When physicians golf in the course of attending a CME meeting, their conversations on the course often involve issues raised in the sessions.

The idea of scheduling CME activities at sites offering golf and other attractions has been discussed and put to bed. It's wrong if the goal of the activity is frank promotion, and the availability of golf and other attractions serves only to make the package more enticing. No argument on this point.

Yet golf does have a role in accredited CME. And while I'm speaking of the game specifically, my comments can be generalized to other non-instructional activities, including conversations in coffee lines, discussions in airport shuttles, and the like.

More Than a Distraction

Golf, as I play it, is a social activity. It is for me a long walk with others over grassy terrain periodically interrupted by having to hit a ball with a club; but this done, we golfers return to the social activity of discussing what's on our minds. While these discussions are of great interest to us just now, I'll return to hitting the ball with a club at the end of this column to argue that it is more than a distraction — that it is a potentially valuable evaluative measure.

When physicians golf during a CME meeting, their conversations on the course often involve issues raised in the sessions they attend. An orthopedic surgeon I once interviewed told me that packing for CME meetings includes reviewing his current cases so he can take along the charts of his most demanding patients. He takes them in anticipation of discussing them with others at the meeting. He packs his golf clubs, too, but only so he'll have a way of interrupting those conversations at intervals as he and his colleagues walk over grassy terrain.

Jane Tipping, Jill Donahue, and Eileen Hannah have published a paper in the spring 2001 issue of The Journal of Continuing Education in the Health Professions on the value of unstructured time (including golf) in physician learning. The research they cite makes the point that doctors need time to think about what they hear at CME activities, and that unstructured time is more conducive to discussion than the four-presentations-in-50-minutes so common at scientific sessions.

The unstructured nature of this time is why golf is so important to physicians attending CME activities. Except for having to interrupt conversations to hit balls with clubs, golf allows doctors to reflect on and discuss what they've heard at the meetings, two things of both psychological and sociological import to them.

How Golf Helps Physicians Learn

Learning is a matter of first gaining experiences and then reflecting on those experiences, thus deriving insights from them. Reflection means that doctors examine what they hear to make sure it “hangs together,” compare it with their own experience, and see how what they've heard might apply to the problems they currently face.

Doctors create meaning through their social, largely verbal, interactions with others. It is through these interactions that they come to see things as others do and agree among themselves on what particular things really mean. Discussions like these are important because they allow the doctors to better understand both what they've heard in the meetings and how their views are similar to those of their colleagues.

These conversations also allow doctors to identify resources they can use in the future. They hear of and often meet people they might turn to when they encounter problems, and they also observe how other physicians cum golfers view things.

These are all important outcomes. Yet there is one more of particular importance to us in CME: Golf provides a simple way to evaluate the quality of these CME-inspired, informal, important discussions. Ask the golfers — they'll tell you that the more time they had for discussion, the more satisfying their time on the course.

Henry B. Slotnick, PhD, PhD, professor of neuroscience at the University of North Dakota in Grand Forks, conducts research on how physicians learn. He has been recognized by the Alliance for CME with several awards for his contributions to CME. Send your questions or ideas to slotnick@medicine.nodak.edu.