The continuing medical education community has gone through a lot of changes lately. The question is: Have they made for a stronger CME enterprise?
Over the last few years we have seen quite a few changes in CME: the Accreditation Council for CME released updated accreditation criteria, and some commercial supporters have changed the way they will provide funding and to whom they will provide it. Both accredited and nonaccredited CME providers have been affected by changes in the economy and the enterprise of CME. The United States Senate, the American Medical Association, and the Institute of Medicine have investigated many aspects of CME.
Having lived through all of this, I am left wondering just one thing: Are we better off now than we were before all of these changes and probes occurred?
The View from Both Sides
Looking at this from the perspective of the providers, I think that we absolutely are better off. I say this unflinchingly for several reasons:
Accredited providers are now tasked to clearly demonstrate the educational value of every activity that they certify.
Nonaccredited providers now must be vetted and shown to be free from bias and conflict of interest, and must attest that they are not in any way commercial interests.
Collaborations between many stakeholders in CME are being fostered not because they're required, but to increase educational value.
I think that commercial supporters are also better off for these reasons:
The internal medical education teams within supporter organizations are becoming far more sophisticated. In some cases the people reviewing grant proposals are more qualified than the providers submitting the proposals!
The quality of the grant proposals being submitted has improved commensurate with the improved quality of accredited and nonaccredited providers.
The value of the role of supporter organizations remains clear and very high.
What About the Learners?
The most important perspective, however, is that of the learners. They should certainly feel that they are better off now because
their educational needs are being assessed more appropriately,
educational activities are being designed to meet their specifically measured needs and gaps,
assessment of their needs is a dynamic and ongoing process, and
the impact of education in which they participate is being measured more appropriately, focusing on their competence, their performance, and the outcomes of their patients.
The evolution of CME will continue to improve, but improvement does not come without a cost. Many say that the current funding model needs to change. Far fewer, however, are able to provide alternative funding models that will allow for ongoing provision of the quality and quantity of medical education activities that are now being offered. The changes implemented in CME so far have created an environment that is more transparent to all interested parties and that is designed to prevent bias and to resolve any conflicts of interest that may be identified.
Critics of the current funding model are quick to point how and why they think that bias can and does exist. I agree with the “can” part of that statement, and know that the enterprise of CME is working daily to ensure that the latter portion of the statement is a thing of the past. It is up to all stakeholders in CME to continue this commitment!
So, are we better off? Absolutely. And a year from now we will be even better off than we are now. Do you agree? Disagree? Let's talk about it.
Lawrence Sherman, FACME, CCMEP, is senior vice president, educational strategy, with Prova Education, an affiliate of Omnia Education, Fort Washington, Pa. He is a frequent lecturer on topics related to the strategic development, dissemination, and evaluation of CME activities. Reach him at LS@provaeducation.com.