Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH (Members only) FULL-TEXT		Volume 23 (3) Volume 23, Issue 3, Summer 2003 J Contin Educ Health Prof 2003; 23(3):133-140 THEORETICAL FOUNDATIONS Stemming the tide: cognitive aging theories and their implications for continuing education in the health professions Eva KW A b s t r a c t As demographic drift among health care providers mimics that of the larger population, it becomes increasingly clear that theory pertaining to the impact of aging on cognitive processing should inform the continuing education efforts designed for health care professionals. The purpose of this article is to offer a critical review of the major theories in this area and outline a sample of the implications that can be derived from these views. Research articles examining the relationship between age and physician performance were identified using MEDLINE, PsychLit, and ERIC. In addition, the psychology literature on age-related changes in cognitive processing was reviewed. Evidence from the medical education literature and psychological theory suggest the importance of increased environmental supports, decreased time demands, and peer review programs as barriers against the impact of aging. The implications of these findings include the potential to tailor continuing education (and physician remediation) efforts toward the age-related abilities/deficiencies of individual physicians. Lessons for Practice As the average age of health care providers rises, it becomes increasingly important to consider the impact of age-specific cognitive tendencies when considering continuing education efforts. Psychological theories of aging tend to agree that dissociations in behavioral measures of performance can be attributed to differences in the cognitive resources required to complete specific tasks and a decline in the cognitive resources available to older adults. Environmental supports might assist older health care providers in externalizing memory, thereby reducing the impact of declines in working memory capacity. Lightening case load or narrowing the scope of practice might assist some health care providers in overcoming speed of processing declines. Although expert clinicians appear to generate diagnostic hypotheses very early in a case encounter, some older individuals may be particularly susceptible to premature closure of a diagnostic search. Focusing on the environmental aspects of clinical practice such as improving the resolution of diagnostic stimuli might prove to be a more successful maintenance of competence strategy relative to any intervention that involves modifying the behavior of practitioners themselves. Peer review and enhancement programs are likely to be increasingly critical determinants of continuing education efforts as the ability to recognize deficiencies in practice might decline with increasing experience and the confidence that accompanies that experience. MeSH Terms: Aging; Clinical Competence; Cognition; Education, Medical, Continuing; Learning; Memory
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