“I'm going to be more aware of how physicians learn, use vignettes in needs assessments, advertise activities in the learner's language, and document my needs-assessment process better.”

That's the contract for change one attendee wrote for herself during a conference entitled “Achieving Exemplary Results in Essential Area 2: Planning and Evaluation,” held in April in Chicago. Jointly sponsored by the University of Wisconsin Medical School's CME office, and Tacoma, Wash.-based CME consulting firm Steve Passin & Associates, the workshop gave CME providers from a variety of settings practical tools for fulfilling the Accreditation Council for CME's new Essentials and Standards (sometimes called System 98).

“System 98 raises to a much higher level the connection between needs assessments and outcomes measures. Everyone was just scratching their heads and saying, ‘I don't know where to begin,’” says workshop co-leader Steven M. Passin. Since the University of Wisconsin Medical School had earned six-year exemplary accreditation status from the ACCME, with the assistance of Passin and physician learning expert H.B. Slotnick, PhD, PhD, the three parties decided to hold a conference to share their strategies for success.

The workshop, which drew 98 attendees from a variety of settings, taught attendees how to do needs assessments and outcomes measures from the physician learner's perspective. For instance, when doing needs assessments, instead of asking physicians “How good are you at dealing with patients when you suspect alcoholism is the problem?”, physicians are given a clinical vignette. The example given by Slotnick was: During a follow-up visit, a patient who broke her tibia in an automobile accident has no recollection of the accident and repeats the questions being asked of her, instead of answering them.

“All of this is predicated on the inability of physicians to identify what they need to know and their incredible accuracy at identifying problems they have,” explains Slotnick.

Workshop leaders also taught attendees how to do purpose statements, which can be used in lieu of educational objectives statements. Again, the difference is that objectives statements are in the language of educators or planners, while purpose statements are in the language of learners, explains workshop co-leader George C. Mejicano, MD, assistant dean, CME, at the University of Wisconsin Medical School. Rather than telling physicians they will learn more about diabetes from a program, a purpose statement would say: “We understand you have problems controlling blood sugar in certain patients. In this workshop we're going help you solve that problem, so you'll be happier about your patient care.” That approach, adds Mejicano, “is personal and specific.”

To learn how to put themselves in physicians' heads, so to speak, and therefore understand how to develop purpose statements, needs assessments, and outcomes measures from the doctor's perspective, participants developed their own vignettes for problems they face as CME providers. And they wrote their own learning contracts. As illustrated by the attendee quote at the beginning of this article, providers were asked what changes they planned to implement as a result of the conference. Workshop leaders will follow up with attendees in three months to see how they are progressing. The most important message attendees took away is, “I can do this,” says Slotnick.

Commitment to Change

The attendees' excitement and commitment to change is particularly important, says Mejicano. “The vignettes showed that there is a tremendous need for CME professional development. These professionals take themselves seriously and they are craving things like this. I was floored [by the response], and I think it's the tip of the iceberg. Whether [professional development] is done at ACCME or Alliance for CME or other industry meetings — we need more of these things to move us along.”

Because of the workshop's success, the co-leaders are organizing a reprise, October 21 to 22 in Philadelphia. For information, call Steve Passin & Associates at (253) 756-1616 or visit www.PassinAssociates.com.