We know physicians and other healthcare providers like to bellyache about having to take days away from their practices to go to their specialty society’s annual conference, or even having to take a few hours off to participate in online and print continuing medical education. But is the time and effort worth it?
According to a recent survey by Global Education Group, the answer is an unqualified “yes.” In fact, healthcare providers rated accredited CME activities as more valuable for their practice improvement and patient outcomes than journal articles and other publications, speakers bureau programs, and promotional and other non-certified education.
One sign of CME’s value: Even though most physicians are required to complete just 30 hours of CME each year, 89 percent of the surveyed HCPs said they routinely complete more hours than required by their state boards. As one explained, “I need to stay current to teach staff and share new information with them.” Another elaborated, “You can never know enough, or everything.”
That wish to know enough is, in part, the philosophy that spurred the research to begin with. “The success of our education depends on the knowledge we have of our learners,” says Amanda Glazar, PhD, CCMEP, Global’s director of adult learning and outcomes. “If we want to thrive in an evidence-based CME/CE environment, we need to collect and incorporate sound data from the learners themselves.” And while what they had to say does provide data to back up CME providers who are sick of arguing whether what they do has value, it also points to barriers that still exist when it comes to gaining real value from the hours HCPs spend on CME.
Certified CME's Value to HCPs
On a four-point scale—where 1 means the item in question is not a valuable source of information/education to support professional practice and patient outcome improvement and 4 means it is a very valuable step toward those goals—CME garnered a 3.6. Journal articles and publications came in second at 3.4, followed by speakers bureau programs (2.6) and medical science liaison visits (2.3). Promotional/other non-certified education and sales rep visits both were rated 2.1, and direct-to-consumer advertising came in last with a 1.7 rating. Among the 89 percent of HCPs who complete more hours than are required, 28 percent said they complete more than 50 hours of certified CME annually.
Why would they do that? Forty-five percent of the respondents said they do more than they have to so they can learn more about new and emerging therapies, while 27 percent participate in additional accredited CME in order to gain additional unbiased/evidence-based information. Another 21 percent seek out additional CME to learn beyond their core areas of expertise. As one respondent said, “The farther I get from medical school, the more I know I don’t know.”
Drivers and Barriers
The survey also asked respondents to break down their reasons for participating in either live or online/print CME/CE activities. For live activities, almost 30 percent said that networking with their professional peers was a main driver. Not far behind was the ability to interact withand thought leaders (27 percent), and 25 percent said that live activities mesh best with their particular learning style.
Another 10 percent said they find content that is more applicable to their practices offered in live-format activities. Plus, live events make it easier for them to dedicate the time to concentrate just on learning, allow them to ask questions in real time, and enable them to acquire a lot of new information in just a few days, they noted in the write-in section. As one explained, live activities provide the “interaction and development of critical evaluation of information that is only possible when a group of professionals convene.” And, while it’s a hassle to be out of the office, they also appreciate the opportunity to combine learning from experts with travel and recreation.
But all is not completely rosy in the live accredited CME world. Seventy percent of the HCPs said they complete their CME via live events less than half the time. Among the barriers they cited were time constraints (53 percent) and the cost of travel (36 percent). Only 3 percent said their most relevant barrier to participating in live CE activities is a lack of educational value—as one person in that minority wrote in, it can be “hard to find the pearl in the oyster full of sand.”
But what hurts participation in live activities is a big plus for online and print CME/CE activities. Forty-four percent said the time savings are the most relevant reason they participate in online/print CE, and one-quarter like the lower costs associated with these forms of CME. Another 16 percent prefer the online or print format because it is more in line with their style of learning. They also like that it is available on demand. As one person wrote, “I can spend sufficient time to digest, and perhaps re-read, and highlight and underline pertinent information. I can then return to the highlighted printed material for future studying.” And for those in areas with few live programs available, online and print CME may be their only alternatives.
But, even in an on-demand world, time constraints are an issue. More than half of respondents consider it the most relevant barrier to HCP participation in online/print CE activities. The educational value also can be lacking, said 17 percent, while 8 percent cited technology challenges as a barrier to online CME. Among the specific complaints: A lack of feedback and interaction related to the material; difficulty finding content that is directly relevant to their practices and interests; and just a general lack of appeal. As one person said, “[I’m] tired of being in front of my computer all day. It’s not a great way to learn for me.”
