From the President’s Desk: CAP Learning: practical and progressive

Create PDF

Dr. Herbek

The refreshed learning strategy adopted by the CAP Board of Governors in August recognizes that learning drives quality and that the complexity of our work creates time constraints. So our refreshed learning strategy is a refinement, not a reboot. Or, as CAP Council on Education chair Michael B. Prystowsky, MD, PhD, has said, the refreshed strategy shows we are listening to our members, to what they want and what they need, and trying to define learning in a way that is very specific so we can deliver the right courses in the right way.

How we deliver does matter, which is why a technical upgrade to the CAP learning management system, or LMS, launched in March. The upgrade accommodates pathologists who use a variety of devices, browsers, and platforms. CAP members can now search the 1,100-option learning portfolio, register for courses, take online courses, test what they’ve learned, and claim credit without disruptive transitions. This more robust and flexible infrastructure makes the most of the pathologist’s time without compromising educational quality.

Maintenance of Certification has been a driver for the CAP Learning refresh because it emphasizes the need for thoughtfully designed, practical, forward-looking CME. American Board of Pathology CEO Rebecca L. Johnson, MD, tells me that, unlike the Board exam, which measures the vast body of knowledge a newly trained pathologist recently acquired, questions on the MOC test probe what pathologists need to know to execute daily tasks without reaching for reference materials. A truly rare tumor, she says, is unlikely to show up on the MOC examination. MOC is about current, practical knowledge.

Self-assessment modules required for MOC are well represented in the CAP Learning portfolio. SAMs are a series of questions that allow participants to demonstrate their understanding of course concepts. Questions are completed online, which means just-in-time and self-paced—two huge benefits for busy pathologists. This year, 188 SAMs will be available, of which 37 are Archives Applied courses.

In June, Philip T. Cagle, MD, editor-in-chief of the Archives of Pathology & Laboratory Medicine, will introduce a new format for the Archives Applied program that will offer more CME/SAM credit. Rather than a single article per CME/SAM activity, the new Archives Applied will be framed on less frequent, more substantial, and more rigorous challenges drawn from a cluster of related original articles. The first will feature learning in immunohistochemistry based on articles published in special issues of the journal (December 2014 and January 2015).

M. Elizabeth H. Hammond, MD, who chaired our first Education Committee and has been a driving force in multidisciplinary development of practice guidelines, sees advantages to online learning for imparting new knowledge, especially in anatomic pathology. When all the members of a group take the same online courses, she says, they will learn to employ the same diagnostic rules and the same terminology, which enables greater clarity and consistency in talking about complex and challenging diagnoses. This underscores a core element of the CAP approach to education: The value of a learning experience emerges in how readily and how often it is applied in practice.

Some of our learning experiences feature both online and live options. For example, more than 750 pathologists have participated in an Advanced Practical Pathology Program (AP3) since 2009. These are the most rigorous of our education offerings; multidisciplinary breast pathology, for example, involves seven online courses and a two-day workshop taught by breast pathologists, oncologists, and radiologists.

I was lucky enough to be able to be part of the pilot for the Breast Predictive Factor Testing AP3, one of three that have earned the prestigious Excellence in Practice award from the international Association for Talent Development. The Ultrasound Guided Fine Needle Aspiration and Laboratory Medical Director AP3s have also received the award, which recognizes exemplary workplace learning.

The excellence of CAP education reflects the generosity of expert pathologist faculty and the support of instructional designers on the CAP Learning staff, who work with them to develop goals and objectives for each program, evaluate test questions, and coordinate peer review to ensure that questions are realistic and consistent with best practices. Because the instructional designers understand how learning works, they can create scientifically valid evaluations so that participant feedback can enable iterative changes that make courses more interesting. Feedback also identifies ineffective courses for removal from the curriculum.

Some of our most successful educational collaborations have involved the American Society of Clinical Oncology. Working with ASCO, we were able to develop and refine guidelines for standardized breast cancer predictive factors testing and educate pathologists in multidisciplinary breast pathology. These intensive endeavors have drawn on the talents and energies of preeminent oncologists, educators, and breast pathologists, such as David G. Hicks, MD, a professor of pathology and laboratory medicine at the University of Rochester School of Medicine in New York.

And we recently teamed up with ASCO and the Association for Molecular Pathology to launch an interactive molecular oncology tumor board series. Each month, the online tumor board features a case-based discussion of genetics and genomics in cancer treatment presented by rotating pathology and oncology faculty. (To access the discussion, log in as a guest at http://university.asco.org/motb.)

A CAP team collaborated with the Association of Pathology Chairs and Association for Pathology Informatics to develop the Pathology Informatics Essentials for Residents, or PIER, curriculum now being piloted in 14 residency programs. A second partnership with the APC Program Directors Section has resulted in a case-based online test utilization program for residents that fosters effective consultation skills around clinician test ordering.

Education is core to our mission. As pathologists, we have a responsibility to provide understanding about disease. Through the College, we teach fellow pathologists how to share that understanding, and we are intent upon doing it well. Because, as Dr. Hammond likes to say, if what we provide doesn’t change behavior, then we haven’t really created any learning at all.
[hr]

Dr. Herbek welcomes communication from CAP members. Write to him at president@cap.org.