Posts filed under ‘Physician Education’

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?

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

Improving Quality Improvement in Medical Education

Those of you patent enough to watch for my episodic posts know I am an improvement nut. My contention is that all CME must be improvement based. As I read the ACCME requirements of accredited providers I see that all providers have to demonstrate an impact (improvement) on the competence or performance of their learners or the impact of their educational efforts on the health status of their learner’s patients. CME is in the improvement business.

I saw this in a post a few days ago by Scott Harris in the AAMC Reporter.
“…………….As the popularity of QI and the evidence of its benefits pile ever higher, medical school curricula, graduate medical education (GME), and continuing medical education (CME) programs around the country are working to put QI’s tools and principles into the hands of tomorrow’s doctors and today’s practitioners………..”
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What an opportunity for CME providers. Follow the link to this article and see what is being done or encouraged in QI across the continuum of medical education.

There are some people on the field of CME who are pioneering work in improvement. Take a look at some of the interviews I have done on my podcast with some of these people. They are laying the foundation for the future of effective CME. See http://www.ctlassoc.libsyn.com. What is woefully lacking is a coherent approach to improvement initiatives. We have as framework provided by the AMA for PI CME. A good step would be to identify a systematic, sustainable, repeatable approach to PI that could be adopted and adapted by CME providers across the country. I have some ideas about what that approach could be. If you are interested, in learning more about this approach, comment on this podcast or send me an email at ctlassoc@mindspring.com.

Until the next time I hope that all of the CME you provide is CME that matters.

September 27, 2010 at 8:36 pm Leave a comment

CME in the News and on the Blogs February 25th, 2010

There is not really much CME news out there right now. I did find two things you might find interesting.

Physician Takes Training in Quality and Safety

We need a lot of physicians with skills in quality and safety. These skills  not taught very well, if at all, in the crowded curriculum of medical education  and graduate medical education. It seems to me this has to change. But the situation does provide an opportunity for CME to meet an important learning need for healthcare professionals.

From the Hospitalist: The eWire, 2.24.2010

Northwestern University’s graduate program in healthcare quality and patient safety can be a valuable tool for hospitalists looking to meld clinical expertise with practice management skills.

So says Kevin O’Leary, MD, MS, thought to be the only hospitalist to earn the master’s degree in the program’s four-year history. “It’s definitely important for somebody who wants to take any role in leading quality improvement (QI) either for their hospital medicine group or for the hospital,” says Dr. O’Leary, associate chief of hospital medicine at Northwestern University’s Feinberg School of Medicine. “A traditional residency program does not prepare, really, any physician in any specialty to take a lead in quality improvement.”

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Promising Practices: Healthcare quality and Equality – RWJF Resources

The Robert Wood Johnson Foundation maintains an extensive inventory of promising practices that have been implemented or developed in their programs across the country. The resource includes summaries of interventions and “how-to” guides for improving care, summaries of major issues in health care quality and equality, and video and audio files that demonstrate these ideas.

You might want to check this out.

February 25, 2010 at 11:08 pm Leave a comment

CME Needs Assessment Data? County Health Statistics

This report has nothing to do with CME but providers may want to look at the data as one source of needs assessment information. Note the caveats in the article.

Report compares health county-by-county
USA Today, February 17, 2010

“For the first time, a new report reveals how counties across America stack up when it comes to health.

Today, whether you live in Malibu or Atlanta, you can learn if your community is holding its own in health. “County Health Rankings: Mobilizing Action Toward Community Health,” a health report card for almost every one of the nation’s more than 3,000 counties, is being released by the Robert Wood Johnson Foundation and the University of Wisconsin’s Population Health Institute…………”

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The report will be released today. You may want to go to the RWJF website to get the report.

February 17, 2010 at 6:45 pm Leave a comment

The Disappearing Pharmaceutical Sales Role

Here is an interesting article suggesting a changing  role for the pharmaceutical sales rep. Worth a quick read.

The Disappearing Pharmaceutical Sales Role

Pharma Reform, January 9th, 2010

“Editorials and commentary on Pharma web and blog sites continue to highlight the massive layoffs of pharmaceutical sales reps. These are frequently accompanied by commentary with justifications and desperate rationalizations for maintaining the role of the traditional pharmaceutical sales representative. Most frequently, the commentaries blame regulatory constraints and promotion guidelines for the diminishing value reps can now provide.  Many forget that the industry has brought this upon themselves by repeatedly compromising market trust with blatant advertising and promotion abuses.

