Friday, June 27, 2014

A warning to family physicians doing educational modules - cultural competency isn't your worst option

The American Board of Family Medicine requires recertification every seven years. The standard modules are rigorous; perhaps absurdly so. They often require answers taken from the medical literature that have a reliability half-life of about 8 months. (That is, half these answers will be incorrect within 8 months of initial publication.)

I'm not warning family docs about those exams however. I'm warning docs who don't actively see patients about something far worse.

If you don't see patients, you need to do one of 3 "alternative modules". As of June 2014 the choices are:

  • cultural competency
  • hand hygiene
  • information management (MIMM)
Emily did hand hygiene. It was annoying and hard on the hands, but pleasantly mindless.

I'm a computer geek, so I thought information management might be interesting.

Oh, fool that I was. I am a broken man on a Halifax pier. Halfway through the exercise I fell sobbing to the floor, begging Emily to end my suffering. By the end, I thought of Winston Smith.  I have foresworn my career. Never again shall I speak of the role of software in medicine. I shall become an itinerant monk, clothed in rags, ranting before the doors of America's medical schools...

Do cultural competency.

You're welcome.


"Doc Saver" said...

I am shocked to see such an evidence-free(TM) recommendation here. Cultural competency could be just as bad, absent evidence to the contrary. Shouldn't you be recommending, er, washing your hands of the matter?

And remember - the ABFM says, "Large numbers of family physicians are participating in MOC. ... The penetrance of MOC engagement shows that MOC has the potential to convey substantial practice-relevant medical information to physicians." Hand washing engagement (at least occasionally) has 100% penetrance and we clearly are missing the opportunity for "smart soap" to provide CME.

John Gordon said...

I'm applying Bayesian analysis. Since MIMM was among the most awful learning-like things I've had to do, it's overwhelmingly likely that Cultural Competency isn't as bad.

I think you really should try that MIMM module.

Then you can get a cardboard box next to mine outside a nearby medical school.