ACCME intentionally used the term professional practice gap in Crterion 2 instead of using patient care. That’s because there’s more dimensions to professional practice than just patient care. There’s research,there’s education, there’s executive practice, and all of those are important parts of what physicians and your learners do. And in all of those, there can be gaps between what the physicians are doing and what they could be doing. Some of that gap is entirely due to the physicians’ inabilities or challenges. Some of the gap is due to other environmental issues that are present in the world where the physician operates. And all of those are opportunities for the accredited provider to intervene.
The ACCME believes that underlying these gaps are always issues with knowledge or performance or competence, strategies. The physicians don’t have the approach to managing these issues or problems. But, the accredited provider should feel free to examine the practice of these physicians and to decide what it is that they want to intervene with. There’s individual gaps, there’s community gaps, there’s population-level professional practice gaps. And if you believe that your physicians, your individual physicians, or your groups of physicians, belong to these communities or populations of physicians that have these manifest gaps, it’s fair for you to say: This is the professional practice gap that we’re going to try to address through our continuing medical education activities and our program. And we’re going to say that at the beginning that the issue or the challenge or the gap is yours. It belongs to this group. And we’re going to measure at the end to see if you no longer have that. And that’s fair. You don't have to do a before or an after for every individual learner. And for every individual learner, you do not have to measure them in their context of their practice, either their clinical practice, their research practice, their education practice or their executive administrative practice. You can use data and information that’s present in their community or in the whole population to design your educational activities, to look for the change that you’re trying to implement for your learners.