Here is the reality. Physicians no longer value sales people or the information they try to convey.  Patients and office staff see sales reps waiting in the office delaying appointments and taking up physician time. Managed markets find sales people a nuisance and counterproductive to their formulary management and cost control initiatives. Legislators and regulators see the reps as uncontrollable extensions of the “not to be trusted” corporate, Big Pharma and feel compelled to restrict sales activities.  Yes, the reality is that sales reps and the information they convey are no longer respected, valued, or trusted. The traditional pharmaceutical sales role has become ineffective, and is quickly becoming obsolete…………”

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January 10, 2010 at 7:38 pm Leave a comment

CME in the News and on the Blogs December 7, 2009

Here us a Blog that takes into consideration what is actually going on in our field.  A refreshing change from some of the blabber we see about CME  in the news and on the blogs.

The CME Improvement Process

Hopkins CME Blog December 7, 2009

“In the October 28, 2009 edition of JAMA, an editorial appeared by Eric Campbell and Meredith Rosenthal entitled, “Reform of continuing medical education: Investments in physician human capital”. Unfortunately these authors seemingly ignored the entire CME improvement process that is already in place in this country. Academic CME in particular has examined itself, has begun an improvement project of its own and has undergone a profound sea change well in advance of this publication…..”

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December 8, 2009 at 5:00 am Leave a comment

CME in the News and on the Blogs September 23rd- 27th, 2009

ACCME Board to Consider Disclosure Policy at December Meeting
MeetingsNet Nov 24, 2009

“ACCME board of directors to discuss increasing transparency around its complaints and inquiries process.

The Accreditation Council for Continuing Medical Education’s board of directors will discuss making changes to its process for handling complaints and inquiries about accredited providers at its meeting December 3-4. According to ACCME’s chief executive, Murray Kopelow, MD, “the board is considering the full range of issues involved for both the accreditor and the CME provider” once a complaint has been filed that a provider is not in compliance with the ACCME’s 2006 Accreditation Criteria. This includes whether or not to make public certain information about activities and providers who have been found to be noncompliant. This information currently is released only to the complainant and the provider charged with noncompliance.”

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(Authors Note: It is not only the US that is grappling with the issue of industry relationships with health professionals. Here is an article from our colleagues in Australia.)

Mandatory Disclosure of Pharmaceutical Industry-Funded Events for Health Professionals
Robertson J, Moynihan R, Walkom E, Bero L, Henry D (2009) PLoS Med 6(11): e1000128. doi:10.1371/journal.pmed.1000128

Summary Points
• There are moves internationally to ensure greater disclosure of gifts and educational events for doctors paid for by pharmaceutical manufacturers. However, there is no agreement on appropriate standards of disclosure. In Australia, since mid-2007, there has been mandatory reporting of details of every industry-sponsored event, including the costs of any hospitality provided.
• Examination of the Australian data shows that although expenditure at individual events is often modest, cumulative expenditure is high, particularly in the case of medical specialists prescribing high cost drugs—oncologists, endocrinologists, and cardiologists.
• Although a significant advance, the new Australian reporting standards do not allow assessment of the educational value of sponsored events, and do not include details of speakers or educational content for most events. However, doctors in training are often present at these events.
• At present, the standards of disclosure are inadequate and should not be tied to an arbitrary monetary value of gifts or sponsorship. Reporting standards should require the names of the speakers presenting, whether sponsors played a role in suggestion or selection of speakers or the development of the content of presentations, and the nature of any direct or indirect financial ties between the speakers and the sponsors.

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A useful resource for those investigating the pharma industry
Croakey the Crikey HealthBlog, November 27th , 2009

“The Drug Industry Document Archive contains over 2500 documents about pharmaceutical industry clinical trials, publication of study results, pricing, marketing, relations with physicians and involvement in continuing medical education. It is a publically accessible web site hosted by the University of California, San Francisco Library and Center for Knowledge Management
Most of these previously secret documents were made public as a result of lawsuits against the following pharmaceutical companies: Merck & Co., Parke-Davis, Warner-Lambert, Wyeth, and Pfizer………………….”

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November 28, 2009 at 5:15 am Leave a comment

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