Education is the cornerstone of an academic health center. Continuing medical education (CME) refers to the educational activities that serve to maintain, upgrade, and increase the skills, knowledge and overall performance of the physician. In fact, it is a valuable lifelong learning process pursued by physicians from medical school until retirement to keep abreast of medical advancements and deliver the best possible care to their patients. The first reported CME course took place in 1935 and in the 1960’s CME started to be discussed as a coherent body of literature. Traditionally, CME took the form of formal lectures or seminars for knowledge transfer.
That was then. This is now. Fast forward nearly 60 years.
What’s changed? A lot!
Think about it. Individuals are more active in their care of patients. Physicians are expected to know the latest in medical advancements and be facile in the use of technology – from devices to electronic health records. Mobile technology and a wide-array of online platforms make education available on-demand, anytime. Care is more frequently delivered in interprofessional teams. And, from an educational standpoint, knowledge transfer is not enough. Demonstrated practice change resulting in improved care delivery and health outcomes is critical for success. In the words of the National Institute of Health, “the new CME’s broad and all-encompassing vision is to transform the overall professional performance and relationships that a physician uses to provide services for patients”.
What does CME look like today?
Studies have shown that traditional CME/passive learning techniques assisted in assimilation of knowledge but did not bring about measurable improvement in patient care. Today, hybrid instruction and strong evaluation methods are essential in effectively impacting learning and a change in practice. Learning objectives must be designed from the learner’s perspective and clearly map the content in terms of expected outcomes.
Well-written learning objectives also suggest the best delivery method and format for the educational activity; knowledge updating, competency development, or performance demonstration. Consideration of the size and the type of the audience (e.g., generalists versus subspecialists) may also dictate appropriate teaching methods.
At the end of the day, the ideal continuing medical education program is linked to quality improvement, is learner focused, is built into the fabric of daily patient care, and occurs at the point of care thereby addressing the needs of the practitioner. For the education program to be linked with quality, it should also induce behavioral changes among practitioners. Applying today’s standards, the Accreditation Council for Continuing Medical Education (ACCME) looks for CME providers to “advance interprofessional collaborative practice, address public health priorities, create behavioral change, show leadership, leverage educational technology and demonstrate the impact of education.”
What does CME look like in the future?
CME is quickly evolving to include other areas of professional development and while this assimilation has already begun, it is likely to continue. Areas such as management, team building, professionalism, interpersonal communication, teaching, and accountability are equally important for the practicing clinician to positively impact care outcomes as is their medical acumen and skill. The health of a person and their community is the joint responsibility of all practitioners. CME programs and their educators must meet this demand, educating in new ways with fresh content that meet the needs of health sciences professionals, the populations they serve, and the organizations where they work. This approach holds the promise and potential to produce required behavioral change in medical practice so that healthcare improvement is achieved and measurable. By measurably improving the expertise of health professionals, the future CME model can help address concerns about the need for reducing the overall cost of health care, minimize the prevalence of medical errors, and be the mechanism by which we reduce fragmentation of care.
Dr. Sandhya Venugopal is the Associate Dean and Shelley Palumbo is the Director for the Office of Continuing Medical Education (OCME) at the University of California, Davis. OCME has been an integral part of UC Davis Health since 1972 and like the field of education, the program continues to evolve.
- Davis N, Davis D, Bloch R. Continuing medical education: AMEE Education Guide No 35. Medical Teacher. 2008;30(7):652–66. doi:10.1080/01421590802108323.
- Accreditation Council for Continuing Medical Education (ACCME) Available from: www.accme.org/cme.providers .