Healthcare Disparities: Promoting Change Through Continuing Professional Development

Healthcare disparities have long been a pressing issue that impact the well-being of patients on various fronts – physical, mental, and financial. The use of Continuing Professional Development (CPD) programs has emerged as a potential solution to address and mitigate these disparities. While the impact of CPD programs focused on disparities remains an underexplored area, this article delves into quantitative data from seven such CPD programs, shedding light on their potential to drive change.

The Systemic Nature of Healthcare Disparities

Healthcare disparities are systemic issues that affect not only individual patients but also entire communities. In our constantly evolving world, where patients come from diverse backgrounds with varying cultures and belief systems, addressing disparities becomes an ongoing challenge. Unfortunately, many medical training programs have failed to consistently incorporate content related to disparities among underrepresented populations into their curricula.

For example, a 2011 survey revealed that 33% of medical schools did not include any LGBTQIA+ education in their curriculum. Radiologists also reported a lack of education in healthcare disparities, with only 16.4% feeling adequately trained in this area. Similarly, a study on pharmacists found that 65% did not have social determinants of health (SDOH) addressed in their didactic curriculum, and 45% reported that SDOH were not addressed during their residency. This educational gap in healthcare training exacerbates the potential for future healthcare disparities.

CPD Programs Addressing Healthcare Disparities

In a recent analysis conducted by Richard A. Menear, Katelyn N. Hernandez, Lisa Handley, Ashley Ann Lora, and Sarah A. Nisly and published in the Journal of CME, various CPD programs focusing on healthcare disparities were examined. These programs engaged a total of 41,588 healthcare providers in educational content and the results were promising, showing a 25% improvement in knowledge-based questions and a 27% improvement in competence-based questions among learners who participated in these programs.

Furthermore, an encouraging 2.5% of learners participated in a post-activity evaluation. Of these participants, 59% reported using information from CPD programs to enhance their current practice, while 34% expressed intentions to implement strategies aimed at reducing or mitigating healthcare disparities. These findings underline the potential of CPD to increase awareness and equip healthcare providers with the knowledge needed to address disparities effectively.

The Urgent Need for Timely Education

The absence of meaningful education in healthcare training for preventing future healthcare disparities is glaring. It underscores the importance of healthcare professionals engaging in timely education to mitigate disparities in their practice. While standalone CPD programming can be impactful, partnerships between CPD providers and healthcare entities can also yield meaningful education in healthcare disparities.

Clinical Education Alliance (CEA), for instance, has focused on educating learners about strategies to reduce healthcare disparities, particularly in high-risk therapeutic areas. CEA emphasizes how social determinants of health (SDOH) impact the quality of care, helping learners recognize these barriers and bridge the gap between at-risk patients and improved healthcare.

Results of the CPD Programs

Between September 2021 and December 2022, the authors of the study noted above identified and summarized seven CPD programs with a focus on healthcare disparities. The programs utilized various educational formats, including live in-person and virtual meetings, as well as enduring components for asynchronous learners. Learners’ demographic information, including healthcare profession and practice specialty, was collected, and participants had the opportunity to complete pre-tests and post-tests to assess their knowledge and competency.

Among the seven CPD programs, a total of 41,588 learners engaged with the educational content, with a balanced distribution between US and non-US participants. The professions of the learners who participated in the CPD programs varied widely. Across the programs, 43 assessment questions were included, revealing a 25% improvement in knowledge assessment items and a 27% improvement in competence assessment items.

Of the healthcare providers who participated in the post-activity evaluation (2.5%, n = 1101), 35% expressed a willingness to make changes to their current practice. Remarkably, 59% reported that they had already implemented the procedures in practice, reflecting a proactive approach to addressing disparities. Only 6% indicated that they would not make changes to their practice. Additionally, it was found that 30% of healthcare providers identified financial issues and insurance as barriers to change, followed closely by patient adherence.

Discussion: The Way Forward

This pilot analysis showcases several encouraging aspects of CPD in addressing healthcare disparities. Importantly, more than one-third of participants expressed a willingness to make changes to their practice to address these disparities, marking an essential first step in breaking down barriers affecting marginalized populations. While quantitative findings in this area are limited, a robust foundation of qualitative data provides valuable insights into effective strategies to mitigate healthcare disparities.

One opportunity to enhance CPD’s impact on healthcare disparities is through collaboration with patient advocacy groups. Patient representation is currently lacking in CPD programs, and including patients’ perspectives is crucial. Patients possess unique insights into their own experiences and invaluable perspectives on the challenges they face. By incorporating patient voices, CPD programs can become more relevant and responsive to real-world needs.

Moreover, educating healthcare professional students is pivotal. To effect change in the healthcare of high-risk patients, engaging healthcare students should be a priority. Institutional education should incorporate content focused on disparities faced by specific populations. This knowledge can then be applied by post-graduate trainees in their practice settings, influencing change within healthcare systems.

While this pilot analysis yielded noteworthy results, it’s important to acknowledge its limitations. Response bias and low response rates could contribute to discrepancies between learner activity and responses to assessment and demographic questions. Self-reported metrics also limit the ability to confirm the actual impact on patients. Furthermore, selection bias may exist in the choice of the seven CPD programs.

Conclusion

Continuing Professional Development (CPD) programs represent a promising avenue for addressing and mitigating healthcare disparities. The quantitative data presented in the study  demonstrate the potential of CPD to equip healthcare providers with the knowledge and competence needed to tackle disparities effectively.

To drive change and break down systemic barriers, it’s important that healthcare disparities education is prioritized and emphasized in both pre-graduate and post-graduate training. Additionally, collaboration with patient advocacy groups and inclusion of patient perspectives in CPD programs can enhance their relevance and impact.

In conclusion, CPD offers a valuable tool for healthcare professionals to bridge the gap in healthcare disparities. As we move forward, let us continue to emphasize the importance of addressing healthcare disparities through education, training, and a commitment to patient-centered care.

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