Where do busy physicians get their information about medical advances?

How do they find answers to their questions about diagnosis
and therapeutics?

How can CME increase physicians’ efficiency in staying up-to-date with medical advances?

Today’s physicians are inundated with information from many different sources and formats, and they must make choices on how best to spend their time when it comes to continuing medical education. There’s the traditional live meeting, journal CME, online courses, webcasts, social media … . The list goes on.

So how do you choose which format and delivery system will encourage physician participation in your CME activity instead of making them shy away? How do you determine which type of educational activity will have the most impact on the physicians you are trying to reach? How do you keep your activity from being a flop?

For starters, make sure your content matches your learners’ needs. What type of audience has it been developed for? Is it general enough and directly applicable to primary care clinicians or a mixed audience? Is it novel and thoughtful enough for specialists? Is the information relevant to their practice?

Know your learners. Why do they seek out information? Why are they participating? Why are they coming to you? Are they tech-savvy? Do they prefer monographs and newsletters? If other formats are available, would they use those instead? You need to know the answers to all of these questions if you want to understand what physicians are thinking when they register for your conference or invest time in completing education through your Web site. And all are important if you want your education to have an impact and if you count on them to participate in your activities again.

Ask questions. Was the information delivered effectively? Did the audience understand the issues you were presenting? What aspects of the information did learners take home and use in their practice? These questions will allow you to understand whether you accomplished what you intended, and also what you need to change for the next initiative.

Physicians’ Information-Seeking Patterns

The successful design and support of an educational activity depends on your understanding of the current medical information-seeking patterns of clinicians.

Physicians come to their practice with deeply embedded knowledge and skills. Yet the constantly changing environment of medicine causes them to often feel ambiguity and uncertainty during patient visits.

When physicians are uncertain about an aspect of patient care, research shows that they develop a hypothesis about how to resolve it based on their knowledge, skills, and experience. Afterwards, physicians may reflect on the specific aspects of the case they were uncertain about and seek information that will allow them to better understand the situation the next time it occurs. This self-reflection tends to create a feedback loop as layers of additional information add depth to the original knowledge and skill levels.

In the summer of 2009, CE Outcomes LLC developed and implemented a survey to investigate the information-seeking patterns of U.S. physicians. The survey instrument was distributed by fax and e-mail to a random sample of 2,000 practicing U.S. physicians. The sample included 16 specialties, with a sample size of 125 from each specialty.

Why Physicians Seek Information
According to the survey results, U.S. physicians see roughly 100 patients per week. On average, they report that six clinical questions arise during patient care each week that require them to seek additional information. However, almost a quarter of the surveyed physicians reported that more than 10 of these questions arise each week. Most often, these questions are related to therapies and drug-drug interactions. Emergency medicine physicians and infectious disease specialists reported the largest number of clinical questions they have to answer by seeking additional information, with an average of eight per week.

Where Physicians Look for Medical Information
Overall, the survey found that U.S. physicians are most likely to receive medical information through journals, national meetings, print monographs/newsletters, and local /regional meetings. (See Figure 1.) Family physicians, OB/GYNs, dermatologists, and psychiatrists are more likely to attend local meetings than other specialties. Internal medicine specialties such as oncologists, rheumatologists, and pulmonologists are more likely to find information through any type of live activity.

The survey also found that U.S. physicians believe articles in peer-reviewed journals, clinical practice guidelines, and CME courses to be the most important sources of information in providing optimal care to their patients. Oncologists, infectious disease physicians, and rheumatologists are most likely to also find the opinions of nationally recognized experts to be important to clinical decision-making. U.S. physicians also rely on articles in peer-reviewed journals, clinical practice guidelines, opinions of nationally recognized experts, CME courses, and input from colleagues and peers before adopting a new advance into their practice. (See Figure 2, above.)

If physicians cannot find clear answers to these questions, they most often turn to a colleague or search online. Physicians report that they spend an average of three hours a week online searching for medical information. Infectious disease specialists, nephrologists, and oncologists spend the most time
searching online.

Barriers to Incorporating Information Into Practice
All else being equal, physicians should always be able to use the information they find. However, this is often not the case.
Physicians rated contradictory information, followed by an overwhelming amount of information to sort through, as the two most significant barriers they face when they attempt to integrate new information into their practices. Other top barriers identified in the survey include the cost of new tests and treatments, and the lack of patient insurance coverage, which makes it impractical to apply many of the solutions they found through searching for relevant clinical information.

Now What?
Now’s the time to plan differently than you have in the past. It’s time to send your message out using multiple channels so that all who want to participate will be able to. Traditional formats may still be preferred, but the trend is definitely shifting.

Know your audience and their preferences. As people move their information-seeking practices to the Internet, move with them. Our research shows that social media is steadily gaining popularity and may be a developing avenue to raising awareness of live events and encouraging “crowd-sourcing,” which entails asking an interested community of people to contribute to finding a solution to a specific problem or challenge.

Stay current with technology platforms. Use smartphone applications to enhance your content and allow physicians to have an at-hand reference to the information you provide. Use your e-mail network to start the “conversation of uncertainty,” which asks questions such as, “What would you do if this patient walked through your doors?”

The more you understand the problems clinicians face, and how they search for solutions, the more successful your educational activities will be.

Greg Salinas, PhD, is director of research and quality, CE Outcomes LLC, Birmingham, Ala. For questions about the complete study, he can be reached at greg.salinas@ceoutcomes.com.

Other articles on physician preferences in CME:

2009 Annual CME Physician Preferences Survey
2008 Annual CME Physician Preferences Survey