Shame on us. For all our collective adult-learning expertise, too many CME leaders have proposed improvements to the enterprise while ignoring principle No. 1: self-directed learning. In short, physicians often don't have a seat at the CME table.

Articles attack funding, so-called “consensus” conferences limit participation to a subset of CME providers, and foundations fund government advisory board discussions about CME conflicts of interest. All this talk, but very few voices from the users of CME themselves.

“Some educators are making proposals to improve CME without the benefit of physician input,” says Barry T. Katzen, MD, founder and medical director of the Baptist Cardiac and Vascular Institute in Miami. “You can't make learning improvements if you don't incorporate self-directed learning principles.”

Docs Speak Out on Funding

Slowly but surely, physicians are raising their voices when it comes to CME. In addition to providing significant input via Medical Meetings' Annual Physicians' CME Preferences Survey, doctors spoke loudly in the 2009 Manhattan Research study regarding commercial support. Of the more than 900 physicians surveyed, 91 percent supported pharmaceutical industry funding for CME and only 8 percent indicated they were concerned about bias.

In addition, many physicians offered detailed input to the Accreditation Council for CME's August 2008 calls for comment regarding commercial support. And based on its summary of the March 2009 board meeting, the ACCME seems to be listening.

According to the executive summary of the March meeting, “The ACCME believes that the CME system's internal controls provided by the ACCME Standards for Commercial Support, and associated ACCME policies, support the development of independent continuing medical education that a) is free of commercial bias and b) does not result in an inclination by professionals to direct care that is unwarranted or unnecessary.”

The Manhattan Research study also elicited these physician perspectives:

• Almost all physicians reported that they utilize CME programs to maintain and grow their medical knowledge.

• Participants reported that CME is the critical link to updated information on the latest advances in their specialty.

Get Doctors' Input

Besides spawning more diverse and intensive surveys of primary care and specialty practitioners, the need for greater physician input into CME is helping to drive the creation of a new not-for-profit group: the Association of Clinical Researchers and Educators. Being formed in New York right now, one of the group's aims is to be a clearing house for physician input on CME topics of concern.

Advancing the CME enterprise demands greater physician input, whether through the Web, medical societies, surveys, or discussion groups. Incorporating adult learners into the educational discussion is the only way to take CME to the head of the class.

Stephen M. Lewis, MA, CCMEP, is president of Littleton, Colo.-based Global Education Group, and president of the North American Association of Medical Education and Communication Companies. Reach him at slewis@globaleducationgroup.com.