectives. Ir J Med Sci 2010;179(4):483-487.
8. 8. Karim SI, Irfan F, Qureshi R, Naeem N, Alfaris EA. Evaluation of continuing professional development pogram for family physicians. Pak J Med Sci 2013;29(2):458-463.

9. 9. Basic Medical Education. World Federation for Medical Education (WFME) Global Standards for Quality Improvement. Copenhagen, 2003. http://www.wfme.org. Accessed March 11, 2008.
10. 10. Brown CA, Belfield CR, Field SJ. Cost effectiveness of continuing professional development in health care: a critical review of the evidence. BMJ 2002;324:652-655.
11. 11. François P. The via crucis of continuing professional development. Press Med. 2014;14:353-354.
12. 12. Brigley S, Young Y, Littlejohns P, McEwen J. Continuing education for medical professionals: a reflective model. Postgrad Med J 1997; 73:23-26.
13. 13. Murgatroyd G. Intelligence unit research. Continuing professional development, the international perspective. http://www.gmcuk.org/CPD_The_International_Perspective _Jul_11.pdf_44810902.pdf. Accessed November 11, 2015.
14. 14. Department of Health. Our healthier nation: a contract for health. London. 1998. https://www.gov.uk/government/publications/our-healthier-nation-a-contract-for-health.Accessed October 17, 2014.
15. 15. The CanMEDS 2000 Project; Skills for the new millennium: report of the societal needs working group. The Royal College of Physicians and Surgeons of Canada's Canadian Medical Education Directions. https://www.surgeons.org/media/301671/canmeds_e.pdf. Accessed on November 11, 2015.
16. 16. Davis D, Galbraith R. Continuing medical education effect on practice performance: effectiveness of continuing medical education: American college of chest physicians evidence-based educational guidelines. Chest 2009;135(3):42-48.
17. 17. Marinopoulos SS, Dorman T, Ratanawongsa N, Wilson LM, Ashar BH, Magaziner JL, et al. Effectiveness of continuing medical education. Evid Rep Technol Assess 2007; 149:1-69.
18. 18. Yaman H. Continuing medical education in Turkey: Recent developments. BMC Med Educ 2002; 19(2):6.
19. 19. Rasch, G. Probabilistic models for some intelligence and attainment tests. Chicago, IL: The University of Chicago Press; 1980.
20. 20. Linacre. JM. Facets® Many-Facet Rasch Measurement Software, version 3.67. Chicago, IL: MESA Press; 2010.
21. 21. Pool IA, Poell RF, Berings MG, ten Cate O. Strategies for continuing professional development among younger, middle-aged, and older nurses: a biographical approach. Int J Nurs Stud 2015;52(5):939-950.
22. 22. Description of American Board of Family Medicine Simulation Activity Modules. https://www.theabfm.org/moc/part2.aspx. Accessed October 22, 2015.