Editor’s note: CME providers face a lot of challenges these days, from learning how to collaborate effectively to performing meaningful outcomes measures and understanding the Accreditation Council for CME’s accreditation criteria. This column is intended to be a place where we can openly discuss these challenges. If you have topics you’d like to explore, or if you have another perspective you’d like to share on a topic covered in this column, please e-mail me (spelletier@meetingsnet.com) or Rick (rick.kennison@peerpt.com). We'll start with a question about performance-improvement CME.

Question: There seems to be a lot of discussion that PI CME has failed to catch on with physicians and is starting to fizzle out. What does the future hold for PI CME?
Kennison: Both grantors and accredited providers are trying to determine what to do with PI CME. Traditional CME activities still fill the most seats, are easiest for participants to complete, and fulfill specific educational needs. And while it’s easy to recruit participants for traditional CME activities, the vast majority of healthcare providers have not embraced PI CME to date, a fact that is reflected in low participation numbers.

However, PI CME has achieved something traditional CME could not on its own: more competent physicians and better patient outcomes. It has also sparked CME providers to find ways to improve outcomes measurement in traditional CME activities, and it has enabled many of these traditional CME creators to obtain Accreditation Council for CME Accreditation with Commendation for their efforts.

While it’s not perfect, the design of these activities focuses on performance and patient outcomes gaps and needs unlike any other type of CME activity. If the gaps and needs are not systematically addressed, the initiative will fail, because if the goal and purpose aren’t obvious to participants, they will not see the value of taking part.

I strongly believe that outcomes-based CME activities such as PI/quality-improvement CME are here to stay, but I do see it being revised daily—for better and for worse. As I see it, there are two major drawbacks to PI CME: watered down activities and “level creep.” Taking a survey twice with an imposed waiting period between them does not constitute PI. The component that gives PI its value is the educational intervention. Pre- and post-educational interactions should be thought of as ways to validate the needs assessment. Again, what are the gaps and how do we close them? We close them through an effective—though not necessarily complex—educational intervention.

What I call level creep is what happens when outcomes are created post-activity to hit a performance level. This usually means a solid Level 3 activity might be described as a Level 4 project, just because something like a survey is added at the end. Outcomes need to come first, before the activity is created. Start with the activity’s primary goal, then develop it to address the identified needs and gaps. Adding a three-month participant survey to an activity won’t improve the learning value of the associated education. All it does is give the participant more work to do.

Rick Kennison, DPM, MBA, CCMEP, has been president and general manager of the PeerPoint Medical Education Institute since 2006. He also is a vocal advocate for improving the CME industry as a whole, and he has presented at the Alliance for CME and the ACCME.

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