There is a fairly striking disconnect between what we know about learning and practice (behavior) change, and what we actually do each day. It seems that the majority of the education that continuing medical educators plan, develop, and implement is planned, developed, and implemented to transfer data and information to the individual. The rub is that the construction of knowledge and wisdom actually occurs through collaboration and teamwork. One could go so far as to argue that no learning or behavior change occurs without some connection to what those around us are “knowing” or doing. (And this may be a troubling thought for those of us hoping to get the most out of our programs.)

So how did we get here?

There are a few ways to answer the question, but the simplest answers are probably the best ones. It seems we develop education for the individual because a) that is what we have always done, and b) it is far simpler to push information out than it is to support the construction a more complete environment for learning. In other words, we seem to have accepted the role of “content creators” instead of taking on the fuller responsibility of educators. This is a very frank reality—the CME community appears to believe that our jobs end once we have packaged up our content for transmission. And we are not alone:

“Many schools have traditionally held a transmissionist or instructionist model in which a teacher or lecturer ‘transmits’ information to students. In contrast, Vygotsky’s [Social Learning] theory promotes learning contexts in which students play an active role in learning. Roles of the teacher and student are therefore shifted, as a teacher should collaborate with his or her students in order to help facilitate meaning construction in students. Learning therefore becomes a reciprocal experience for the students and teacher.” (From

How do we move the CME profession forward?

First, let’s begin with the notion that “social learning” theory does not mean we need to start producing CME activities on Facebook—in fact I would strongly discourage this idea (at least for now). Instead, we need to embrace the reality that learning occurs most effectively in consult with other learners—learners “norm” off one another, they look for validation, and they look for confirmation. So we need to think about how to engineer this type of social (or connected) learning environment in any education we create.

Second, we need to consistently “break the fourth wall” of education. Regardless of format, faculty need to step out of the “lecture moment” and engage learners directly. (Think of Ferris Bueller talking to the camera during the 1980s movie Ferris Bueller’s Day Off). By engaging learners and directly supporting their learning actions—note taking, reminders, focused searches, etc.—faculty encourage higher level cognition and learning.

And third, we need to find and share best practices that are driven by the science of CME. This is certainly not a new call to action; I have been making this point for years. We need to understand more completely what “social learning” means in the healthcare professions, and we need to logically and systematically explore novel ways to leverage social learning theory.

If we look outside of the CME silo we will see whole new worlds of adult-education possibilities. As a profession, we must begin to leverage new learning environments that others have piloted, we must find new “architectures for learning” that can more effectively support learning and assessment, and we must stake our professional flags in the areas where evidence exists.

The reality is that I have drawn these opinions from nearly a decade of social learning myself, so if you are interested in how I have come to these conclusions, the answer is fairly simple. As the adage goes, “I learned it from watching you!”

Brian S. McGowan, PhD, has dedicated the past 12 years to medical education as a faculty member, mentor, accredited provider, and commercial supporter. The opinions expressed are McGowan’s and do not represent the views of past, current, or future employers. Contact him via Twitter: @BrianSMcGowan.