Question: What do you think is the best way to keep learners engaged, either across a multifaceted activity or through a long-term activity? In other words, how do you reduce the amount of attrition in your activities?

Anyone involved in CME who has attended any sort of national meeting within the last few years could tell you that programming is becoming more complex. This fact, coupled with increased attention to detail as far as regulation is concerned, has really raised the level of expectations of CME professionals.

We lock ourselves away for days designing the ultimate educational experience—you know, the one with so many pieces of education that the flow looks like a game of Chutes and Ladders. Then we have to step back and ask ourselves one simple question: “Would I do this activity?”

There’s absolutely nothing wrong with striving for greatness, closing every single educational and quality gap facing a particular disease state or condition. However, don’t repeat the mistakes many of us have made trying to draw learners into long-term relationships.

Here are four key principles I try to follow during the design phase of every activity that we produce. I hope some of these points will help you decrease attrition while closing or narrowing as many gaps as possible.

1. Learning objectives are not set in stone. More often than not, CME professionals think that once an activity has been approved, no changes can occur. I would contend that quite often new gaps and needs surface during the content development phases. These gaps are often in greater need of being addressed than the original learning objectives, and they should take precedence. Tying yourself to irrelevant learning objectives does your learners a disservice, and they may not see any value in continuing with the activity.

2. Ask others what they think. We CME professionals are proud of what we design. It’s almost as if these formats and products become our children, and criticism can be difficult to take, even if it’s constructive and correct. But if four of out five people you ask have serious reservations about your design, chances are the learners will too.

3. Determine if what you are asking them to do will be an administrative burden. In today’s busy practice, there’s not a lot of spare time to dedicate to long, drawn-out activities, especially those where the educational value may be questionable to the learner to begin with. In our first performance-improvement CME activity, we sent participants a three-inch binder full of “education” that was designed to close every gap associated with the care of the activity being addressed. So our intentions were good. However, we quit doing this immediately after one participant told me he was using the binder as a doorstop!

4. Don’t expect learners to completely understand what they are supposed to do just because you told them. I remember partnering on one initiative with multiple moving parts. There were live meetings, Web simulations , PI activities, print materials, you name it. After one Web component was launched, the learners needed to be “promoted” to the next level. My team wasn’t involved with the development of the Web component and were unfamiliar with it, but because our phone number was visible on other parts of the initiative, dozens of physician learners called us for further information—and we were clueless. I wonder how many learners dropped out because of the disconnect?

In today’s educational arena, there are too many activities competing for what little time the learner has set aside for CPD. CME professionals must take this into consideration in order to have their activities realize their greatest potential.

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.
E-mail him at

Rick’s previous column:

The Fizzling of PI CME?