The Fifth Annual Harrison Survey, conducted by the Association of American Medical Colleges and the Society for Academic Continuing Medical Education, in collaboration with the Association of Faculties of Medicine of Canada, identifies seven trends that have emerged over the past five years for CME in the 184 academic medical centers and colleges in the U.S. and Canada that responded to the survey. 1. Academic CME offices increasingly are integrating with the quality- and performance-improvement departments of hospitals and healthcare systems. Sixty-two percent of the U.S. medical schools reported they had either moderate or extensive interaction with physician or hospital QI programs—extensive interaction has grown from less than 10 percent to more than 15 percent since 2008. The relationship between CME units and QI/PI departments, as defined by number of interactions, also has gone from being the fifth most important in 2008 to the second most important in 2012. The respondents are integrating more with graduate medical education and faculty development as well. The survey also points to areas where relationships are still lagging, such as faculty practice plans, undergraduate medical education, and hospital accreditation. 2. The CME offices surveyed continue to have good relationships with CE providers for non-physicians; about three-quarters said they plan and provide continuing education for an inter-professional audience, and 74 percent said they had either moderate or extensive interaction with CE programs for other health professions. Eighty-two percent said they occasionally or regularly develop meaningful inter-professional planning methods. 3. Use of evidence-based learning methodology has become the norm. Almost all of the 184 reporting CME units said they regularly (80 percent) or occasionally (19 percent) augment subjective needs assessments with objective measures when planning activities, compared to 85 percent who chose one of those survey options five years ago. They also are including more interactivity now, with upward of 90 percent saying they include case studies, audience participation, or Q&A at least occasionally—60 percent said they include it regularly. The use of practice facilitators or enablers such as flow charts has increased from 61 percent in 2008 to 81 percent; as has the use of simulation (from 56 percent to 69 percent). Three-quarters said they use some sort of post-event quality metric to evaluate an activity’s impact, compared to 54 percent five years ago. Seventy percent provide some sort of post-activity followup, such as e-mailing new information, reinforcing commitments to change, and asking additional questions. In 2008, 64 percent followed up post-course. 4. Academic CME offices are assessing outcomes beyond the “smile sheet” to determine the effect of CE on healthcare provider competence, performance, and patient outcomes. Sixty-three percent of academic CME activities now measure competence through the use of tools like a post-course multiple-choice exam. Forty percent used self-reported measures to assess changes in performance, 13 percent measured patient outcomes, and 9 percent tracked changes in population health outcomes. 5. CME offices are using a growing number of methods to reach out to regional community-based hospitals, health systems, and individual HCPs. More than 80 percent are educating via live audio and video teleconferencing, about three-quarters provide visiting speakers at medical society or community hospital grand rounds, and more than two-thirds provide opinion-leader and train-the-trainer programs. Other methods include individual training or tutorials, communities of practice, and learning/individual coaching. While social networking is only being used by about a third of the respondents, it is growing, according to the survey. Academic detailing—where a CME unit sends a trained HCP to provide individual or team-based education at a regional hospital or health system—has seen a big jump over the past five years. Fewer than 10 percent of respondents used it in 2008; in 2012 almost 70 percent reported using academic detailing. 6. Institutions continue to show a commitment to supporting academic CME. More than half said that institutional support has pretty much stayed the same in the past year as a percentage of the fixed CME budget; 16 percent said it increased, while 30 percent experienced a decrease. 7. There is a meaningful, if still relatively small, group of CME units that are conducting research into HCP education best practices, funded by internal and external sources. Forty-three U.S. and Canadian CME units said they were conducting a median of two research studies. A full PDF of the report can be downloaded here.