CME, Industry and Outcomes


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Recent medical literature describes the challenges of demonstrating the impact of CME on physician learning (with a focus on the lack of impact), and the need to reform the current system.  Writers suggest that it really is not having the impact that it should, given the financial resources provided.  Others have questioned how it is funded, suggesting that it may be biased given the resources provided by industry, and that it should be changed.

While I admit my own bias as an Associate Dean for CME for a major medical school, I feel that it is important to study the peer-reviewed literature to best understand this important topic.

First, is the industry influence really that significant?  A piece by Cervero discusses this, and found limited evidence of the impact of industry influence on CME.  In the recent ACCME 2014 report (Table 8), only 11% of accredited CME received commercial support from industry.  My interpretation of this is that the commercial support is certainly not an overwhelming part of CME programs (our own institutional data would definitely mirror this finding).

Second, what is the real impact of CME?  The same above author recently published a piece in JCEHP (full disclosure: I am the social media editor for this journal, but was not involved in any way in the creation, revision, or decision to publish this manuscript) that concluded that CME can indeed impact patient outcomes and physician behavior (the former more than the latter).

Third, improvements in how CME is disseminated should occur.  Within this realm, patients should be included, and interprofessional learning should occur in team environments; this is highlighted by the new President and CEO of the ACCME, Dr. Graham McMahon, in a Viewpoint piece in JAMA that came out online earlier this week.

So where should we go from here?  I think there are several things we can consider.  Most importantly, physicians and other healthcare providers should continue to learn in order to provide optimal care of their patients in a changing environment; CME is one way to aid this learning.  Those in the field have been thinking about how to restructure it for many years and have made major strides in focusing on quality improvement.  Second, we should also consider learning healthcare systems as a way to promote learning for those who provide care for patients.  Lastly, we should be diligent about using technology to make our learning more effective.  Examples include online journal clubs and virtual communities of practice.  Given the complexities that abound in medicine in the current environment, anything that can make the process of learning how to “keep up” and best care for our patients easier should be welcomed.

Learning Health Care Systems


Recently, I have been reading about Learning Healthcare Systems.  A very recent Incidental Economist post described this concept.  In addition, a piece in JAMA a year ago described the transformation to this as separate from the “usual” tripartite mission of research, clinical care and education.  CME and CPD offices can facilitate learning by engaging faculty in adopting this term and supporting expansion of a positive educational climate.

How best can learning health systems flourish?  In medical schools affiliated with health systems?  What about community hospitals who traditionally have supported education in the form of training residents?  I am curious what the CME and CPD communities think of this, and how they can work with others in their systems to support learning needs.  Feel free to comment.

Point of Care Resources in CME and CPD

A fascinating article came out recently in the Postgraduate Medical Journal describing point-of-care resources for continuing medical education (CME).  In this article, the authors describe the current state of how health care providers access resources to help them care for patients. They stress that self-directed learning is critical to the lifelong learning process. The fact that health care practitioners (HCPs) “drink from the firehose” of information certainly strengthens the need to consider point of care resources over traditional methods of attempting to “read the journals when they arrive.”

I enjoyed reading this article, especially the part describing how technology is playing an ever-increasing role in the education of physicians and other HCPs. This “on-demand”-education (also known as “just-in-time” learning, or JITL for short) is aptly described in this paper. More about JITL in primary care was written in JCEHP back in 2013, and can be found here.

I’m curious what readers of JCEHP and others in the continuous professional development community think about point-of-care resources. Do your physician and HCP learners take advantage of such resources? Beyond “getting the credits”, why else do you think learners might prefer this method of learning? What can our community do to help foster the use of point-of-care resources?

Please feel free to comment here on the blog. As always, thank you for your support of JCEHP!

JCEHP blog goes live



We are excited to now officially make our blog live.  As mentioned recently in JCEHP, the vision for this blog is to allow another opportunity for communication between readers and the editorial leadership of JCEHP.  We will create posts pertinent to the continuing education community, and encourage professional dialogue within the community.  The intent of doing this in a blog format is to engage more in real time.

As the journal considers new initiatives, this blog is a perfect opportunity for comment about those initatives.  We will include features such as polling that allow for interaction with readers and to gauge opinions on a variety of topics of interest to those within the field of continuing education of health professionals.

Please feel free to comment on the use of this blog as a means of communication.  Thanks so much for reading JCEHP!

JCEHP enters the blogosphere!

This piece marks the first post of the JCEHP blog.  We are excited to expand the reach of JCEHP through this innovative social media tool.  The editorial leadership realizes that it is important to reach the readers where they are.  This blog marks another way to disseminate important content about continuing education to our audience.

We hope that you will enjoy the blog content.  We encourage you to post comments about our blog, and to suggest future themes for posts.  We intend to use this blog as an adjunct to our quarterly journal.

Thank you for reading JCEHP!