APA Brings Grand Rounds To Your Computer

Getting continuing medical education (CME) credits can be as easy as turning on your computer and opening your e-mail.

And it might just turn out to be a more memorable experience than the run-of-the-mill conference or symposium, say psychiatrists who have participated in APA’s new free CME service, Grand Rounds Online.

Deborah Hales, M.D., director of APA’s Division of Education, Minority, and National Affairs, told Psychiatric News that Grand Rounds Online capitalizes on e-mail technology to provide a convenient venue for discussing important professional topics with APA members—while picking up CME credits.

“We are interested in developing new ways to offer psychiatrists continuing education,” Hales said. “I am a fan of e-mail, and since e-mail is ubiquitous now, we decided that a list-serve-based discussion of professional topics would be a low-cost way to offer educational programs to members.”

Members who wish to participate will need to sign onto Grand Rounds Online at www.psych.org/members/grandrounds with a username and password. Once signed in, they will find one or more case discussions being presented by a moderator with expertise in the subject. The case is likely to be drawn from real clinical experience, highlighting important aspects of the subject for discussion.

Members choose a topic they are interested in and join the list serve. Then all pertinent comments by the moderator and other participants will be sent regularly to each participant’s e-mail address. Members can add their own thoughts on the case or respond to comments by others on the list serve.

Occasional Quizzes Included

Active discussion of a case lasts a month, at which point all cases go into an archive where they are accessible for one year. At the end of the active month, a quiz is posted on the APA Web site; members answer the questions, press “submit,” and receive two hours of CME credit. The certificate arrives via e-mail.

It’s free and it’s user friendly. “All you need is a computer and to know how to use e-mail,” Hales said.

A look at either of the two cases already posted on Grand Rounds Online reveals that “discussions” are liable to be more lively than what typically occurs in a crowded conference symposium.

“It was very interactive,” said Miles Shore, M.D., who moderated a case discussion on patient safety. “It gets people engaged. I didn’t count up the responses, but I would say that people who responded tended to be very involved in the subject matter.”

Anthony Ng, M.D., who led a discussion on disaster psychiatry, agreed. “It’s a great way for people to connect with colleagues who may or may not be doing the same thing,” he said. “It promotes networking and provides a forum for discussion about topics that people don’t typically have any input into.”

School Shootings Discussed

Ng, who is a member of APA’s Committee on Disaster Psychiatry, moderated discussion of a case describing a school shooting. He said the discussion took on a special poignancy since it was active around the time of the sniper shootings in the Washington, D.C., area.

He is also medical director of Disaster Psychiatry Outreach, a national nonprofit group based in New York.

Shore, who is a professor of psychiatry at Harvard Medical School, moderated discussion of a case of a man presumed to be homeless; he was brought to the emergency room of a large teaching hospital and placed on a standard detoxification protocol. Only later was it learned that the man had multiple fractures and had been hit by a car.

Shore said his goal in discussing the case was to move participants away from “the guilt culture”—whereby individual physicians are held accountable and punished for oversights—toward a “culture of error prevention” in which the focus is on protocols and procedures that can be made error proof.

“Participants tended to think in terms of improving individual professional performance, rather than using procedures and technological processes to make it impossible for mistakes to happen,” Shore said. “I kept prodding people to pay attention to protocols, such as making sure that residents don’t write orders unless they are checked by a central authority.

“There were a few people who were really onto the culture of error prevention,” Shore said. “These tended to be psychiatrists who were working in general hospitals where they had responsibility for programs that included other specialties.”

Hales said Grand Rounds Online currently has about 300 subscribers. The volume of e-mail “traffic” has been “just about perfect,” she said, with participants receiving approximately seven e-mails a day on the heaviest day.

Hales hopes to keep Grand Rounds Online slightly out on the edge, away from the topics that typically predominate at CME conferences. Future subjects for discussion include ethics and women’s mental health issues.

The discussion on cultural competence ended in late February, and the next discussion will begin after APA’s annual meeting in May.

Hales urges members to give Grand Rounds Online a try. “Providing continuing education is one of the core functions of a professional society,” Hales said. “We are interested in developing more and better products for our members.” ▪