Does It Get Results?
Two of the main thrusts in healthcare in the U.S. these days are improving patient care while simultaneously lowering costs. The ongoing debate is whether or not CME really does help push that agenda forward. According to the survey results, a full 98 percent of respondents said CME/CE activities provided them with information that has helped them improve patient care. Close to 60 percent believe the information that they gathered from accredited CME has helped them reduce the cost of the care they provide.
When it comes to improving patient care, the majority—almost half—said that CME activities does so by giving them awareness of additional or more effective treatment options. Thirteen percent said it helps them identify their own areas for improvement, while almost 10 percent said the connection it provides to peers and/or faculty aids in furthering their knowledge, competency, or skills. Other benefits cited include improved patient and/or caregiver education (9 percent), and improvement in how they approached challenging cases.
When asked for specific examples, one wrote, “During a cardiac arrest in the OR, I was able to identify the need for a drug that had been recently added to the algorithm. I was able to suggest it because I had recently attended a lecture on this and the others in the OR had not.”
Looking at healthcare costs, 29 percent said CME/CE gave them knowledge that enabled them to consider more cost-effective treatment options, and one-quarter of respondents said using the more-effective treatment options had resulted in fewer patient followup visits and/or less consult time. Other cost-reducing benefits they cited: They learned to better use their healthcare team resources, resulting in a streamlined approach to patient care; and they learned how to better manage their patients, which resulted in patients improving their adherence to recommended treatments. CME also helps make them more efficient in diagnosing their patients, according to 12 percent of respondents.
Specifically, respondents said CME helped them avoid unnecessary and/or ineffective drug therapies; choose the most effective drug for their formulary instead of having to supply multiple drugs of the same class; and reduce the number of colonoscopy tests by following the guidelines they learned. One said that using the American College of Radiology Appropriateness Criteria for Imaging for evaluating abdominal pain enabled him to reduce the use of CT for abdominal cases, lowering both the cost and the radiation exposure to patients.
This new data can be added to a growing pile of evidence that CME does, in fact, help healthcare providers do their jobs better and that, in turn, results in improved patient outcomes and lower costs. And the survey results bode well for the future of CME, says Stephen Lewis, MA, CCMEP, Global’s general manager and a Sunshine Act’s final rule.)columnist: “The combination of this quantitative and qualitative data with the recent Sunshine Act decision to carve out an appropriate CME exemption makes for a more positive outlook than we have seen for years.” (Here's more on the
The survey, developed by Global Education Group and Medical Meetings magazine, is the second phase of quantitative and qualitative study designed to analyze the perceived and in-practice value of CME compared to other forms of physician information. The first phase of the research was conducted in 2011 and reported in 2012. This second phase expanded the scope of analysis to learn more about physician learning preferences and CME outcomes.
Global Education Group developed the 20-question survey with input from Medical Meetings. The CME/IME departments of multiple academic centers, pharmaceutical CME teams, and education companies reviewed the survey. It was disseminated via online tool SurveyMonkey to 6,500 U.S. healthcare providers. A survey link also was sent to more than 62,000 members of the proprietary CME education Web site, CMEZone.com, which is owned and operated by Applied Clinical Education. The survey was sent in December 2012 with a follow up in January 2013. A total of 1,417 HCPs responded to the survey.
Nearly 42 percent of the total 1,417 HCP survey respondents were physicians, while 35 percent were nurses or nurse practitioners, and 16 percent were pharmacists; the rest were physician assistants, PhD/research scientists, case managers, or other non-specified types of healthcare providers. They hailed from 49 of the 50 U.S. states, plus Washington, D.C., Guam, and Puerto Rico. Anesthesiology was the most common primary clinical specialty (18 percent), with primary care a close second (16 percent) and oncology third at 9 percent. The rest named surgery, obstetrics/gynecology, pain management, psychiatry, cardiology, pharmacy, neurology, infectious disease, and other clinical areas. Sixty-four percent had been in practice longer than 20 years, 22 percent from 11 to 20 years, and 14 percent 10 years or less.
Ten percent of respondents were from states that do not currently require CME for state licensure. (Six states currently do not require physicians to complete CME for state licensure.)