New Data Suggest Remedial Courses Reduce Recidivism
New Data Suggest Remedial Courses Reduce Recidivism
As a provider of remedial education, PBI Education is often asked whether remedial continuing education (CME/CE) courses actually work. Specifically, do they have the kind of impacts that would assure referring entities and the public that professional wrongdoing has been corrected and will not recur? An exciting new research report in the journal Academic Medicine provides evidence that remedial CME courses can help reduce physician disciplinary recidivism in certain circumstances.
A research team from the Federation of State Medical Boards and Laurentian University looked at allopathic physicians disciplined by their US licensing boards for the first time between 2011 and 2015. 4,061 physicians met inclusion criteria. As a result of this first-time discipline, some physicians were ordered to complete remedial education, and some were not. Of the 4,061 total studied, 35% (n = 1,426) ended up receiving additional discipline at a later date. A noteworthy finding was that 73% of those disciplined a second time had not been mandated to complete remedial CME. The authors’ additional data analysis suggests that physicians who were mandated to complete remedial CME as part of their first discipline were less likely to receive additional discipline than those who were not.
Understand the Difference
If you are familiar with the intensity of remedial courses, you will not be surprised by these findings. However, many are still unclear about what remedial courses are and how they differ from general continuing education courses.
The fundamental difference is the goal of each type of course. Simply put, general CME courses are oriented towards preventing problems—akin to primary prevention in clinical care—while remedial courses are targeted at areas that need a remedy—as in secondary prevention of a clinical condition. What referring entities hope for, and course participants work hard to achieve, is a transformation in the clinician’s approach to their professional practice.
This table presents the major differences between general courses and PBI Education’s approach to remedial CME. Note that all remedial education providers are not created equally, and regulators should carefully vet any providers they are approving. Some things to consider are the provider’s years of experience in this highly specialized field, the size of the classes, the experience level of the faculty, the level of active participant discussion vs. content-driven didactic lecture, and any potential for conflict of interest with their faculty to name a few. Read PBI’s Poster for guidance on this topic.
The Major Differences Between General and Remedial Courses
| General CME/CE Courses | PBI’s Remedial CME/CE Courses | |
| Goals | – Stay current in the field – Learn something new – Buff up skills – Comply with required topic areas (e.g., mandated reporting, communicable diseases) | – Explore why the professional wrongdoing occurred – Learn ways of decreasing the risk of wrongdoing – Develop a corrective action plan to practice more safely – Reduce recidivism |
| Format | – Large lecture/conference – Online, self-paced – Group demonstration – Audit and feedback | – Small group (~10-15) – Pre-course readings and submitted assignments – Interactive discussion – Intense, personal, emotional |
| Duration | – Each topic takes one or more hours – Could have multiple short sessions within a conference lasting one or more days | – One to three full days (typical, but could be longer) |
| Pass/Fail | – Attendance can be sufficient for earning credit hour(s) – Only some require passing a quiz (with multiple attempts) | – Attendance insufficient for earning credit hours – Clear criteria for passing or failing – Individualized written report available |
Most clinicians who are directed to take a remedial course are smart, highly educated, well-trained people who have good intentions. They don’t understand how they could have exercised poor judgment, caused harm, or violated laws or rules. The process orientation of a rigorous remedial CE course demands that participants discover the process by which they committed their misdeeds and take responsibility for their words and actions. Mere course content is not sufficient to accomplish the kind of personal and professional transformation necessary to assure regulators and the public. The contribution of remedial education to the prevention of recidivism can likely be traced to that deep transformation.
PBI Education’s Research on Recidivism
PBI Education has conducted research on rates of recidivism after participation in a remedial course. We looked at a subset of our own course participants and followed them for up to 11 years. The data showed that only 2.9% of the 210 clinicians who met inclusion criteria re-offended with the same type of infraction within that time frame, and 6.7% re-offended, but with a different type of infraction. With such a long follow-up period, our findings also point to the positive impact of remedial CE.
To circle back to the question posed at the beginning about the impact of remedial CE, we answer yes, indeed—intensive, process-oriented remedial CE courses can contribute to the correction of wrongdoing and prevention of recidivism.
Takeaways
- A recent research report suggests that remedial courses are likely to help reduce recidivism after professional discipline.
- Remedial courses and ordinary continuing education differ considerably because of their different goals.
- Remedial courses are a reliable remedy for a professional problem.
- Regulators and other referring entities should consider including remedial CE courses in disciplinary measures.
What PBI Education Learned by Studying Recidivism
References
Caldicott CV. Why Quantifying Recidivism After Remediation Is So Difficult: The Experience of an Education Provider. Journal of Medical Regulation 2022;108(1):21-28.
Arnhart K, Wenghofer E, Pei X, Young A. The Likelihood That Remedial Continuing Medical Education (CME) Reduces Disciplinary Recidivism Among Physicians. Academic Medicine 2024. DOI: 10.1097/ACM.0000000000005774
View Other Posts
- Summer School: Reduce Stressors, Avoid Burnout
- Don’t Wait Until it is Too Late: How a Personalized Protection Plan© Decreases Violation Potential
- The What, Why, When, and How of Remedial Educational Interventions
- Revisiting Moral Courage as an Educational Objective
- If It Isn’t Documented, It Didn’t Happen