Defining and Identifying Professional Practice Gaps
Educational activities at The Endocrine Society are designed to identify professional practice gaps that underlie the need for the activity and it’s intended target audience.
The professional practice gap is best defined as the difference between the current state of knowledge, skills, competence, practice, performance or patient outcomes and the ideal or desirable state. Several examples are provided below.
An international survey of both generalists and specialists showed that more than 40% did not view beta cell dysfunction as a key determinant of T2DM progression (Busse et al., 2007, Diabetes Res Clin Pract 76:445-8)
Physicians and endocrinologists recognize and understand the importance of interventions to maintain beta cell function in order to prevent progression to diabetes
Only 63% of participants in ESAP 2008 showed proficiency in the use of the ADA's new screening and diagnostic methods for gestational diabetes
Endocrinologists should employ the ADA's current screening and diagnostic methods to identify and manage gestational diabetes to avoid complications to mother and fetus
Acceptable Sources of Information/Data on Professional Practice Gaps:
Notes and/or communications from planning/steering committee or faculty
Peer-reviewed scientific/clinical publications
Clinical practice guidelines/treatment algorithms
Evaluation data/participant suggestions from CME activities
Expert input (must identify expert[s] and other support gaps identified with information from another source)
Identifying and Addressing Barriers to Ideal Practice
Below are examples of factors that may impede changes in physician practice and/or impact patient care. Whenever possible, topic-specific barriers to ideal practice should be identified in developing CME content. Identified barriers should be included as part of the content, along with information and practical strategies for overcoming the barriers.
Sometimes physicians themselves present barriers to change, and physician education can play an important role in helping to overcome such barriers.
Lack of detailed knowledge about new procedures or treatments
Resistance to change/inertia
“Information overload” leading to lack of awareness about new treatments or procedures
Lack of awareness or detailed knowledge about new or updated clinical practice guidelines
Lack of agreement with new or updated clinical practice guidelines
Various patient factors may present barriers to change. Physicians and other healthcare professionals may be able to help patients overcome these barriers. Education that includes practical strategies for addressing such barriers can be helpful to physicians.
Examples of patient-level barriers include:
Poor health literacy
Limited or no health insurance coverage
Resistance to change
Inaccurate perceptions/beliefs or fears about treatments (eg, fear of vaccines or fear of self-injection)
Noncompliance with treatment
Please note that the Hormone Health Network provides patient education resources, including bilingual patient fact sheets, on a wide range of endocrine disorders that can be downloaded for free online.
Often barriers to change are systemic and as such, may be more difficult to address with education alone.
Lack of resources
Hospital restrictions (eg, treatment not on formulary)