Creative Disruption columnist Dr. Bob Lester is the chief medical officer at WellHaven Pet Health, a former practice owner and a founding member of Banfield Pet Hospital and the Lincoln Memorial University College of Veterinary Medicine. He serves on the boards of Pet Peace of Mind, WellHaven Pet Health and the Lincoln Memorial veterinary college. He is president-elect of the North American Veterinary Community.Read Articles Written by Bob Lester
The continuing education myth is the fallacy that attending CE events keeps veterinary professionals current with contemporary standards of practice. Remember when your professor told you that half of everything you learn today will be obsolete in five years? Man, was she right!
Lifelong learners, that’s what we all aspire to be. In fact, we swore in our Veterinarian’s Oath, “I accept as a lifelong obligation the continual improvement of my professional knowledge and competence.” The Veterinary Technician’s Oath is perhaps even more powerful: “I accept my obligations to practice my profession conscientiously and with sensitivity, adhering to the profession’s code of ethics, and furthering my knowledge and competence through a commitment to lifelong learning.”
Lifelong learning is about creating and maintaining a positive attitude on learning for both personal and professional development.
How, Where and What?
When I served as a member and chairman of the Oregon Veterinary Medical Examining Board, I and the board were accountable to the animal-owning consumers of our state. Consumers want assurances that the veterinarians and nurses who care for their animals are up to date and practicing at or above a minimum standard.
So, how can boards in good faith let the public know that the veterinary professionals in their state are lifelong learners and equipped to provide contemporary knowledge and skills? Answer: By mandating that licensees complete a set amount of periodic, approved continuing education. Makes sense, right? But consider this: How is most approved CE delivered, where is most CE delivered and what CE do most veterinarians attend? I’ll explain.
Arguably, the worst adult learning modality is CE that takes place in a dark room, lasts 50-plus minutes and is delivered in a series of PowerPoints. “Death by PowerPoint,” as the saying goes. Quick, try to recall the last three traditional, dark room, hard chair, sage on the stage, PowerPoint lectures you attended. Do you remember the topics? Did your attendance up your practice game? I suspect not.
CE is frequently offered in cool places like casinos, cruise ships, resorts and sunny destinations. Did you attend all the CE for which you registered? Did you split your time and brain between a few lectures and the pool, golf course, slot machine, beach or your favorite pastime? Color me guilty.
What CE did you attend? A handful of topics fascinates me; I can’t get enough. I attend lectures catering to my strengths and passions. What I don’t attend are the topics I’m not so interested in, and as a result, not so good at. Hmm? Maybe I should attend a few lectures and labs that address my weaknesses?
A Growth Mindset
We’re all born with a passion for learning that for many of us sadly fades over time. School and the performance pressure that comes with it likely robs us of some of the joy of learning. Regardless, many people fall into the rut of sticking to what they know — a safe and crippling state of being. The motivation to stretch, get uncomfortable and fail at times fades.
A mindset of continuous learning best positions us for an ever-evolving future. Dr. Carol Dweck, a psychologist and Stanford professor, distinguishes between a fixed mindset and a growth mindset.
In a fixed mindset, people believe that their basic qualities, like intelligence or talent, are fixed traits. They believe that talent alone, without effort, creates success. They believe that they are “smart” or “dumb” and that there is no way to change. No matter how hard they work at something, a ceiling prevents them from getting better.
In a growth mindset, people believe that their basic abilities can be developed through dedication and hard work. Brains and talent are a starting point. This view creates a love of learning and a resilience that is essential for great accomplishments. The sky is the limit. It’s not about proving yourself, it’s about improving yourself. Three cheers for a growth mindset!
“Future Shock” author Alvin Toffler once said, “The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn and relearn.” Learning and relearning can be fun. Unlearning is hard. It’s hard discarding old thinking, protocols, treatment plans, business practices and communication styles. But that hard work is necessary to progress and grow as people and professionals. Unlearning is particularly difficult for adults; kids are good at it. Our thinking becomes more rigid as we age. Practice unlearning. Challenge yourself as to what you think you know.
How difficult was it for medical professionals of the past to unlearn bloodletting, lobotomies, arsenic and mercury treatments, urine for teeth whitening, shock therapy, and heroin for children’s coughs? All were considered contemporary medicine in our great-grandparents’ day. The importance of learning, unlearning and relearning has never been more important than in today’s rapidly changing workplace.
A New Way to Look at CE
Today’s CE norms center on attending a prescribed number of annual events so that veterinarians and veterinary nurses can stay abreast of our rapidly changing field. But perhaps there’s a better way? Alternative CE norms could include:
- Being recertified periodically. Should we retake the NAVLE/VTNE or similar examination periodically? These are proven methods of demonstrating contemporary competence. I’m not signing up for that. National boards nearly killed me when I took them.
- Embracing open ledger technology (blockchain) to track agreed-upon competencies focused on relevant learning outcomes. This provides for gaining “badges,” or demonstrating competence via examination or skill demonstration throughout your career and documenting attainment in an electronic ledger. I suspect this will be the norm in 10 years. We’re not there yet, but I see Gen Zers and millennials embracing a competency-based system of continuing education supported by open ledger technology.
Or you can stay with the honor system of state board-approved annual CE. More dark rooms, more PowerPoints and more hard chairs. Ultimately, I trust my colleagues and believe that the majority of us are conscientious and sincere in staying up to date with contemporary standards of practice.
A Practical Method
Credit to President Theodore Roosevelt, who famously said, “Complaining about a problem without proposing a solution is called whining.” I’ll readily admit that I’m mostly whining. The clear solution is to require periodic recertification, but as I said, I am not ready to sign up for it. Kudos to organizations like the American Board of Veterinary Practitioners that require periodic recertification, and to the majority of our colleagues who conscientiously strive to stay current.
A practical method to continuously grow and learn is the 70:20:10 model. Seventy percent of learning is on the job, 20% is through mentors/coaches/sponsors, and 10% is through CE offerings like conferences, podcasts, webinars and reading.
Our profession is blessed with great learning platforms like VetFolio, VetBloom, AVMA Axon, VetMedTeam as well as great in-person CE at the VMX, WVC and AVMA conferences. Beyond these, make learning a part of what you do every day. Learners are made, not born. The deliberate use of dedicated strategies to continuously improve can make us all better at getting better.
Always Be Learning
In my lifetime, we have moved from stressing IQ (intelligence quotient) to EQ (emotional quotient), and now to AQ (adaptability quotient). AQ is the ability to adapt in a fast-paced environment. Those most successful going forward will adapt, continuously learn and relearn, skill and reskill, and remain curious. The rate of change will never be slower than it is today.
I have a friend and colleague in our WellHaven Pet Health practice who frequently reminds me to “ABL” when unusual or difficult situations arise. What is ABL, you ask? It’s her shorthand for “always be learning.” Clearly, she’s a lifelong learner.
Ultimately, we all own our learning. We’re obligated to stay up to date for the good of the patients and families we serve, and keep ourselves and teams engaged, excited and current. Stay curious, be engaged and remember to ABL.