CME meets ADDIE, Part 1

My colleague Robert Edgar worked on military training projects for Deterline and Associates in the 1970s. Deterline wasn't paid until they demonstrated that their training materials were effective. So Robert, and other military and corporate instructional designers, used instructional design systems that were systematic, reliable, and produced measurable results. Typically, these systems were variants of ADDIE, an acronym that stands for:

• Analyze: Define the learning need, audience, and the instructional objectives, media, and format.
• Design: Development of a specification for how the content will be presented and assessed, often including an outline of the content and types of user interactions.
• Develop: The instructional designer, and any applicable subject matter experts, writers, editors, a/v producers, graphic designers, animators and programmers create, integrate, prototype, and test the program's content.
• Implement: The program is delivered to learners.
• Evaluate: The effectiveness of the program is assessed.

What does this have to do with CME? Consider how ACCME's updated criteria correlate with the ADDIE model.

• Analyze: The overall goals of the program are specified (Criterion 1), educational needs are based on professional performance gaps (Criterion 2), and CME activities are designed with consideration to learning and setting attributes (Criteria 4 and 5)
• Design: CME interventions are designed to achieve program mission (Criterion 3), and CME content is developed in the context of desirable physician attributes (Criterion 6)
• Develop/Implement: Content is developed and delivered independently of the influence of personal financial and commercial interests (Criteria 7, 8, 9, and 10)
• Evaluate: Changes in learners are measured (Criterion 11), the effectiveness of the overall program is measured (Criterion 12), and the overall program is improved (Criteria 13, 14, and 15)

In sum, I think that the updated criteria can be considered as promoting a variant of the ADDIE model, with some guidelines focused on individual educational activities, some addressing the overall program, and some relating the individual activities to the overall program.

At the recent ACME annual conference in Phoenix, discussions of the updated standards often mentioned instructional design techniques common in ADDIE implementation. For example, one speaker discussed "learning hierarchies," an analysis process in which educational goals are sequentially broken down into a series of smaller, better defined instructional objectives. Other speakers applied Kirkpatrick's 4-levels to the evaluation of CME activities.

While ADDIE-based instructional design might seem new to CME managers, this approach has a long history in military and corporate training. Furthermore, the benefits and drawbacks of ADDIE-based design have long been debated within the instructional design community (e.g., ISPI, ASTD). In Part 2, I discuss the implications of an increased emphasis on ADDIE-based instructional design for CME.