Do We Have a Problem with our Problem Solving Behaviors?

August 30, 2011 at 2:14 am 2 comments

In our drive to design CME activities that we hope will demonstrate impact or improvement on a professional practice gap we often jump to potential causes or even solutions before we fully understand the real nature of the gaps that give rise to presumed educational needs. We frequently don’t take a careful approach to understanding the problems causing the professional practice gaps and educational needs.

Often the first inclination we have when we think we have identified a professional practice gap is to identify something we can act on to address the perceived gap. But in a systematic, sustainable, repeatable, data based approach to identifying and acting on a professional practice gaps we should wait until we have a clear and precise understanding of what the gap(s) actually are and if there are any educational needs that, if targeted, could potentially reduce the gap. This should be our starting point in designing any CME activity. Without this understanding we have no way to measure our success. Without this understanding we have no way to know if we actually reduced the identified gap(s) or educational needs.

Carefully gathering information that explains what is actually occurring in practice and trying to make sense of the identified gap as specifically as possible will move us from acting subjectivity to taking actions based on facts. We can’t reliably measure subjective assessment of situations. We can gather reliable data that clearly describes current circumstances in a practice setting. To accurately depict a real professional practice gap it is important to look at existing data related to the actual situation in which the gap is occurring. We can’t only rely on what others say about the situation. You change what you measure. Show me the data.

To truly understand the practice gaps(s) and educational needs arising from those gaps we have to describe them clearly and precisely. Further we need data that will help us gain an understanding of why the professional practice gaps and educational needs exist. With this level of understanding we can break the causes of the gaps and needs into manageable pieces. Having manageable pieces is invaluable in developing an instructional strategy. Without a specific instructional strategy established to systematically address the causes of professional practice gaps and educational needs we are more likely than not to fail in demonstrating any impact from our CME efforts.

The key to solving any problem is to follow a systematic data based process that leads us to real solutions addressing the cause of the problem instead of acting on opinions and feelings. Opinions and feelings only lead us to more opinions and feelings.

What is your approach to this process? Mine is A3 Problem Solving. Look it up.


Entry filed under: CME, CME Issues, Improvement, Physician Continuing Education, PI CME. Tags: , , , , .

CME Shown To Produce Positive Clinical Outcomes Can I Improve What I Don’t Measure?

2 Comments Add your own

  • 1. Larry Hiner  |  August 30, 2011 at 2:40 am

    I agree that there is a lot of training “out there” that turns out to be less effective in helping meet its ultimate objectives. It may be brilliantly designed and executed, yet still fail. Why is this?

    Don Kirkpatrick has been talking about this for around 50 years, and now his son Jim and wife Wendy are continuing and expanding on the ideas ( Essentially, they say, “start with the results” in mind, then design back to the training event/s. It works a bit like this (numbered in reverse on purpose…):

    4. What is the business result you want to achieve? Be as specific as possible.
    3. What behaviors or attitudes would have to change in order for that business result to be achieved?
    2. What skill or competency would need to be acquired in order for that behavior or attitude to change?
    1. What training event/s would result in acquiring that skill or competency?

    Once you’ve walked through this process, measuring the effectiveness of the training would follow the revers (which is the reason for listing them in descening order, above):

    1. Was the training event successful in teaching that skill or competency?
    2. Was the skill/competency acquired with some persistence?
    3. Did the behavior/attitude change?
    4. Did the business result occur?

    With CMEs, the business result may be improved clinical results or patient satisfaction, e.g. The behavior may be a particular protocol. The competency would be around the clinical capability to know/perform the protcol. And the training would be designed to train up that skill.

    I’m not associated with Kirkpatrick, not certified in their model – but it may inform your process…


    • 2. Floyd Pennington  |  August 31, 2011 at 11:52 pm


      Good points. I am familiar with the work of Kirkpatrick. This scheme works well once you understand what is causing the problem(s) you are trying to address. Without knowing root causes and addressing those you may be throwing “training” at things that won’t lead you to your desired business results.

      if readers are not familiar with the work of Don Kirkpatrick, look it up. Good stuff.



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