The Case for Rapidly Deployed Remedial Education

The Case for Rapidly Deployed Remedial Education

June 2021

A synopsis of the poster presented at the 2021 AIM/FSMB Spotlight Poster Session

The Issue

When regulatory agencies allow a clinician to continue practicing after a professional violation, the regulator takes important steps to ensure the welfare and safety of patients. The regulator may insist on an assessment of the person’s fitness to practice or order the use of a practice monitor. They may place restrictions on the practitioner’s license or put them on probation for a period of time. And to correct the deficiencies that led to the violation in the first place, regulators often order clinicians to complete remedial education courses.

Judging by the thousands of regulatory orders PBI Education has reviewed over the years, regulators generally insist that all but one of these interventions be implemented promptly. Remedial education is the only exception. Licensees are often given as long as one year to complete mandated courses. During this time, the deficiencies in the clinician’s practice remain uncorrected. Contrary to the regulator’s intentions, patients continue to be exposed to the sub-standard practice that merited the intervention.

PBI’s Recommendation

As a matter of public health and safety, PBI recommends that remedial education be deployed as rapidly as other regulatory interventions.

The Case for Rapidly Deployed Remedial Education

Sparking prompt changes in participants’ behavior and practice. Participants leave remedial courses eager to put their learning to use. “We see it over and over again in the course evaluations people submit the week after they graduate. Participants share lists of action items they are already beginning to implement,” says Leia Leiser, PBI’s Director of Education. “Just recently, a participant shared that they had decided to close their practice for two full days in order to discuss and readdress training and documentation with all staff.”

Reducing the risk of new violations. Having learned about their professional responsibilities and personal vulnerabilities, practitioners are able to take steps that lower their violation potential. These safeguards help prevent not only a recurrence of the original violation, but new infractions as well. As one recent graduate put it, “I learned about other things I had been doing that were risky in addition to the reason I came to the course. I am very glad my eyes are open now to the ways I might have caused additional harm.”

Strengthening the connection between misdeed and remedy. Practitioners learn best when the problem they are seeking to remedy is still fresh in their memory. “As the length of time between the infraction and the remedial education increases, the connection between what was done and what needs to change becomes attenuated,” notes PBI Faculty, Catherine Caldicott, MD, FACP. Shortening the timeframe strengthens that connection and solidifies the change.

Increasing receptivity to remedial education. Whether a practitioner denies wrongdoing, blames others, or tries to rationalize what they’ve done, their refusal to accept responsibility prevents meaningful change. To be successful, remedial education must overcome this resistance, which grows stronger over time. According to Caldicott, “Participants are more receptive to learning and changing when resistant thinking has not had an opportunity to become entrenched.”

Improving patient access to healthcare. Practitioners are sometimes unable to practice until they complete regulator-mandated coursework. It’s not necessarily the regulator that stops them, but other entities such as insurance companies and specialty boards. This loss of care is especially critical in underserved areas. Shortening the timeframe for remedial education shortens the time these clinicians are out of the workforce.

How Virtual Education Facilitates the Rapid Deployment of Remedial Education

Virtual courses dramatically increase availability. Venues do not have to be booked months in advance and faculty do not need to clear their schedules for extended travel. Freed of these logistical challenges, providers can quickly add courses to meet the demands of the regulatory community.

Virtual courses offer more immediate access. Participants do not have to take time away from patients and family to travel. Nor do they need to make advance plans to book reservations or cover the costs of transportation and lodging. And for practitioners with health conditions or physical disabilities that make travel challenging, virtual courses greatly increases access to education. Without these obstacles slowing them down, practitioners can act quickly to meet their obligations.

Fewer participants means higher educational quality. To be effective, education delivered via a virtual format necessitates a limited number of participants in each course. Providers can easily accommodate more people by scheduling more courses. With a smaller class size, instructors are able to spend more time delving into each participant’s case and providing individual attention. And participants have more opportunities to interact with each other, a crucial factor in effective remedial work.

Four Ways Regulators can Facilitate Rapid Deployment of Remedial Education

  1. Require licensees to complete remedial education in 60 to 90 days. Regulators no longer need to specify a timeframe for registration, since participants will need to enroll promptly in order to comply.
  2. Expedite enrollment by providing a list of pre-approved courses and/or course providers. This will reduce the time participants spend researching courses that meet the regulator’s criteria and waiting for regulators to evaluate and approve courses.
  3. Continue approving qualified virtual-live courses after pandemic restrictions are lifted. To qualify, courses should limit enrollment, provide synchronous interaction, and include mechanisms to hold attendees accountable for participation and engagement. For continuity, a singular primary faculty should facilitate the entire course. Click here to see how PBI policies ensure the highest quality of virtual education.
  4. Accept courses that licensees take proactively, as long as they are on the regulator’s approved list. Individuals who complete courses before they are required are protecting patients and taking responsibility for self-correction, and thus should not be made to repeat courses they have already taken.

Conclusion

Immediacy matters. By adopting these recommendations, regulators can bring remedial education into alignment with the other interventions they order, bolster the effectiveness of corrective or disciplinary actions, and further protect the health, safety, and welfare of the public.