The setting is pretty common: Megagigantic Pharmaceuticals has a product to launch, and so they hire Slick Communications to set up CME activities for them. Both Megagigantic and Slick understand what's required to ensure fair and balanced presentations, so there is no problem on that account. The question remaining is what should be covered in the CME activities?

The answer is much more complex than the question. Most CMEers (e.g., providers, people from industry) will tell you that the content is determined by needs assessment findings. But physicians who attend the CME sessions are there for reasons beyond learning solutions to problems they have that may — or may not — involve Megagigantic's new products; they are also there for the CME credit awarded and for the colleagueship of the other MDs in attendance. At the same time, the people from Megagigantic want doctors to know things about their company. And the educators at Slick want everyone to know they are professionals who leave no instructional i undotted and no testing t uncrossed.

Commercialized CME Shortchanges Doctors

And all of these things — formal content, “informal content,” CME credit, opportunities to socialize — can be realized by doctors in attendance. Since learning engages the senses, the mind, behavior, etc., much more is learned than the concepts and principles being taught. Thus, if Slick focuses solely on content of importance to Megagigantic, it is selling doctors 11 short of a dozen since they have the potential for learning a lot more even if they just sit quietly.

Just because something is important to Megagigantic or Slick doesn't mean it is important to the physicians in attendance. Megagigantic may want the CME to cover patient care problems where their products have unique indications. But what happens if doctors in attendance already know how to handle those problems using the company's drugs? Does this mean they won't learn anything, and so Megagigantic should be displeased? Maybe the doctors will learn that their current approaches are standard-of-practice as regards the patient problems of importance to Megagigantic — something that is very important to doctors even though it is not consistent with the behavioral objectives Slick created.

Let me summarize things by focusing attention on learning activities — which can be taken to be the things that take place at CME activities. For the doctors who attend the CME meetings, learning activities provide the opportunity to do the three things cited earlier (learn solutions to problems of import to them, accrue CME credit, and associate with friends). For Megagigantic, the activities provide the opportunity to put their commercial message in front of prescribers and to be seen as a company that cares about patients and health care providers; and for Slick, mounting learning activities means controlling the education of physicians in ways that contribute to their corporate success.

But what does this all mean to pharmaceutical manufacturers like Megagigantic and communications companies like Slick? It means that people from both entities must ask the same three questions:

• What things do I want to happen at the CME meetings that we are planning? How will I know if they do or do not happen?

• What do the others want to happen at the CME meetings being planned? How will they know if these things happen?

• What will happen if I insist on things of importance to me? Or if someone else insists on something of importance to them that I do not value?

These three questions are easy to ask. They took only 75 words. But don't let brevity fool you; the ways in which these questions are answered make or break CME efforts.

Henry B. Slotnick, PhD, PhD, visiting professor, University of Wisconsin Medical School in Madison, conducts research on how physicians learn. He has been recognized by the Alliance for CME with several awards for his contributions to CME. You can e-mail your questions or topic ideas to Slotnick at hbslotnick@facstaff.wisc.edu.