Comment on the Alliance response to the Macy Foundation Chairman’s Summary: “Continuing Education in Health Professions:Improving Healthcare Through Lifelong Learning”

January 15, 2008 at 12:49 am Leave a comment

Congratulations to the Alliance for Continuing Medical Education for quickly commenting on the Josiah Macy Jr. Foundation, Chairman’s Summary report of the conference “Continuing Education in Health Professions:Improving Healthcare Through Lifelong Learning”. I understand the necessity of making the Alliance membership aware that the organization had no role in the meeting or framing the report. However, I read the comments on behalf of the Alliance as dismissive of the report. I certainly hope that is not the case. Some impressive people who have shaped the field of CME are involved in this effort. A look at the roster of people involved in the conference include several Alliance past presidents. In addition, there are CME scholars and other leaders in the field of CME joined by very thoughtful people.

The Alliance comment on the report states:

“This report reflects the individual views of a selected number of people who conducted a two and a half day session out of the country last fall.”

Let’s be honest here.

  • A large number of people in CME concur with much of what is included in the report. These are not only the views of a selected group of people.
  • What difference does it make that the meeting occurred out of the country? Does that diminish its value in some way?

The comment states:

“The report includes broad generalizations of divisive issues that have not been vetted …..”

You have to be kidding.

  • Most of these issues have been vetted for years by many individuals and groups the CME world, in the literature, in regulatory agencies, and some even in the Congress of the United States.

The comment further states:

“………and we believe may not be in the best interests of the CME community at large.”

Do we not believe it is in the best interest of the CME community to:

  • acknowledge legitimate observations about the current CME system and implement many of the features mentioned?
  • do all we can to ensure independence for commercial bias n our CME activities?
  • address the failures of the current accreditation system?
  • implement the principles put forward by the group to guide continuing education of health professionals?
  • embrace the suggested fundamental purposes of continuing health professional education?
  • acknowledge that maintaining professional competence is a core responsibility of each health professional and that systems of care profoundly affect patient care?
  • acknowledge that traditional single intervention lecture-based CME activities are largely ineffective in changing health professional performance?
  • see the importance of practice based learning and improvement as a promising approach to improve the quality of patient care?
  • recognize that information technology is essential to practice based learning?
  • embrace engaging approaches to teaching in CME?

If not in agreement with the contents of the report then what is the position of the Alliance Leadership on these issues?

  • Should practice based learning emerge as a primary form of CE?
  • Should we seek support to develop technology that facilitates point of care learning including easy access to clinical decision support resources?
  • Should we encourage the development of life-long learning skills at all levels of formal health professions education.
  • Should we encourage a national initiative that advances the science of CE addresses the proposed charges to such an institute?
  • Should we continue due diligence in ensuring that the CE of health professionals is based on the best science available, independent of commercial influence, using the best learning resources available. Can we do this with commercial support?
  • Should we limiting the kinds of organizations that can become accredited providers? Should any organization that can meet the accreditation standards be excluded? If so on what grounds?
  • As a matter of convenience and cost containment, is a single accreditation organization for nursing and medicine is a good idea?
  • Why not incorporate information technology and interactive scenarios into CME activities?
  • Should CME to do its part to encourage the development of practice-based learning skills and make every effort to help health professionals maintain those sills throughout the professionals’ career.

I found I agreed with much – not all – of what was in the report. Is there not something in the report that the leadership of the Alliance finds in the best interest of its membership and the field of CME? I sure hope so. If not our society is pushing itself closer to the brink of irrelevance.

I am looking forward to publication the proceedings that will provide a rich background on how this group arrived at its position. Then perhaps we can comment in a more thoughtful and balanced way.


What do you think?


Entry filed under: CME Issues, Continuing Medical Education.

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