New CME Model Makes Learning a Dynamic Process
AAMC Reporter: May 2012
By Barbara A. Gabriel, special to the Reporter
Here is an article worth a quick read. If you follow this Blog you know my opinion is that CME and “improvement” are inextricably bound together. Here is an initiative putting this into practice.
“Launched in January 2011, ae4Q is designed to help medical schools and teaching hospitals align their clinical quality improvement with their CME programs and activities. The goal is to go beyond simply issuing certificates of attendance to physicians and instead move toward helping them demonstrably improve their performance. The programs assess clinical data to identify practice gaps and then develop a CME activity with that information. When the educational intervention is complete, physician performance is measured again to determine if it has improved.”
Not all of us practice in settings were there is a Quality Improvement function. However, we can still use many quality tools to guide the development of our CME Program and the activities we offer healthcare professionals.
This is not a fad. The future of CME has arrived with the integration of quality thinking and professional development.
Improvements include clinical quality, patient experience, staff satisfaction and financial savings
Here is an article for the Wellspan Health newsletter from Monday, May 14, 2012.
I have been a proponent of A3 Problem Solving for some time. I think it offers the CME professional a structured approach to use for several purposes. It can provide a systematic, sustainable repeatable framework for developing P I CME activities. It can be used as an approach to guide improvement initiatives in ones own CME operation. It gives the CME professional tools to use in understanding and participating in organizational quality improvement initiatives in many healthcare settings. Bottom line is that it works. Do yourself a favor and read about A3 Problem Solving. It might be something you will find adds value to your CME operation and your ability to participate in larger organizational improvement efforts.
Here are the results of a survey on physician use of technology that you might find interesting.
Take a look.
Are you finding more demand for online CME among your target audiences?
I recently visited a small community hospital to talk to them about PI CME. Like in many small settings. responsibility for coordinating the CME program is an add on role. The person assigned the responsibility has other responsibilities. They have no training in CME. They may or may not have experience in education. They may or may not have clinical experience.
One person at the session had just been given the responsibility for CME and was in the Marketing Department. This person had no idea what was required of CME providers. No idea what it means to be an accredited CME provider. Absolutely no knowledge or understanding of what is required by the ACCME, AMA, etc. All they know is that the setting in which they work wants to offer the physicians “CME’s” Whatever CME’s are. What a learning curve.
In situations like this the person assigned responsibility for the CME Program should get together with the Quality Improvement people and ride the quality improvement initiatives like a tight saddle on a bucking bronco. in fact the CME program should probably be assigned to the QI people in these settings. They have they data. They can learn the CME rules and regulations. They can link CME to quality initiatives that make a difference to the patients in that setting.
All approved CME activities have to be evaluated in improvement terms. Improvement in competence, performance or patient outcomes. Lets put CME where the people have the skills to assess these improvements. Quit screwing around with CME as part of marketing or even the medical affairs office. Enhance the educational skills of some of the the improvement people. Enhancing the improvement skills of the CME people doesn’t seem to be working. Let’s try another way to link education to physician competence and performance. Especially if they have patient outcomes data.
Hot-button issues drive state CME mandates
By Carolyne Krupa, amednews staff. Posted Feb. 13, 2012.
“At least eight states in the past five years have approved rules governing what subjects doctors should study as part of their continuing medical education…………………At least 16 states mandate what CME subjects physicians must study. Of those, eight states have approved 14 new course requirements in the past five years. They come in response to a variety of issues, including domestic violence, the aging population and more awareness of the burdens of health disparities on minority communities.”
Should CME providers be jumping with joy? After all this is a business opportunity. More mandate, more CME activities to meet the demand, more money in the CME coffers. But wait. Where is the evidence that any of these mandates have had any significant impact on physician competence, performance patient heath outcomes? Show me the Data! Legislators are engaged in single loop logic here. Mandate something physicians must attend to in their CME and change will occur. Not so simple. Read the article. What do you think?
How many times have you sat in an Alliance, ACCME, or other CME related educational activity wondering how the heck you are going to apply what the speaker is talking about in your CME setting? The same thing happens to our physician learners all of the time.
We have to do the hard work of being sure our instructional and learning objectives are relevant to improving the work our physician learners are engaged in back home. This seems obvious. The difficulty comes when our learners are back in the practice setting and need a strategy to successfully apply what was taught so that doing so becomes reinforcing rather than extinguishing.
Our instructional and learning objectives must be derived from an in depth understanding of current practice and the eventual application of a more desired set of behaviors in the practice setting. These are the gaps from which educational needs and objectives are derived. We’re required by the ACCME to do this heavy lifting. Part of that heavy lifting is a careful analysis of current and desired behaviors that leads to an understanding of why a professional performance gap exists and of how our learners can apply what is being taught back in their practice. Without this understanding we need to ask ourselves the question, “Do I have a good enough understanding of what is required to apply in practice what is learned during my CME activities. Can I design content that will help the learner develop strategies they can use to apply what is being taught? If not, maybe I need to do more work that leads me to that point.