Mandatory Continuing Education - What Is It Good For......and How Can We Make It Better?

Although MCE provides assurances, it does not ensure competence, nor does it fit adult education's meaning.

Mandatory continuing education (MCE) brings to mind visions of professionals going to courses, conferences, and seminars to hear and learn about the latest cutting-edge trends in an ever-changing society while maintaining their professional certification or licensure. Perhaps instead, one might listen to MCE and think of the seemingly endless parade of mandated training classes intended to comply with almost countless regulatory standards of the U.S. Department of Labor's (DOL's) Occupational Safety and Health Administration (OSHA), the U.S. Environmental Protection Agency (EPA), and the U.S. Department of Transportation (DOT).

What Is MCE?

MCE is the on-going professional development courses taken within one's field to stay current, demonstrate competence and maintain certification or licensure. Nurses and other allied health professionals are usually required to acquire a certain quantity of continuing education units (CEUs); physicians require continuing medical education (CMEs); Certified Industrial Hygienists (CIHs) need certification maintenance points (CMs); Certified Safety Professionals need CEUs as well; the list goes on.

Also, a wide variety of para-professionals are required to go to some form of annual refresher training to be kept up-to-date and to be able to qualify for recertification. Designers, Inspectors, Monitors and Abatement Workers in both Asbestos and Lead-Based Paint (LBP) abatement fields go to one-day, eight-hour training courses (including a mandatory exam at the end), once per year to be allowed to work in their field, as do Hazardous Materials/Hazardous Waste Technicians. Some consultants who work in all three of the above areas and are multi-disciplined within each can expect to go to upwards of eight or more different one-day mandatory courses each year.

Why MCE?

If any, few persons would question the need for professionals responsible for others' health, safety, and welfare to stay current and demonstrate competence in their field of practice. Many sources consider a professional "half-life" (the time required to forget or invalidate one-half of one's professional knowledge) to be about five years (a number of years coincidental with many boards' required recertification). Nor would common sense let us be dissuaded from recognizing the need to educate persons (workers or the general public) on the hazards that they face in their jobs and lives. However, whether or not it should be mandated, is there a better way to ensure competencies, and how can MCE be improved?
So, why mandate continuing education for certain professions in the first place? Perhaps there are several reasons. In a world of constant change and rapid advancement, it is more important than ever for professionals to stay current in their field. According to Professor Michael Brady at the University of Southern Maine, there are 7000 new articles published every day! This is undoubtedly a staggering figure. Also, today's society changes several times during each generation, whereas, in the past, it would take several generations to change the culture. If society is changing so rapidly, how else can we ensure that the physicians, engineers, and health and safety professionals are up-to-date on the latest techniques and trends available and appropriate to their practice? The general public, for whom these professionals perform services, wants them to be held accountable to the highest level of their profession and assured of such. In this highly litigious society, maintaining professional accountability through MCE is its defense against liability, sort of a form of Errors and Omissions (E&O) insurance, if you will.

In addition to professional accountability, society demands that anyone handling hazardous substances, e.g., asbestos, hazardous waste, and LBP, be properly trained to not risk accidental exposures or releases into the environment. Along the same lines, we want our workers protected against hazards they might face as a part of their job responsibilities. The easiest way to ensure that they are trained and educated about these hazards is to regulate and mandate them.

Table 1: MANDATORY CONTINUING EDUCATION

Why Not MCE?

So, if MCE provides assurances of accountability and currentness in today's ever-changing world, what's the problem with it? In a nutshell, it runs 180 degrees counter to the very principles on which effective adult education and learning are based. There are several widely accepted tenets of adult education that MCE either violates or disallows by its structure.

Adult learners are typically self-directed, and as such, adult education must be voluntary. The content of any training must be flexible; in fact, adult learners like to participate in the planning and selecting course curriculum. For truly effective adult education, there must be a need and relevance for the learners to apply it. In particular, this problem expands exponentially when adults are required to participate in the same training year after year, i.e., Hazard Communication, Bloodborne Pathogens, Asbestos, etc.

Exams imposed at the end of the training are not necessarily a measure of competency as much as they are a measure of knowledge or test-taking ability. Forcing someone into a classroom or attending a conference will not guarantee any learning. In fact, considering expected resentment or even hostility toward the course, any education as an outcome would be unexpected. By the same token that "you can lead a horse to water, but you can't make it drink," one might say that, "you can lead adults into a classroom, but you can't make them think (or learn)."

"New and Improved " MCE

With so many problems inherent to MCE, the situation would appear hopeless, but this is far from the case. MCE, as a profession, can be improved upon in many ways that would help to meet the needs of adult learners.

