Gap Statements

Gap statements are used to identify the specific audience and intent of your event.

Gap statements should be two to three sentences and state two important facts: 1) current physician behavior; and 2) desirable physician behavior.

The following statements are suggestions for completing the gap statement section on the activity planning form. The examples below can be modified for a specific target audience and their educational needs:

• Pediatric Series will address the core competencies of common pediatric problems and provide an update about standards of care in order to reflect the most current evidence-based knowledge and guidelines to improve pediatrician competence.

• This tumor board is designed to review existing cases and apply the most current evidence-based knowledge and guidelines to establish treatment plans for improved patient outcomes.

• The field of psychiatry is rapidly changing with new and innovative diagnosis and treatment protocols. Psychiatric physicians who are using older protocols for management of psychiatric-related diseases and disorders are not able to provide optimal patient care. Through increased knowledge about and competence in the use of newer therapies psychiatric physicians will improve patient outcomes and decrease disease burden in our community.

• Currently, PCP’s, general pediatricians, and family practice providers do not have the knowledge or tools to confidently assess, diagnose, treat, and manage children with autism spectrum disorders. With a discrepancy between the population of children within the Autism Spectrum and the number of professionals available to help them and their families, primary care providers, nurses, and allied professional are increasingly being charged to provide the basic tasks of early identification, early intervention, and coordination of care for them. To achieve quality of care and confidence on taking on these tasks, our PCP’s need to be equipped with the ability to appropriately identify children with Autism Spectrum Disorder, the initial step to diagnosis and co-morbidities with the help of other experts in the field, to understand their multiple medical and mental health needs, and finally to coordinate the necessary services to succeed in school, at home, and in their community.

• Effective management of subarachnoid hemorrhage (SAH) is critical in pre-hospital, hospital, and post-hospital care. TTUHSC El Paso physicians in critical care, ED, neurology, psychiatry, anesthesiology, surgery, and neurosurgery need an update on current guidelines in the identification, treatment, and management of SAH. Interdisciplinary teams are responsible for treating patients with SAH in hospitals. According to observations from hospital leaders, physicians and residents need to improve their skills in patient transport, diagnosis, ED care, monitoring, and management. Improved management skills will result in mortality rate reductions.

• Because rib fractures are rarely life-threatening, severe visceral injury inside the abdomen or chest can be missed. Physicians are not knowledgeable about critical signs and symptoms or fully trained on assessment, treatment, and management of patients with thoracic trauma. Following this educational intervention, the practice gap will be closed as physicians make accurate diagnoses, order appropriate tests/radiographs, and initiate effective treatment strategies for improved patient outcomes.

• Hyperthermia in patients is often related to toxic ingestions. Physicians do not currently have all of the pertinent information required to properly identify specific antidotes that may be used to treat toxin-induced hyperthermia. This course is designed to close the gap in clinical practice by improving knowledge and competence to diagnose these conditions correctly, institute appropriate therapy, and improve patient outcomes.

• Over the last decade, technological advances have made huge strides in diagnosing common GI disease. In addition, several new and innovative treatment protocols have emerged for managing GI diseases. Primary care physicians who are using older guidelines for identifying GI-related diseases and disorders are not providing optimal care to their patients. Primary care physicians must be equipped with the ability to appropriately identify GI diseases and disorders, as well as be knowledgeable about treatment options for their patients.

• Ethical challenges in medicine are not simple and often require a great deal of thought to manage appropriately. A solid knowledge of medical ethics and the practical application of clinical ethical reasoning skills are essential components of a physician’s skills. This series is designed to develop a greater awareness among participants of how to recognize, analyze, and respond to situations with ethical challenges.

• The field of surgery is broad, complex, and specialized in the surgical management of a wide variety of medical conditions. Due to the complexity of the field, surgeons cannot maintain competence without ongoing education in the field as a whole. Participation in this series will improve the knowledge and competence of the participants, both in and out of the areas of specialty.

• The field of pain management is complex and challenging for the physician. In addition to numerous treatment methodologies to choose from, multiple causative factors, co-morbid conditions, psychological disorders, high risk behaviors, opioid abuse, controlled substance laws, and ethical dilemmas add to the complexity of diagnosis and management of pain. Through increased knowledge about and competence in managing complex cases, physicians will choose effective treatment plans to improve patient outcomes.

Professional Practice Gaps

From a CME accreditation standpoint, the goals of continuing medical education have changed during the past ten years. CME is now based on the concepts of quality improvement in order to achieve and maintain physician competency and performance. The ultimate achievement of CME is the improvement in patient health status.

Both individual educational activities (e.g., conferences) and series activities (e.g., grand rounds) are designed around identified practice gaps. The term, professional practice gap, is defined as the difference between what a physician currently knows and is doing and what he or she should know and do.

Identifying professional practice gaps is a straightforward process, utilizing the following questions:

• What areas in practice do you and your colleagues find challenging? (examples include: difficult-to-manage or non-resolvable cases; prevalent public health problems; lifestyle-related health problems; patient safety concerns; limitations or obstacles occurring in the health care system)

• What factors contribute to the problem?

• What educational interventions are needed to change current behavior to "best practices" behavior? (Or what does the target audience need to do differently in order to improve practice?)

• What is the best format for teaching and learning the concepts to be presented? (examples include: Case presentation and discussion, demonstration, expert panel, lecture and discussion, moderated audience discussion, problem analysis and application to practice, question and answer session, role play, simulation, self-directed learning, skill development, or small group discussion)

• What additional CME or non-CME strategies must be incorporated in order for the target audience to achieve "best practice" behavior? Non-CME strategies may include applications added to smart phones or tablet computers to make resources more readily available; discussions held in medical staff meetings to reinforce learning; assessment tools; patient education materials; laminated reference cards; clinical practice guidelines uploaded into electronic health record system; printed algorithms, etc.