From My “For What It Is Worth Musings” About PI CME

A thought.

There is a need for serious conversation about what we mean by PI CME and what is required of PI CME to have any lasting impact in improving the delivery of healthcare. It is no longer enough simply to consider how physicians learn – an emphasis promulgated by the adult educators (and I am one) far too long. While an understanding of how physicians learn is important, it is not enough. The end product of learning – knowing- is not enough. Physicians know how to do far more than they actually do in providing care.

The more important question is where physicians learn. Physician learning takes place at three levels. First, it occurs in the physician-patient interaction where care is being provided. Second, it occurs in the organizational systems and work processes that comprises practice settings. And third, it occurs in the socio-political-economic systems that frame healthcare delivery. These are each sub-systems of our larger, very complex healthcare system. Change occurring in one subsystem requires change in other subsystems. That is how systems work.

If structured in a way that acknowledges learning occurs in these subsystems PI CME can have a major role in effecting change in physician competence and performance in complex health systems. I believe this. I also believe that CME professionals need to understand improvement theory and the tools used to effect improvement in complex health systems. PI CME offers the CME professional a way to add tremendous value to their organization. We need to step up and take advantage of this opportunity.