Read the Life Support column on page 20 for information you can use to solve this case study. To see how some of today's CME leaders would solve this, to post your own solution, or to read more of this continuing series, go to Medical Meetings' Web site,, and look for Calling All Future CME Leaders.

You have been the vice president for medical education in your hospital — a major regional medical center — for the past two years. During that time you and two coordinators have been responsible for CME for the 235 physicians that serve the medical center. They have expected CME activities based upon their specialty on a regular basis (grand rounds and weekly/monthly conferences). Your CME Advisory Committee, which existed prior to your arrival, is composed of eight physicians representing most of the specialties in the medical center. The eight members have served on the committee for more than 10 years, since its inception by your predecessor. They meet once a year to identify the topics for the regular recurring activities.

This has been a frustration for you, since the committee is chaired by an older, well-respected physician who does not believe in making major changes in something that he believes works well. As a new VP for medical education, you believe there is an opportunity to change CME to demonstrate that it can improve performance in practice and the quality of care provided by the medical center health care team.

Two months ago, a new chief executive officer was employed by the medical center. He has a strong belief in quality improvement for all aspects of the medical center and he expects significant changes in the organizational performance very soon. A sense of urgency has been created that fits your expectations for CME and its future role in the new organizational culture. Interestingly, it has caught the attention of your CME Advisory Committee Chair, but not the other members of the committee.

What do you need to do to develop a guiding coalition to lead this new direction for CME in your medical center?

Joseph Green, PhD, Robert E. Kristofco, MSW, and James C. Leist, EdD