Continuing medical education for life

Abstract

Continuing medical education (CME) is being pressured to change in response to increasing and changing educational needs of practicing physicians, fostered by technical innovations, evolution of practice styles, and the reorganization of health care delivery. Leadership in the reform of CME falls primarily to the medical specialty societies in light of their traditional responsibilities for accrediting CME and maintaining professional standards. To address the need for reform, the American College of Obstetricians and Gynecologists in 1997 organized a conference to assemble CME program administrators from several medical specialties and academicians with expertise in postgraduate learning. At the conference, issues facing CME were examined. The authors, who were conference participants, state and explain eight principles that emerged from conference discussions. (For example: "Educational activities should be supportive of and coordinated with the transition to evidence-based medicine.") The principles reflect the interspecialty and interdisciplinary consensus achieved by the conference participants and can serve as useful guideposts for educators as they work to improve CME in their institutions. The authors conclude by noting the need for a more systematic and rigorously analytic approach, where CME content is determined according to assessed needs and CME is evaluated by measuring outcomes; for this to happen, CME educators and faculty must be brought up to date through training, including the use of problem-based learning. CME must also instill collegiality, interaction, and collaboration into the learning environment instead of being a solitary learning activity. Finally, CME must not only emphasize the acquisition of knowledge but also instruct physicians in the process of decision making to help them better use their knowledge as they make clinical judgments.

Designing effective on-line continuing medical education

“…In all of these cases, the educational design process is one of enrichment; on-line resources and activities are optional features intended to enrich, or worse, merely substitute for the old learning program with few real educational benefits gained by the conversion. Whilst guiding principles for the development of CME have been published (Abrahamson et al, 1999), they do not reach the level of educational strategies needed to take advantage of the learning opportunities afforded by new technologies. If we are serious about developing effective on-line CME courses, then some 'pedagogical re-engineering' (Collis, 1997) is required to reconceptualize and redesign CME for technology-rich and on-line environments in light of experience and evidence (Harden et al, 1999).…”

“…The broad goals of CME are to improve physicians' clinical performance as part of a continuous lifelong process occurring in the context of improved patient care (Lloyd & Abrahamson, 1979). The need for CME is intertwined with the future of medical practice and follows the expansion in scientific knowledge, increasingly sophisticated diagnostic technologies and the evolving complexity of clinical practice (Abrahamson et al, 1999). The Internet has led to rapid exploitation of the medium for CME with nearly 100 websites offering accredited on-line courses in the USA alone.…”

The educational effectiveness of problem-based learning discussions as evaluated by learner-assessed satisfaction and practice change

“…To this end, it is necessary to choose appropriate learning methods, of which PBLD has been suggested as an appropriate and potentially advantageous modality, because of the selfdirected learning and active acquisition of knowledge that it engenders. 4 The CME Advisory group of the Association of American Medical Colleges, in their "new vision of the professional development of physicians," recommends the development and implementation of new systems to measure learning including outcomes assessments and measures to validate educational effectiveness. Accordingly, they recommend that institutions and organizations begin to develop resources to define outcomes and assess them, to develop an inventory of evaluation resources and tools that can be used in CME efforts, and to encourage the development and testing of new assessment tools with training to use them.…”

Continuing Medical Education Methodology: Current Trends and Applications in Wound Care

“…A "journal club" is a far richer and more effective educational experience than the solo reading of journals. Abrahamson and colleagues 3 observed that significant improvement to rote learning experiences is gained by adding "collegiality, interaction, and collaboration into the learning environment, instead of being a solitary learning activity." The more interaction added, the more effective the education becomes.…”