Wednesday, December 15, 2010

In Search of the Perfect C.E.

When I first graduated as a pharmacist I joined the organizations, subscribed to the magazines and made every effort to plow through them and keep current with continuing education. Obviously, it is very important -- and not just because CE is required to stay licensed, but to do our job responsibly. I went to the day-long CE events in the hotel ballrooms and convention centers, and the dinners, and the luncheons, and all that.

Gradually I lost interest in a lot of those things --- not because I don't want to learn anything, but because I began to realize how little I was getting out of them. I would plod through some long article and an hour later not remember a single thing I had read. Nothing was relevant to those of us who work not in academia, not in research, but on the front lines of pharmacy. I would sign up to attend a lecture on, say, "Recent Advances in the Treatment of Asthma." I would think great! --- I need to get a little refresher on some of the new inhaled medications and what distinguishes them from each other in practical terms. But alas, what I got was someone who spent 45 minutes reviewing the causes and epidemiology of asthma, which by now we've all heard a hundred times. Then the speaker would realize they were running out of time and hurriedly throw up a slide listing all the classes of asthma drugs, their brand names and refer me to some handout which was no more helpful than any textbook, and bye-bye I'm out of here. Well, I didn't need to waste a Saturday on this.

I can't tell you how disappointing most of these things are to me. No prescriber has ever called and asked me to explain what causes asthma. What they want to know is, "Can you suggest something for my patient who has failed on this-this and this?" or "Which product do you think is easiest to use?" Or, "we need help figuring out some devices to get this recalcitrant 4-year old to use an inhaler."

I know the problem with most of these CE lessons is they have to be objective and not exhibit commercial 'bias.' That's too bad, because I think some kind of bias is what we need. I truly appreciate it when a speaker can relay their own practical experience to me.
Of course I can evaluate it in the scope of my own experience. But the things I remember most are when, say, a pediatrician says "New Liquid Medication X works great and is low-cost, but I NEVER prescribe it because my patients simply won't take it -- it tastes that bad." Now, that helps me. That's something I can USE. I am always desperate for those tips, insider experience, or 'pearls' as we used to call them.

What made me write this post was deciding to give it another shot yesterday and read an article in one of those pharmacy magazines. It didn't go well. One of the articles was on Medication Therapy Management (which used to be called patient counseling, then profile review, then pharmaceutical care -- but that's another story). Another article was on the well-worn topic, "Selecting A Blood Glucose Meter." OK, great, I'm always looking for tips there. It turned out to be a pretty short article:

"A blood glucose meter is an essential tool.... patient should use....blah blah.

Yup, got that.

"Pharmacists play an essential role... selection of meter... key features.. blah blah.

Yup, that's why I'm reading this. Please continue.

"Key features that may be considered.... sample size....alternate testing sites....portability..... memory options.... blah blah.

OK, we're getting closer. Let's get down to brass tacks. Names, specifics please.

"After a meter has been selected, it is important that the patient understand...."

WAIT A MINUTE, THAT'S IT?? WE'RE DONE?? Didn't we skip over the whole 'selection' part? Oh, I see you've ended by providing me with a nice list of all the names of blood glucose meters. Well gee, so that's what all those crazy things are on my pharmacy shelves. Thanks a whole lot.

Well, I'm still searching for the ultimate CE .... good ol' Pharmacists Letter will have to be my lifeline for awhile longer. And no way am I picking up one of those magazines, unless I'm on the cover.


Pharmgirl said...

I LOVE the Pharmacist's Letter. Practical advice, short and sweet, and unbiased, keeping cost and effectiveness in mind. It's expensive, but well worth it. I think you have to pay even more for their CE's. I always use PowerPak for my CE's. It's free, keeps a running tab on years of CE, so if I'm ever audited I can look them up in a second. I learn a little from them, but I find I do my own "CE's" all year long whenever I research something I need to know more about. I'm still learning and keeping current, just not getting actual credit for it. This tactic has worked for me, at least for the past seven years...

Anonymous said...

ce has become a for profit self regulated industry with theory based principles applied to the real world so as to increase the profit. a worthy cause hijacked by the greedy.

FlyAway504 said...

My state has just accepted CPD (Continuing Pharmacist Development) as a form of CE. You get to BUILD YOUR OWN plan and choose your own learning path. You can turn a patient counseling question into a learning activity... turn your most frequently asked questions into a learning plan for the year. Its a-maz-ing! I too struggled with the fact that I would do a CE... and then dump everything I had just "learned." CPD lets you apply what you need to know so you retain it. Write a letter to your BOP :)

Grumpy, M.D. said...

For my CE, I save whatever freebie ones come in the mail (or ones that are a few bucks) and do them on driving trips while my wife drives. I don't go to meetings or any of that junk I find they're a waste of time and money.

Anonymous said...

My state association has all the ce I need for licensure, but most of it is herbal medications. Not once in a while, but every year for the past several years. It is useless to me. I also like The Pharmacists' Letter, I just don't subscribe to the ce.

The Redheaded Pharmacist said...

I can get The Pharmacist's Letter through my employer and I really enjoy their CEs. I also have attended some of those day long CE classes and sometimes I even get some useful information out of them. You just need the right speaker to be able to relate the topic information to you and your practice setting. I get what I can out of the CEs I do for my license and hope for the best but sometimes I feel like I need to be doing a lot more to keep up!

Anonymous said...

My state pharmacy organization provided CPD training several years ago, and I too, enjoyed it immensely, as it gave a focus to what I wanted to study, develop expertise, and stay relevant having graduated > 20 years ago.

I, too, like Dr. Grumpy, save up the free C.E. programs, for reading matter on commutes, trips, and like Pharmgirl subscribe to PL.

What I like about PL is access to comparative charts, therapeutic regimen, for example when I work retail out of town and don't have access to the company website or other references, PL has charts on advising products for pregnancy with cold symptoms. At my regular job PL serves as a 'tickler' to open up debate and provide something ahead of what the doctors are going to ask (as a matter of chit-chat and for their own reference).

PL has a way to keep track of CE that a person enters from different sources. I use PowerPak, CME Outfitters, MedScape, etc. to keep track of CE, but really have been keeping a CPD chart in the broad areas that I want to stay up-to-date.

It's fun to look over the past five years to see the CE and experiences I've accumulated in several areas, and easier to 'watch' progress.

For example, CHF is a top diagnosis on admission to hospitals, so have been keeping track of all the CEs and programs attended, plus the amount of time spent in preparing talks and back-up for the HF support group. The cumulative body of knowledge is helpful in serving as speaker on smoking cessation, diabetes, sudden death (to advocate for acquisition of an AED) etc. Check with your BOP. Several states have adopted this added feature to a CE audit, and I understand this is the way CE is 'done' in UK (Canada, included).

Anonymous said...

In addition to the Pharmacist's Letter, I'm a fan of The Rx Consultant.

If you're not familiar with it, it's a monthly in-depth look at one topic (such as Restless Leg Syndrome or Advances in HIV Treatment) and it includes patient counseling points. Having a subscription gives you access to all the previous issues (online) and CE credit for completing them. The price is on par with PL (a little less, perhaps), but it's very thorough and it makes you feel more confident in an area.