Docs on CME

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There is some interesting chatter going on in some physician blogs about the recent AM News article about tying CME and quality improvement together. Medrants says, "The future of CME must link education (and thus patient outcomes) with method." But David doesn't think it's doable:

The problem is: how do we measure the outcomes? This is not easy in practice. For starters, how can you do a proper controlled trial in which the change in clinical outcome (if any) is directly and unequivocally a result of an educational intervention alone? How do we even get access to this clinical data in the day of HIPAA? How easily can confounding variables be eliminated?

The consensus of the small group of physicians at a recent CME meeting I attended was that this was a worthy, but unattainable, goal. I also don't think medical education and clinical decision-making is that one-dimensional. Physicians may learn evidence-based care through many venues, and reinforcement is critical. Most people forget most of what they learn at a CME meeting shortly after leaving the conference. Online case-based education fares pretty well in this regard, but physicians still may forget important concepts. Or miss them entirely.

But my favorite, a comment in response to Medrant's discussion on active vs. passive CME, was this:

I was so blinded by my natural brilliance that it took the onslaught of student evaluations at the end of one of my more obtuse [and therefore, in my befuddled mind, stellar] semester s work for the evidence of my uselessness to sink in. Even in a medical continuing education setting where the intelligence and acumen of the participants can hardly be questioned, students need *context* for learning, such as a case study or a patient story. There is great wisdom in the ancient oral traditions there is a connection there that is lively, liquid, and applicable versus the staid and often stultifying effects of pure lecture. At the very least, a lecture course requires assessment by practicum but even then what is really being assessed is the lecture and not what the student has learned. With the more interactive CME, I d wager that the natural and considerable talents of your audience go far beyond the minimal objectives of the course. Blah blah blah sorry for running on!

There is some interesting chatter going on in some physician blogs about the recent AM News article about tying CME and quality improvement together. Medrants says, "The future of CME must link education (and thus patient outcomes) with method." But David doesn't think it's doable:

The problem is: how do we measure the outcomes? This is not easy in practice. For starters, how can you do a proper controlled trial in which the change in clinical outcome (if any) is directly and unequivocally a result of an educational intervention alone? How do we even get access to this clinical data in the day of HIPAA? How easily can confounding variables be eliminated?

The consensus of the small group of physicians at a recent CME meeting I attended was that this was a worthy, but unattainable, goal. I also don't think medical education and clinical decision-making is that one-dimensional. Physicians may learn evidence-based care through many venues, and reinforcement is critical. Most people forget most of what they learn at a CME meeting shortly after leaving the conference. Online case-based education fares pretty well in this regard, but physicians still may forget important concepts. Or miss them entirely.

But my favorite, a comment in response to Medrant's discussion on active vs. passive CME, was this:

I was so blinded by my natural brilliance that it took the onslaught of student evaluations at the end of one of my more obtuse [and therefore, in my befuddled mind, stellar] semester s work for the evidence of my uselessness to sink in. Even in a medical continuing education setting where the intelligence and acumen of the participants can hardly be questioned, students need *context* for learning, such as a case study or a patient story. There is great wisdom in the ancient oral traditions there is a connection there that is lively, liquid, and applicable versus the staid and often stultifying effects of pure lecture. At the very least, a lecture course requires assessment by practicum but even then what is really being assessed is the lecture and not what the student has learned. With the more interactive CME, I d wager that the natural and considerable talents of your audience go far beyond the minimal objectives of the course. Blah blah blah sorry for running on!

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