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I asked some questions about CE of a friend who is vastly experienced in the psychologist professional liability insurance area and here are her replies.
Hi Ed!
Let me try to answer your questions:
Do you know if there is evidence that CE courses make any differences?
I know of no empirical evidence to support CE making any difference. I believe that CE requirements generally get enacted as a barrier of entry by the professions. Not only does one have to be licensed, but one has to take CE. It also adds an air of legitimacy to the profession since its suggests ongoing quality control.
I do think CE is a good idea, by the way. I suspect that more people than we would like to think would not engage in continuing education unless it was mandated. I also believe that encouraging professional interactions and exchanging ideas is healthy. However, I know of no scientific research that proves it.
Do states with mandatory CE requirements vs those without them show a difference in malpractice suits, ethics complaints, etc.?
Not that I am aware of but for good reason. A state like California has mandatory CE, but practitioners are somewhat more likely to get sued there than any other place. But California's loss experience is also driven by the fact that the CPA ethics committee actively adjudicates ethics complaints (versus passing them off to APA) and their licensing board is active.
I believe, but do not have any evidence, that psychologists who take CE courses have lower risk of being sued (complained against?) Is there evidence?
I agree with you, but I don't believe it can ever be proven. The problem with malpractice litigation is that there is this incredibly long delay from the alleged malpractice to the point the suit is filed. The exceptions would be tripping and falling claims and suicides where the date and awareness of the "injury" are easily established. Too much time passes to be able to establish why one person is sued and another is not.
I have seen some research for physicians that suggests that PERSONALITY plays a role in the chance of being sued. That research determined that physicians with warmer personalities were less likely to be sued than physicians with colder, more aloof personalities. It makes sense. You don't want to sue someone you like. If your physician was negligent and you liked him/her, then you probably are going to be more open to accepting an alternative resolution.
Does taking ethics CE courses lower that risk even more?
Nothing that can be proven. The reason the professional liability companies sponsor risk management courses is NOT because they think they can lower the risk in any measurable way. It's a way to market themselves and their product.
Do you know of any research on the value of CE courses for anything?
No.
Sorry to sound so negative, Ed. I do believe that CE is valuable for maintaining overall quality of care and creating opportunities for interacting with peers.
Jeffrey Barnett
I have found this discussion of continuing education requirements and competence to be both interesting and important. I appreciate the many excellent points made thus far, to include the need for evidence.
Our training dictates that we not merely accept things, but seek the evidence for any assumptions we make. I do believe that licensure laws and their C.E. requirements can only set minimal standards for us. Certainly one can meet those mandatory C.E. requirements and not be competent in certain areas of practice. As has been pointed out, competence is a much more complicated construct than just the need for CEUs.
Several have pointed out how they maintain competence and expand it, in ways that go far beyond mandatory C.E. requirements. It is clearly up to the individual psychologist to make sure we each obtain adequate training to establish and maintain our competence. Merely meeting mandatory licensure renewal requirements may not be sufficient.
With regard to references in the literature I didn't find anything definitively demonstrating the value of continuing education activities either. However, VandeCreek, Knapp, & Brace (1990) state that in addition to attending workshops and reading the professional literature obtaining supervised clinical experience is an important component of developing and maintaining clinical experience. They also point out the following about continuing education programs that are found to be most effective: They have an identified target audience, they include participants with a genuine desire to learn, the learning objectives of the program are clear, the training addresses a specific area of weakness or training need for participants, active participation in discussion and clinical procedures is required, and there is an opportunity for supervision in clinical practice in addition to the training provided.
Of course an individualized approach is best and no one size fits all. Also, that article was written prior to the current wide use of technology that has been mentioned. I have no evidence for this, and perhaps we can survey those who write licensure laws for the answer, but my understanding is that licensure laws are present for to protect the public. Those writing the laws are setting a minimal legal standard for continuing education activities in the hope that it will help reduce the chance of harm to the public. We don't actually know if this is effective as Harry points out. Perhaps a good study to do would be to look at those states with mandatory CE requirements and those without them and see if there is a difference in malpractice suits, ethics complaints, etc.
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