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Toni Talks about PT Today

The Problem with Continuing Education

Published July 1, 2009 9:21 AM by Toni Patt
I'm a continuing education junkie.  I love going to courses.  Home study courses aren't bad either.  I've had to cut down and limit myself lately because things have gotten so expensive.  I will no longer travel for a course, unless it's NDT next year.  I've restricted myself to either neuro or geriatric topics in preparation for those exams.  Over the years, I've been to excellent courses as well as courses on which I thought I'd wasted money.  My biggest disappointment was a course I paid a lot of money to be told things I already knew and listen to the speaker brag about his accomplishments.  After that experience I've learned to be more critical of what I take.

There are two courses coming up in Houston and I would like to go both.  Both are one day offerings that fit my budget.  I'd really like to go.  Both sound like they would be beneficial.  One concerns radiology, something I became interested in after my class.  The other covers motor control theory, something helpful for treating neuro patients.  The problem is I'm not sure I'll get my money's worth.

CEUs were introduced as a way for therapists to keep current on skill and knowledge.  Currently 30 states have a mandatory amount of hours required for license renewal. Some of those states (I couldn't find the exact number) use a peer review process for approval.  Texas is one of those.  The idea behind peer review is that someone familiar with the topic will be a better judge of the quality of the course.  There are three problems with this system.  First, there are no objective quality control standards for any courses.  Second, there are no requirements that courses be updated on a regular basis. Third, peer review only works if adequate materials are submitted for the review.

The APTA has published standards for CEU offerings. They cover things such as: the instructor must be knowledgeable about the topic; the instructor must include evidence-based practice; there must be specific written learning outcomes; the course must be designed in response to an identified need; there must be a written record of who attends, and so forth.  None of the 11 standards really describes any quality control.  Taken at the bare minimum someone could go out and research something in which they have no experience, develop a course based on the research and then offer it as a CEU opportunity. 

Since I've been a therapist a number of years, I've noticed that many courses have been around a long time.  I took one recently on neuroanatomy that probably hadn't updated since the speaker developed it.  The handout was crowded and difficult to follow.  She had a lot of knowledge but I doubt anyone got much out of the course because of the poor presentation.  While all courses seem to have handouts, not all of the handouts are adequate.  I've spent so much time trying to write down what wasn't included that I missed things that were probably important.  Yes, I got my CEUs, but I didn't get my money's worth in information.

Another problem with courses is that awarding of the CEUs is based on attendance, not knowledge.  One of the APTA standards is that each course must have a way of evaluating a participant's learning.  I know people who wait until the last minute to take courses.  They take whatever is available and pay little or no attention to what is being taught.  I have a PTA friend who a few years ago waited until the night before he was due.  He bought a bunch of online courses and finished them in a marathon sitting.  He learned absolutely nothing but did have enough CEUs to renew his license.  What part of that improves skills or increases knowledge?

I'm a volunteer peer reviewer for Texas.  As a result, I see bits and pieces of what is submitted.  Texas has a form it requires each sponsor to fill out.  Some sponsors do a good job and include all pertinent information. Others, and these seem to be courses from one facility or a small setting, do the bare minimum.  I've seen several that were at least 10 pages long.  Nine of those pages were resumes of the presenter(s).  One actually described the course.  The only sort of review included is one of the course itself.  Okay, it's helpful to get feedback if I'm the course sponsor.  But what does location and room comfort really have to do with what I may have learned?  We've all filled these out.  The questions are pretty much standardized. 

Obviously the system needs an overhaul.  The idea is good. The implementation is a little lacking.  The end result is a potential participant debating whether the course is worth the time and money because there is inadequate information upon which to make the decision.  Nobody has money to waste.  No matter how much I enjoy courses, I want to actually learn something from going.  With the economy today I have to be picky.  Later this year the TPTA is sponsoring a CI certification course in Austin.  Austin is about 2 and half hours away.  If I go, I would have to drive up the night before and drive home afterwards.  The whole thing isn't that expensive, but now it's a question of which courses I would rather attend.  At least in that instance I know the quality of the course in advance.

There are several solutions.  Implementing them would slow down the CEU approval process and probably drive up the costs.  I would like to see courses reviewed every 3-5 years.  The renewal date would then be included on any literature advertising the course.  In peer review states the sponsors/presenters should submit a copy of the handout as well as required forms.  I can tell a lot more from a handout than a form.  The APTA needs to redefine or develop more specific criteria for courses.  Finally, and I know this is unpopular, each course needs a brief pre/post test. The instructors would be held accountable for the results.  If the courses are poor, the course doesn't get renewed.  Yeah, there are ways around that, but it's a start.

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