In 1986 a project group, led by Dr. John Premi, assessed the feasibility and effectiveness of using a case-based, self-directed learning approach for practicing family physicians. A group of eight physicians began meeting twice monthly. Discussions, led by a physician facilitator, were based upon clinical problems from their own practices and summaries of the relevant literature.
At the end of 1987, the project group concluded that practice-based small group (PBSG) learning would be a viable and effective approach to continuing medical education (CME). The study demonstrated that, given academic support, family physicians could better define and satisfy their learning needs through small group peer discussion than by attending traditional CME programs (Premi 1988).
A follow-up to the pilot study was initiated in 1992 under the McMaster University CME Program and endorsed by the Ontario College of Physicians. The PBSG Learning Program began with 117 physicians organized into 16 small groups based in Ontario.
In 1994 the program extended across Canada, with membership growing to 310 physicians in 42 groups. Further growth was also fuelled by the program receiving MAINPRO-C accreditation from the College of Family Physicians of Canada (CFPC).
Evolution of PBLP
The expansion of the PBSG Learning Program required a new structure to manage the program. In 1997 The Foundation for Medical Practice Education (FMPE) was incorporated, creating a non-profit organization dedicated to continuing professional development for family physicians. The FMPE Board provides direction and sets policy for the PBSG Learning Program. The FMPE Board consists of nine members selected from five geographical areas across Canada, along with three academic family physicians.
In 1997 an effort was undertaken to adapt the program for family medicine residents and provide the opportunity to develop practice reflection skills in the early stages of their careers. By 2000, the PBSG Learning Program was offered to residency programs across Canada and internationally. Currently, 16 of 17 Canadian family medicine residency programs are involved with PBSG. During the 2013-14 academic year the program reached 2600 residents.
In 2001 the Practice Based Individual Learning (PBIL) Program was created to provide those physicians unable to participate in the group program with an opportunity to engage in structured evidence based learning and practice reflection. The program has seen slow steady growth over the years with many participants choosing to move into the PBSG program when the opportunity presents itself. There are currently more than 500 members participating in the PBIL program.
In collaboration with FMPE, a PBSG Learning Program in Scotland was created in 2005. The program now includes more than 20% of all GPs in Scotland. Following the success of the Scottish program, PBSG also expanded to England in 2011. In addition to the creation of new programs, groups of physicians from around the world have adopted our PBSG program as a learning tool; over the years groups have formed in Africa, Asia, Europe and elsewhere in North America.
In 2012 the PBSG program was honoured by the College of Family Physicians of Canada with the CPD Program award “for providing an exceptional learning experience to Family Physicians through the Mainpro accredited program”.
In conjunction with our 30th anniversary we have renamed our program as Practice-Based Learning Program (PBLP). This coincides with the rebranding of our organization with a new logo and website. Our aim is to bring The FMPE more front and centre as an organization, as well as Practice-Based Learning as our flagship program.
Over the past 30 years the Practice Based Learning Program has continued to evolve and maintain its innovative approach to promoting learning and practice change. The enduring strength of the program is illustrated by the continuing growth in membership and the commitment of members to the program over the long term. The current membership includes over 6,000 family physicians, residents and nurse practitioners, in more than 750 established PBLP small groups. This represents approximately 25% of Canadian family physicians with a certification in family medicine. Of those members 60% have enrolled in the program for six years or more, and nearly 40% for greater than 10 years.
The Practice Based Learning Program continues to benefit from the dedication and support of its PBLP members, family physician authors and editors, pilot test groups, research participants, and directors and staff. The Practice Based Learning Programs continue to adapt and evolve in order to provide members with the best possible learning experience.