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am interested in the question of the value of CE although I acknowledge that I
and very likely no one else is going to do anything to change the CE
requirements for psychologists.
We, I believe, must, as scientists (at least as consumers of empirical evidence), acknowledge the meaning of the present lack of evidence about the benefits of CE. We must acknowledge, if we are to have integrity, that we give, take, and require CE units on faith alone. It may, in fact, be even worse. We may do it despite the evidence.
In the November 1999 American Psychologist, was reprinted Leonard Bickman's address to the APA convention, when he received the Award for Distinguished Contribution to Research in Public Policy. It was entitled "Practice makes perfect and other myths about mental health services." Myth # 3 (of 6) was entitled "Continuing education improves the effectiveness of clinicians"
In a thorough search of the literature in psychology "I found greater than 1, 000 titles relevant to continuing education and mental health providers. Although there are three studies indicating continuing education can change clinicians' knowledge, they do not evaluate whether that knowledge affects providers "clinical behavior or clients" outcomes [ citations omitted]. One [other] experimental study found no significant differences in clients' outcomes, even though the clinicians in the experimental group reported greater improvements for their clients [citation omitted]. In conclusion, although the medical literature suggests that continuing education improves clinician proficiency and client outcomes, the mental health literature offers little evidence of continuing education's effectiveness."
Can we all agree that:
Effectiveness is to be evaluated in improved clinician proficiency.
There is an absence of evidence for the effectiveness of the current kind of CE.
Our actions should be based on empirical evidence and therefore
No CE of the present type should be required, and, if we are to consistent:
We should all refuse to take CE of the present type.
We should challenge our licensing boards to demonstrate its value before requiring it.
We should petition APA to abandon approving the current type of CE .
Only CE efforts of demonstrated effectiveness should receive the imprimatur of APA.
Am I going to do this? No. I
am not but I will not pretend that CE is more than ritual to support the guild
and not improve the breed or benefit the client.
I am sorry, as a long time APA member and because I am proud to be a psychologist, that this whole CE business is one more failing of my organization to show scientific and organizational integrity.
This essay is reprinted by permission of the author, who holds the copyright, and the website of the Division of Independent Practice (42) of the American Psychological Association.
Dr. Zuckerman lives and consults in rural Pennsylvania. He is the author of The Clinician's Thesaurus and The Paper Office in his series of practical tools for clinicians called The Clinicians' ToolBox from Guilford Press of New York. He can be reached at firstname.lastname@example.org
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