Paul E. Mazmanian

A survey of accredited and other rehabilitation facilities: Education, training and cognitive rehabilitation in brain-injury programmes

Although it is routinely acknowledged that cognitive rehabilitation therapy comprises a major part of the services provided to survivors of brain injury, there continues to be no general consensus regarding the methods and training of those who provide cognitive rehabilitation services. This survey of 398 head-injury rehabilitation facilities includes information on which disciplines are providing and supervising cognitive rehabilitation therapy, which therapy formats are used, and a first attempt to define the costs and providers for cognitive therapy staff training in Commission on Accreditation of Rehabilitation Facilities (CARF) approved and other (non-CARF) facilities. The education and training of junior and senior staff members is compared, and respondents suggest changes in the education and training of those who provide cognitive rehabilitation therapy. The results of this survey suggest no significant differences in the organization and delivery of cognitive rehabilitation therapy in CARF and non-CARF programmes. They indicate that cognitive rehabilitation therapy and the education and training of providers deserve further study and definition, given the widespread provision of cognitive rehabilitative services.

A Decision-Making Approach to Needs Assessment and Objective Setting in Continuing Medical Education

This study was designed to describe educational needs assessment and objective setting strategies in continuing medical education (CME) program development. A general model por traying needs assessment, objective setting, and program development was developed from descriptions of practice at ten major medical schools. Research methods used to guide the inquiry were those of grounded theory. Results indicated that the predominant stimuli of program ideas were social structural forces external to the CME organizational unit. Planners responded by recognizing a possible problem in medical practice, identifying and gathering resources for analyzing a program idea, refor mulating the program idea, and proposing a change in learner behavior. Three types of planning behavior—coordinative, administrative, and consultative—enabled CME program planners to facilitate systematic decision-making by planning groups.

Evaluation-based accreditation: Alternative approach to regulating continuing medical education providers

&NA; Approximately 2500 organizations are accredited to sponsor continuing medical education (CME) in the United States. Although teaching‐oriented and learner‐centered approaches predominate current thinking in regard to CME accreditation, the prevailing model in the US is teaching oriented. A third strategy, evaluation‐based accreditation, is proposed. It encourages sponsors to progress through higher levels of accreditation, based upon their proficiency in evaluating CME activities. To the extent that sponsors demonstrate success at implementing evaluation, they become sanctioned to provide selected CME instructional designs, culminating at the highest of four accreditation levels with the ability to measure patient outcomes and the privilege of joint sponsoring CME activities with unaccredited organizations.