Despite the thoughtful and good intentions of CME professionals, sometimes educational activities fail. While no one purposely creates inappropriate or unsuccessful educational events, the potential for such results is always present. When things go wrong, the result is misdirected or unsubstantiated CME content, tarnished faculty relationships and reputations, provider embarrassment, grantor dissatisfaction, and misuse of funds.

Too Many Cooks

The best-laid plans are derailed when too many people are involved in the process, especially initially, without having their roles and responsibilities delineated from the outset. When no one is really in charge, well-intentioned participants may proceed in separate directions, heedless of whether their activities contribute to a cohesive whole. Problems will occur from such fragmentation that may undermine both the direction of the project and its success.

Problems are also created when planners do not focus sufficiently on the purpose of the educational activity, needs assessment, and learning objectives — and unfortunately, this oversight may be selfishly motivated. When providers abandon sound educational principles to meet supporter deadlines or preferences, or to retain grant funding despite a lack of cooperation among educational partners, problems and perhaps project failure lie ahead.

Cooperation among educational partners often is a delicate balance. The more people, groups, or companies involved in planning and development, the greater the potential risk. Each of us brings our own experiences, issues, biases, and agendas to the project. Each person's contributions can add to positive educational experiences if those contributions are cohesively blended in a focused environment in which participants' roles and responsibilities are clearly defined. But when a participant's views are disregarded without due consideration by all, or when people are forced to accept a particular position regardless of how they feel, chaos results and flawed performance is inevitable.

Don't Micromanage

Another potential pitfall occurs when higher-ups who don't have sufficient knowledge of the educational goals, assigned responsibilities, or the planning process intervene in the development of the project. Often, their staff responds by performing without conviction, taking the project in a different direction, losing focus, or making poor decisions.

While those in authority have every right to oversee the project development, they should respect and trust qualified staffers, delegate day-to-day responsibility to them, and empower them to make decisions. When the project development seems clearly off course, the project leaders have the responsibility to take corrective action.

Communicate, Communicate

The management of large and complex CME projects requires openness and candor at each decision point and careful communication with all involved. Don't ever assume that project participants have somehow assimilated messages or decisions if you haven't communicated that information, or that they will know what to do because of their past experience. Communicate the most important information in writing and file it for quick access. This will assure accurate assignments and attention to project components, and it will provide a written record of the project development.

Continuing medical education is a complex process. If you apply sound business principles and do everything you can to ensure that project leaders take an inclusive approach and empower participants, you will increase the likelihood of creating successful projects.

Robert F. Orsetti is former assistant vice president, continuing education, University of Medicine & Dentistry of New Jersey in Newark. Orsetti, a 30-year CME veteran, is a member of the American Medical Association's National Task Force on CME Provider/Industry Collaboration. Contact him at For more of his columns, visit

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