Notes on Commitment to Change and Best Practices in Ongoing Professional Education

Knowledge growth leads to obsolescence; durability about $6-7$ years; faster turnover in areas like psychopharmacology, child health, forensics, substance use, and neuropsychology.
Best practices aim to enhance comprehension, retention, and application to sustain ongoing professional competence.
Strategies include adapting learning to individuals' learning styles, presenting information via multiple media, and providing opportunities for input, application, and rehearsal, plus peer or instructor feedback.
Allied health fields have long devoted themselves to developing and evaluating novel learning mechanisms, drawing from science-of-learning, adult education, and performance literature with common objectives.
Benchmarking and self-assessment are examples of educational practices that facilitate quality assurance and ongoing professional development.

Benchmarking = express comparison of one’s own work with that of other professionals, using best practices and evidence-based practice (EBP) to improve performance.
Typical procedure: videotapes of peers performing a procedure, depicting varying levels of quality; the practitioner evaluates their own screening against benchmarks; receives information about key components present or absent.
Benefits: anchors self-assessment, increases accuracy, and imports higher-benchmark elements into practice.
Evidence: benchmarking improves accuracy of self-assessment; Lane and Gottlieb (2004); Gottlieb (2004); supervisor feedback further improves accuracy.

Self-assessment forms vary but share the core aim: reflect on and evaluate current skills and future professional needs.
Ontario Quality Assurance Program: psychologists perform a self-review every $1$ to $2$ years using a Self-Assessment Guide and Continuing Professional Development Plan; questions address strengths, growth areas, and gaps; remediation plan; collegial review.
CPD plans promote continuing competence and quality improvement, address changes in practice environments, and incorporate evolving standards; subject to peer review by the College of Psychology of Ontario.
Benchmarking and self-assessment together reflect the effort involved in promoting professional growth.

CTCs are generated after an educational event; participants identify specific behavioral changes they wish to make and formulate them in applicable terms; rate commitment on a $1$ to $5$ scale.
Follow-up after $1$ to $2$ months asks whether they enacted or attempted the CTCs and to describe outcomes.
Three core elements: timing (immediately after learning), commitment rating (anchors importance and likelihood), follow-up (accountability and translation reflection).

CTCs have a long history in organizational change and allied health; effectiveness ranges from $47\%$ to $87\%$ , influenced by ease of adoption and personal control; environmental constraints reduce likelihood of change.
Reflection vs CTCs: Hebert, Lowe and Rappolt (2009) showed that adding CTCs yielded greater practice change than reflection alone; after two months, significant changes overall; $67\%$ vs $50\%$ .
Ratelle et al. (2017): 223 CME attendees; reflection scores correlated with planned CTCs (r = $0.65$ , p < $0.01$ ); 65.5\% of CTCs implemented; more reflection associated with more opportunities such as audience response and case illustrations.
Conclusion: CTCs are a promising tool for learning and translating knowledge into practice, though mechanisms require further study.

Simple reflective questions can enhance learning and translation, e.g., how to apply knowledge and what could be changed in practice.
Extensions to increase impact: post-course behavior surveys, peer reporting on CTCs, timelines for completion.
CTCs may become part of Best Practices in ongoing education; ongoing examination and application are needed.