Posts filed under ‘CME’

CME – Who Gets the Assignment

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.


May 10, 2012 at 11:48 pm 1 comment

Do We Have a Problem with our Problem Solving Behaviors?

In our drive to design CME activities that we hope will demonstrate impact or improvement on a professional practice gap we often jump to potential causes or even solutions before we fully understand the real nature of the gaps that give rise to presumed educational needs.

Continue Reading August 30, 2011 at 2:14 am 2 comments

CME Shown To Produce Positive Clinical Outcomes

PRLog (Press Release) – May 25, 2011

Physicians who participated in live half-day, multi-format CME symposia were 50% more likely to provide evidence-based care for chronic obstructive pulmonary disease (COPD) than those who did not participate, according to a newly published study. The results reported go on to say:

“In addition to being more likely to provide evidence-based care, participants were more likely than non-participants to correctly recognize COPD in a patient presenting with dyspnea (94% vs 74%; P=0.007); recognize that women may have a greater susceptibility than men to the toxic effects of smoking (90% vs 54%; P< 0.001); and identify the mechanisms of action of emerging therapies (65% vs 33%; P=0.003). Each of these areas had been identified as gaps in current COPD clinical practices; thus, these findings show that continuing medical education can help narrow these gaps.”

Read More

This is the kind of report I would like to see more of in the media and the blogesphere. It validates what we have been saying for years about what constitutes effective design in CME.

May 26, 2011 at 9:29 pm Leave a comment

Recent Trends in Continuing Medical Education Among Obstetrician–Gynecologists

A abstract of arecent article in Obstetrics & Gynecology (May 2011 – Volume 117 – Issue 5 – pp 1060-1064. Burwick, Richard M. MD, MPH; Schulkin, Jay PhD; Cooley, Sarah W.; Janakiraman, Vanitha MD; Norwitz, Errol R. MD, PhD; Robinson, Julian N. MD) reports on a study conducted “To estimate current trends in continuing medical education among obstetrician–gynecologists in relation to the Maintenance of Certification program.”

A validated questionnaire was mailed to 1,030 randomly selected physicians of the American College of Obstetricians and Gynecologists in the United States, Puerto Rico, and Canada. Participants were asked about current practices and opinions regarding continuing medical education activities. Responses were compared between members mandated for Maintenance of Certification (board certification 1986 or later; time-limited certificate) or not (board certification

Some interesting results were provided:

1. College physicians mandated to participate in the Maintenance of Certification program were more likely to rely on Annual Board Certification articles as a major source of continuing medical education credits compared with those not requiring Maintenance of Certification
2. Maintenance of Certification requirement led to decreased use of the national or international meetings and self-selected continuing medical education materials as sources of continuing medical education credits.
3. Physicians in both groups equally valued:

  • the relevance of Annual Board Certification articles
  • the importance of content at academic meetings
  • the usefulness of simulation drills and
  • the general ability of continuing medical education activities to improve skills as a physician

As for conclusions it appears that the:

1. requirement of the Maintenance of Certification program has led to significant changes in continuing medical education choices by obstetrician–gynecologists, and,
2. changes in continuing medical education appear related to mandated obligations rather than personal preference.

A subscription is required to access the article so I didn’t see the survey or other results reported. I don’t know if any questions were included and results reported about the performance improvement component of the MOC process.

I find it a little distressing that the changes reported appear to be less matter of personal preference and more related to mandated obligations. I am not sure what to make of this. What do you think?

April 25, 2011 at 9:40 pm Leave a comment

Physian Performance and Quality – No Relationship?

“Performance improvement” CME

I found on a Blog called Trusted MD. It is syndicated by R. W. Donnell | Mon, 04/18/2011

It is a response to a comment by Daniel Carlat a few days ago.
about the emerging importance of PI CME.

He says, “I knew we were moving in this direction but I was not aware that “PI CME” was official. Dan Carlat blogged this yesterday. As one would expect he’s mainly concerned about industry getting in on the trend, but between the lines of his post I read a measure of concern about the whole idea of PI CME. I’m concerned too. Performance has little to do with quality, or good doctoring by any definition.”

Unbelievable!  What physicians do – their performance – has little to do with quality, or good doctoring”? I completely understand there are many determinants of quality and good “doctoring”. To assert that what physicians do -their performance- in patient care has no impact on quality is unfathomable to me.

April 19, 2011 at 8:18 pm Leave a comment


PI CME is gaining traction but there are still few physicians taking advantage of this learning format. Some physicians still say they have no idea what PI CME is. Others say they are too busy to engage in this form of CME because takes too much time or it is too much trouble. So why should we be diligent in offering PI CME and trying to increase the number of physicians engaging in this dynamic learning format? I can think of a number of reasons.

  • Improvement is a part of the fiber of the practice of medicine. Every physician I have ever met is continuously seeking ways to provide optimal patient care. They are constantly looking for ways to improve the outcomes their patients can achieve.
  • PI CME is physician centric. Yes it is “All about me”. Me as a learner. My practice. My patients,
  • PI CME is data driven. Physicians are scientists. Data are important. Data derived from their own practice and compared to “best practices” is informative and challenging. You change what you measure.
  • Engaging in practice improvement activities is required for Maintenance of Certification and is in the framework for Maintenance of Licensure. Accredited hospitals must engage physicians in improvement efforts in their own settings. Some third party payers are offering incentives for engaging in improvement initiatives that can demonstrate better patient outcomes.
  • PI CME is aligned with sound adult learning principles – physicians learn by solving problems. They have a need to know. This, among other principles, is core to adult learning. .

The AMA has a framework for offering PI CME credit. One of the best things the CME profession could do to support PI CME is to adopt a systematic, sustainable, repeatable approach to guide PI CME initiatives. With the emergence of Lean Healthcare and one of its central tools – A3 Problem Solving- we have a framework that is effective and efficient. We should embrace it as a new way of doing our PI CME business.

Integrating CME and Improvement – The New Normal

February 4, 2011 at 11:07 pm Leave a comment

Communities of Practice – A Framework for Learning and Improvement

One of the sessions at the 2011 annual meeting of Alliance for Continuing Medical Education that I was supposed to participate in was to report on the work of a “Community of Practice”. The session was canceled because an attempt to get a community established failed to materialize. So what are these things called Communities of Practice (COP)? Take a look at the graphic. It provides a good description of a COP.

COP’s are usually comprised of a group of individuals who find they have a common area of interest or a common concern. They build a trusted relationship with each other around the area of common interest and begin to share their unique knowledge and experience related to the issue. By doing so they soon develop a shared understanding and approach to the issue and build a collective knowledge base which informs their practice guiding how they approach the common area of concern. The end result is that the experience of the COP builds in each member a collective knowledge base that, when applied, improves their individual performance and can have a dramatic impact on improving the issue they were drawn together to address.

Think of all of the things happening in CME that might benefit from COP’s forming to explore issues, develop deeper levels of understanding, produce resources for all of us to use. Things like Maintenance of Certification, Maintenance of Licensure, Integrating QI and CME, PI CME, Utilizing Social Media in Healthcare and Physician Learning – and this just scratches the surface of possibilities.

COP’s are engaging, intellectually stimulating, and fun. Find one or start one. You’ll be glad you did.

Integrating Education and Quality Improvement – The New Normal

February 4, 2011 at 2:19 am 7 comments

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