Institute for CME

April 3, 2008 at 1:05 am Leave a comment

In a recent editorial in the CMAJ, (March 25 2008;178(7):805-806), the Editor in Chief, Paul C, Hebert, MD MHSC, joined a growing number of people calling for establishing an Institute of Continuing Health Education. He argues that continuing medical eduction is driven by the pharmaceutical industry and that physicians seemed to think they are entitled to the benefits of that involvement.

The editorial then asserts:

“To arrive in a healthier place, we need to disentitle physicians and adopt a more principled approach. The only way out is to take ownership and reinvent the system. Most importantly, given that the provision of efficacious continuing education is a quality-of-care and patient-safety issue, its focus must be on improving clinical knowledge, skills and attitudes as a means of improving clinical outcomes and quality of care by enhancing a practitioner’s performance. In addition, continuing education activities must provide accurate information free from real or perceived biases. They should focus on themes and topics based on the needs of patients or health professionals; make greater use of a broad range of proven, effective adult learning techniques; include all health professionals; and be affordable, accessible and, where possible, integrated into clinical practice. Finally, all these initiatives should be easily implemented, monitored and accredited so that public trust is maintained. We might even consider publicly posting every physician’s dossier of continuing medical education activities in the interest of optimal transparency.”

We probably all agree with these proposed attributes for CME. But will an Institute for CME adequately address the concerns underlying the argument for establishing an Institute for CME. The Editorial suggests that mandate for the Institute would be to:

  • Set guidelines and standards for efficacious and unbiased continuing education.
  • Develop, support and promote interprofessional educational opportunities.
  • Monitor sources of all funds and set accreditation standards for continuing education providers.
  • Provide continuing education grants to accredited institutions.
  • Identify education and treatment gaps.
  • Develop more effective ways to educate health professionals.
  • Find new ways to integrate education into clinical practice.
  • Help health care professionals overcome barriers to lifelong learning.
  • Act as a central clearinghouse for continuing education for all health professionals

It is my contention that, at least in the US, some, not all, of these mandates are being addressed by the current CME system. There is room for improvement. The question is whether a central focus for the continuing education of health care professionals will make any difference at all. Perhaps, but I am a skeptic at least as far as CE in the US is concerned. So someone step up to the plate and try it. Not as the sole way to do CME but as a competitive model in the mix of what is already happening.

It is my guess that funds for such an Institute would still need to come from pharma. Would an Institute be able to attract adequate funding to give the idea a good test? Maybe so. Maybe not. Pharma will think very carefully about providing funds to such an enterprise. What is in it for them. Will an Institute be seen as a value by industry and thus an attractive alternative to how they currently allocate money to the CME enterprise?

The idea of an Institute deserves debate and perhaps a test. I am not convinced it is the panacea that some think it will be.

What do you think?


Entry filed under: CME, CME Issues, Continuing Medical Education, Continung Professional Development, Physician Education.

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