Learning, Teaching and Education

While attending the annual board meeting for the National Board of Medical Examiners, I once again was struck by the plethora of opinion on the state of medical education and the various capabilities in place that influence our professional development. We have all felt, and continue to feel, the impact of this network that is colloquially referred to as the “House of Medicine.”

Given the rapid change occurring in health care, a question often raised about our profession: Is the house in order?

Well, let’s start by clarifying what is in the house:

1. Accreditation Council for Continuing Medical Education.

2. Accreditation Council for Graduate Medical Education.

3. American Association of Colleges of Osteopathic Medicine.

4. American Board of Medical Specialties.

5. American Medical Association.

6. American Osteopathic Association.

7. Association of American Medical Colleges.

8. Educational Commission for Foreign Medical Graduates.

9. Federation of State Medical Boards.

10. Liaison Committee on Medical Education.

11. National Board of Medical Examiners.

12. National Board of Osteopathic Medical Examiners.

There they are — a dozen entities that influence the education and professional development of physicians (allopathic and osteopathic). And, each has its own distinct mission or purpose ... which, at times for some, feel as if they are working at cross-purposes. This also is the educational landscape in which AAPL is continuing to place itself to be better recognized as the most important organization representing all levels of physician leadership within health care.

Interestingly, the topic of interprofessional physician leadership surfaces within these various entities on a regular basis. And yet, while there are only a few initiatives underway within those entities, with nearly 45 years of experience in this arena of physician leadership, AAPL is recognized as the lead organization with its legacy of expertise and quality programming — something for which we can all be proud. And I continue to believe we are on the vanguard (pun intended, given the name of our special group for highly seasoned physician leaders) in this arena.

As to whether the house is in order? I would have to say yes and no, based upon my interactions with most of these organizations at some point in the recent past. On the “yes” side, each is undergoing significant revisions and refinements to its books of business and how it approaches its respective missions in the current era of health care. Each is to be commended in this regard. On the “no” side, health care is an inherently conservative industry, and medical profession education, coupled with professional development, is having a difficult time keeping pace with the rapid cycle of innovation and disruption occurring within the industry from its other sectors (such as technology, payment, biosciences, etc.). The pace of change for education, therefore, struggles to keep up with the pace of change in clinical delivery systems.

It is in this latter realm of clinical delivery where AAPL has its sweet spot. To maximize the potential of physician leadership, AAPL concentrates its activities in three strategic focus areas:

1. Insightful thought leadership and communications.

2. Contemporary learning and performance.

3. Personalized career development services.

The ultimate overlap of these primary strategies is where AAPL creates the greatest impact with interprofessional physician leadership. AAPL’s organizational growth continues to expand not only with the provision of programs, products and services to individual physicians, but we also continue to expand our capabilities within the variety of clinical delivery systems across the country.

As I ponder our own vision, mission and values, and the directions we are headed, I continue to appreciate how expert we are in the delivery of education and professional development. It is our legacy — and our future.

In order to support our future, with full engagement from our board of directors, we have invested heavily over the past few years in the AAPL infrastructure, its programming tactics, our staff resources, and the development of a unique professional-development technical platform that supports our capabilities to deliver exceptional programs, products and services to our constituency in a wide variety of ways.

While I am extremely proud of all we have accomplished in a relatively short period of time, it is this professional development technical platform for which I believe we shall become highly recognized in the near future. This platform (see Figure 1), in addition to several other newly launched AAPL initiatives, is being rolled out formally during the AAPL Annual Summit in Washington, D.C., in May.

Figure 1. The AAPL platform

Given how we are so expert in the delivery of education and professional development, it provides a moment to go back to basics and consider the differences among learning, teaching and education. For your refreshment:

• Learning “ ... is the transformative process of taking in information that — when internalized and mixed with what we have experienced — changes what we know and builds on what we do. It’s based on input, process and reflection. It is what changes us.” (From The New Social Learning, by Tony Bingham and Marcia Conner, 2010 Association for Talent Development.)

• Teaching is the process of attending to people’s needs, experiences and feelings, and intervening so that they learn particular things, and go beyond the given. (From Infed, at infed.org/mobi/what-is-teaching .)

• Education is the act or process of imparting or acquiring general knowledge, developing the powers of reasoning and judgment, and generally of preparing oneself or others intellectually for mature life; the act or process of imparting or acquiring particular knowledge or skills, as for a profession. A degree, level or kind of schooling. (From dictionary.com .)

AAPL does all of this.

As an association, we are one that is continually learning for itself while simultaneously helping to provide an environment where others can learn more simply and readily as they transform their leadership capabilities. We also pride ourselves on the outstanding AAPL faculty members (that is, teachers) who impart their knowledge in ways that facilitate better learning by others so they go beyond the given. And we provide a constellation of opportunity to develop skills, acquire knowledge, to obtain certificates or degrees that allow others to advance themselves and their organizations.

Within the complexity of health care delivery, and in the context of an equally complex House of Medicine, we do a pretty darned good job — an exceptional job, actually. But there is still more to be done.

Going back to the House of Medicine, there is another entity out there — a coalition within the house that is making efforts to improve the coordination and continuity along the spectrum of medical profession education. It is populated by the dozen or so entities mentioned and meets on a regular basis. The Coalition for Physician Accountability (physicianaccountability.org ) has a mission to advance health care and promote professional accountability by improving the quality, efficiency and continuity of education, training, and assessment of physicians. AAPL is in communication with this coalition and has hopes to become a participant at some level in the near future. In so doing, AAPL then will be clearly active in both health care arenas: clinical delivery and medical education.

LEADING AND CREATING CHANGE is our association’s overall intent, by helping to create significant change in health care through physician leadership. AAPL maximizes the potential of physician leadership to create significant personal and organizational transformation. We are in the process of rolling out more initiatives, and will provide even more in coming months, in our efforts to help build a stronger health care system — for patients, physicians and other providers.

I encourage each of us to continue seeking deeper levels of professional development, and to reflect on how our ongoing learning, teaching and education goals are being satisfied through professional development. We can generate positive influence in these arenas at all levels. As physician leaders, let us get more engaged, stay engaged and help others to become engaged. Creating a broader level of positive change in health care — and society — is within our reach.