The business of continuing education
Now is the time for CE providers and users to demand more from learning experiences and work together to raise the standards.
Creative Disruption columnist Dr. Bob Lester wrote in the last issue about the state of most in-person continuing education. (Read “Always Be Learning” at http://bit.ly/2ZMT7qt.) A lot of CE, he stated, is delivered in dark rooms and 50-minute chunks by a sage on the stage, a format he described as “arguably, the worst adult learning modality.” CE often takes place in cool cities that offer more than just education. Dr. Lester admitted that many people, himself included, will attend if the material interests them and not necessarily because they need the material.
It’s worth spending a few minutes to understand how we got here with CE and how we’ll get to a better place. Let’s look at historical reasons, licensing standards and the ease of production as three main reasons CE looks the way it does, and I’ll examine why we should move beyond the status quo.
Historical Continuing Education
People today would question anything taught 100 years ago, but not enough of us question the means by which we are taught. Imagine going to a hospital today and being prescribed leeches for bloodletting or watching a veterinarian jump from surgery to exam to surgery without using proper hand hygiene. And yet, our educational system is built on a model of the scarcity of information that dates back thousands of years.
When formal education first emerged in Europe and then in the United States, few people were qualified to teach the masses. A student couldn’t just pop in and get a lesson on, for example, splenectomies; rather, because of the scarcity of instructors and the abundance of learners, the educational experience needed to be structured so that the single instructor could convey information to many students at one time.
Then, because of prerequisites, time-bound cohort systems needed to be built so that learning could progress in a linear fashion from the less complex to the more complicated. The scarcity of information created the barriers of space and time that either limited or too quickly accelerated the growth of the learner.
We no longer need to gather in particular places to access information. Today, we have more computing power in our pockets than the astronauts did when they landed on the moon. And yet, what are the major uses of our smartphones? Facebook, Instagram and email.
In a world where attention is becoming more precious than money, it is always going to be difficult, if not impossible, to compete with the clickbait of social media, but we must try. Too often, we placate ourselves with the slot machine of our social feeds, hoping that one more pull will yield the reward we’re looking for. Unfortunately, there is no jackpot. Evidence shows that our pleasure in searching social feeds comes more from the searching than the finding — the dopamine comes from the hope, not the reality, of social media.
In sum, we don’t need to gather in darkened rooms to access information. Information is ubiquitous, and so, too, should be learning opportunities.
The Registry of Approved Continuing Education is recognized as the standard for most continuing education, including that provided at conferences and webinars. Getting RACE approval means your CE material will satisfy individual state requirements. The key part of the RACE program is it provides standardization across the industry. As well, it provides criteria that must be satisfied, including formal requirements for the instructor. The result? Most of our CE follows the 50-minute plus five-question rule that RACE prescribes. This format is better than not having assessment techniques in place, but it perpetuates the idea that content covered equals content learned. As you’ll see below, that’s not necessarily true.
We need not move beyond equating licensing standards with learning standards. We need to demand more of our in-person lectures. It can start with three steps.
1. Know Your Audience
As with all businesses, so too with education; knowing your audience means understanding the needs of your audience. Taking a few minutes before any lecture and asking yourself why people are attending helps to adapt the information to the learners and ensure that everyone gets what they’re hoping for: a great learning experience.
2. Chunk the Information
Summarizing the lecture every 15 minutes or so — typically the length of time someone can focus on a given topic — allows the learner to synthesize the information and create recall cues for future use. Remembering four main ideas is much easier than remembering a series of connected but disparate thoughts.
3. Take Learning Objectives Seriously
If your objective is simply to get the learner to understand something, then you haven’t thought seriously about what the learner will get out of the presentation. Instead of filling buckets with information, think about the observed behavior you want your learners to demonstrate. And if you’re feeling bold, think about how the new skill will be practiced and assessed. Leaving out the implementation strategy for new information means you’re leaving out of the most critical aspects of lecturing.
In sum, we have to go above the minimum bar set by licensing bodies. People involved in the business of continuing education need to demand more of ourselves. Our learners deserve better.
Ease of Production
Getting an instructor and room and then filling it with attendees is relatively easy. Lectures and their online versions, webinars, are easy to produce, but that’s not justification for doing so. In some instances, not having an appropriately structured learning environment might adversely affect learners.
A 2014 study published in Management Science showed that a one-hour learning experience that was not followed up with repeated interventions can have a negative outcome. Twelve months after the learning session, attendee confidence was high because they recalled being at the one-hour lecture, but their retention was low because they didn’t use or weren’t reminded of the information provided. This created the worst possible situation: Confidence exceeded competence. It’s not much of a stretch to see this as an analogous case in veterinary medicine.
A simple solution for avoiding memory decay is to regularly follow up with learners, such as through monthly emails or discussion boards, to ensure that they have retained the right information. Plenty of veterinary CE platforms allow for such engagement, like those mentioned by Dr. Lester: Axon, VetBloom and VetFolio.
Justifying a business pivot when the market doesn’t demand one is difficult, but being ahead of the curve is sometimes better when the opportunity and the evidence points in that direction.
Too many of our continuing education business models are not following the validated and well-established principles of how we learn. Take Ruth Colvin Clark’s “Evidence-Based Training Methods: A Guide for Training Professionals,” a book filled with myth-busting facts about how people learn. For example, learning styles (acoustic, visual, tactile) are a myth, she writes, and yet these influence most learning content. Instead of different learning styles, we are on a spectrum of learning — from simplicity to complexity, not from one sense to another.
The book should become a canonical text for anyone offering CE courses. It’s a text that is helping us shape veterinary continuing education at Colorado State University.
Now is the time for CE providers and users to demand more from learning experiences. As evidence-based as veterinary medicine is, we have a long way to go before we can say that our current CE standards are evidence-based.
If you’d like to learn more about what these standards should look like or just continue the conversation, please connect with me on LinkedIn or email me at [email protected]. We need to work together to raise the standards of continuing education.
Innovation Station columnist Dr. Aaron Massecar is assistant director of continuing education at Colorado State University’s Translational Medicine Institute.