From Teaching to Learning: CME's Great Leap Forward

Continuing medical education (CME) is changing, or is trying to change, in a big way. The organization that sets standards for CME, the Accreditation Council for Continuing Medical Education (ACCME) requires educational programs that produce "real world" results. They want to see measurable changes in health care resulting from CME activities. So people like me who manage CME programs need to shift our attention from what is being taught to what is being learned.

This brings up an interesting issue: How do physicians learn? I suspect that much of what doctors learn is through conversations with other doctors and other informal interactions. In some ways this isn't a problem for CME providers. We can give doctors credit for "performance improvement" resulting from their informal learning as long as we can provide ACCME with adequate documentation. However, it is hard to see how this approach can be financially viable. CME providers are likely to spend far more on creating documentation and policies, and reviewing, filing and analyzing data, than we will be able to charge in fees for this service. The same issue comes up with giving CME credit to physicians for learning in preparation to deliver CME content. Sure, we can provide this service, but it will cost more to manage than it is likely to bring in.

Perhaps a solution is to produce traditional CME lectures, that make money from commercial support and registration fees, in conjunction with opportunities for informal learning. You can think of this in sales and marketing terms. Formal/traditional lectures are marketing. They get learners familiar and comfortable with new ideas. Informal conversations with colleagues are sales. This is where doctors really become convinced and committed to changes that will improve health care. CME providers need to collect data to give learners CME credit for both, and to find out what sources of data led to changes in health care practices.