As a start, all MCE offerings need to be more flexible. Courses and training classes need to acknowledge that people go to training to learn, and it's pointless to be restrictive in the course content. Be flexible, be adaptable, give the students choices - let them vote on the curriculum. Then deliver the students' training and the way that the students want or need it to learn. Certifying boards should show greater flexibility in allowing credit for courses taken that help professionals perform their work better, even if it's tangential to the field of practice. For example, health and safety professionals who take courses in management are certainly better able to manage their health and safety programs. Yet, they typically cannot count those courses as part of their accrediting board-required continuing professional development. Many conferences are already making headway here by incorporating a greater number of breakout sessions of a somewhat diverse nature within the field of their target audience. But not all conferences are accessible or affordable, and worse yet, attendees' biggest complaint is the session was a lecture with overhead slides unreadable from much of the auditorium.

This brings up the next recommendation, provide better training. People retain only ten percent of what they hear. Additionally, many people are visual or tactile learners. This doesn't even factor in those persons with auditory processing difficulties. So, why do so many trainers and teachers lecture if it's not effective? Good question. It's how they, in turn, learned as school kids, and it's easy -all you have to do is talk to the students. Many adults don't learn that way; they learn by doing and by themselves teaching and working with others, which is why all well-structured and facilitated, small group work in training is so successful.

Also, trainers should engage and encourage their students. The trainer is an educator, there to facilitate the best learning for all of the participants - the trainer should remember that he or she isn't the star of the day - all that matters is the participants' learning be enhanced to the best possible degree. They should take a train-the-trainer or other course in adult education principles and techniques (though I'm not for mandating it).

Certainly, a frustrating problem area is annual refresher training. Year after year, going to the same training session is at best ineffective and at worst insulting to adults and professionals. There are several viable options here:

1. Do away with it altogether - if it's ineffective, then it's a waste of productivity.
   
   
2. Lengthen the time between refreshers. Why is it annual in the first place - was there good data to support requiring retraining every year, or was it merely convenient? Using an estimate of the professional "half-life" (5 years) makes much more sense.
   
   
3. Allow persons to "test out of" or "challenge" the training. If they know or are competent at the material, why make them sit through the training?
   
   
4. Of course, in true adult learning fashion - make it voluntary. If they want to come to the training, they will, and if not, they won't.

Even all of the above improvements can only improve MCE to the point that it still may not achieve what it's supposed to; maintain professional competency and currentness, assure the general public, and protect the health, safety, and welfare of targeted groups and populations. So, what about the other options besides MCE?

Alternatives to MCE

If MCE doesn't ensure that it's supposed to, let's get rid of it or put something else in its place. There are several viable options to MCE, some better than others or greater success.

The peer-review process is probably the most popular alternative to MCE. In any of a variety of structures, have other peers evaluate their professional colleagues. After all, who else is better suited to determine true competency than fellow professionals?

An offshoot to peer review is competency determination through some professional associations. Allow the association to "regulate their own." Without its downside, visions of "good old boy networks" are among the biggest potential complaints.

If retention of competency is the need, then competency-based recertification is the answer. Require that competency be proven or demonstrated by any of a wide variety of means or methods; exams, articles, attestations, etc.

Another competency-based alternative, especially well-suited for the technical or para-professional, is a demonstration of work practices. Allow the affected professional the opportunity to show their abilities in a structured fashion audited by an objective third party.

Popular in some circles is periodic (re-) examination. Since most certifications or licenses require an entry exam, continue with exams every five or so years based on a professional "half-life." Exams have their inherent problems, but they have a high degree of control standardization and, believe it or not, can be highly motivating.

It would certainly be hard to argue that the authoring of professional articles or texts was not some form of competency maintenance. The research and actual writing process and editing involve extensive work and are a great learning tool. It even has built into it the third-party objectivity of either an editorial board or publisher.

Similar to writing professional articles or books is writing a journal or the process involved with self-reflection and self-evaluation. The documentation of any of the above can form a means by which professional practice competencies can be evaluated again by objective third parties, peers, boards, or the public.

The final alternative to MCE is perhaps the most obvious but most difficult to ensure, consumer education. An educated consumer is the greatest control of professional services. Just ask anyone who has felt "ripped off" by some service. Unfortunately, often it amounts to "too little, too late," not exactly very reassuring in this heavily litigious society.

Table 2: Alternatives to MCE

• Peer Review Process
• Periodic (Re)Examination
• Consumer Education
• Self-Evaluation/Reflection/Journaling
• Competency-Based Recertification
• Professional Associations
• Demonstration of Work Practices
• Authoring of Professional Articles

MCE - What Is It Good For?

So, back to our original question - what is MCE good for? Control, standardization, compliance, reassurance - all yes. But true learning, education, maintenance of competency, and currentness - no. MCE has its pros and cons (it's greatest being its conflict with adult learning tenets) like most things and has several venues for improvement of training effectiveness and facilitation of the learning process. There are, additionally, many viable alternatives to MCE worthy of further attention and investigation but perhaps not necessarily worthy of mandating.