Continuing medical education: The paradigm is changing

Abstract

With the realization that lifelong learning is more than attending conferences, the potential for greatly expanding effective continuing medical education (CME) has never been more encouraging. Databases from groups and individual managed care practices and advances in information technology are providing major opportunities toward this goal by identifying specific information deficits and promoting practice-linked education. The National Committee for Quality Assurance (NCQA) standards, requiring audited Health Plan Employer Data and Information Set (HEDIS) reports, are a step forward in the development of CME linked closely to practice. The optimal educational use of practice data to improve clinical outcomes will require research to determine the best methods. HEDIS standards will probably continue to deal with common problems of omission rather than with those caused by physicians' lack of knowledge, which will require other approaches. Development of these methods will provide rich opportunities for demonstration studies. The spectacular advances in information technology, especially the almost limitless capabilities of the Internet and electronic mail, offer boundless possibilities of information sources and enhanced communication among physicians about puzzling patients. The further implementation of the electronic medical record with computerized reminders and other clinical information delivered at the point of need will trigger major advances. An appealing user-friendly, practice-linked, and self-directed CME is on the horizon, promising to help the practicing physician optimize patient care.

Beneficence, justice, and lifelong learning expressed in medical oaths

“…This fact is worth analyzing because traditionally the purpose of permanent learning has been the maintenance of professional competence in order to avoid some of the problems that the medical practice brings along, as noted in our introduction. [2][3][4][5][6][7][9][10][11][12][13] In sum, the universities and medical associations have acknowledged lifelong learning not as an end but as a means to improve patient care and, therefore, the health conditions of the general population.…”

“…6,16,22,24,26,29,[34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] For their analysis, medical oaths were divided into those that mention the commitment toward CME 5,9,11 and those that do not express it, based on the following definition: process aimed at maintaining and increasing the wealth of knowledge, skills, and attitudes permanently throughout the professional lifetime. 9,[11][12][13] After this commitment was identified in the texts, the process of analyzing the contents and their relationship with the principle of beneficence was undertaken. To determine the expression of this principle, the following characterization was considered: it is focused on positive medical actions: for example, the prevention and elimination of harm and the achievement of more benefits than harm.…”

“…8 Accordingly, to fulfill these principles, health professionals should also commit to obligations that are fundamental today, such as lifelong learning and continuing medical education (CME). 5,[9][10][11][12][13] Fulfilling the committment to lifelong learning and CME should contribute to the improvement of competence and lead to permanent improvements in the quality of care.…”

“…Professionals should in turn have a rigorous and effective graduate and postgraduate education and mainly be committed to lifelong learning, often expressed as CME. 5,[9][10][11][12][13] .…”

La educación médica continua como herramienta constante de aprendizaje

“…Todo lo anterior, ha llevado a que nuestra base para una educación médica continua en el pos grado, deba enfocarse hacia profesionales que son cada vez más autodidactas, capaces de buscar por si mismo información relevante tanto para resolver los pro-blemas ya sea clínicos como de la comunidad 6 , con pensamiento crítico, capaces de trabajar en equipo y con sentido comunitario, en donde las habilidades de comunicación deben jugar un rol preponderante así como también las habilidades o competencias en gestión, las que deben estar acordes con un manejo racional de los recursos.…”