ofdigital technology, according toMurray Kopelow, M.D., chiefexecutive ofthe Accreditation Council for Continuing Medical Education (ACCME), “There is now the ability for the doctors at the University of Chicago to do a live surgical case in the operating room and beam it into your meeting and talk the participants in the room through what’s happening.” Such methods—or at least the spirit behind them—aren’t
MEDICAL MEETINGS
of109 respondents, 53 percent said yes, 18 percent said that their CME offerings have always been this way —and only 5 percent said no. (Fourteen percent of respondents said that they weren’t involved in provid- ingCME,while 10 percent answered, “I don’tknow.”) Onerespondent elaborated:“We are nowdocumenting thou-
new. Kopelow graduated from medical school in 1978 and fin- ished his training in the mid-1980s, during which time, he said, “we were already having a day [ofeducation] being halfsmall-group learning or hands-on and halfdidactic.” What is relatively new is the emphasis
that ACCME and its CME-provider members are placing on analyzing whether their learning opportunities are having an impact on physician competence and performance, and on patient outcomes. In other words, they want to know ifthe physicians who participate in their CME pro- grams are learning what they’re sup- posed to be learning.
ON_THE_WEB
To watch a video of ACCME
Chief Executive Murray Kopelow, M.D., giving a quick overview of ACCME’s Accreditation Criteria, visit http:// education.accme.org /video/accme-video-faq /criteria-overview.
‘Fannies in the Seats’ JeffHurt, director ofeducation and engage- ment for Velvet Chainsaw Consulting, thinks thatCME“is actually evolving through the report- ing process, and [CME providers’] self-studies.” He wouldknow—he’s helped clients, including the American Acad- emy ofOphthalmologists, implement these sorts ofchanges. A majority of medical meeting planners seem to agree with
Hurt. In late February, Convene conducted an online survey that asked planners: “Have you noticed a shift in emphasis forCME from simple ‘information transfer’ to showing quantifiable change in competence, performance, and/or patient outcomes?” Out
sands of changes in competence and performance from ourCME program, and look forward to showing measurable change in patient outcomes with future activities.” Another said:“We are trying new strategies in education and hope to get to competence and maybe performance but patient outcomes will be hard to get to.” (See the chart on p. 52.) For now, to achieve or retain accreditation, ACCME’s emphasis is on CME providers analyzing whether learners have changed as a result ofthe education, rather than proving change has occurred. “Ifyou don’t assess whether change has occurred, you’re out ofcompliance,” Kopelow said. “If you conduct analyses and you find there’s no change, you’re in compliance. There’s one more step to say you’ve got to conduct analyses and show that there’s change—and we haven’t taken that step yet.” One CME provider with a great deal
ofexperience in this process is the Philadel- phia-based Institute for Continuing Healthcare Education. “We do a lot with outcomes, and the desired outcomes will drive the way that the activity is
formed and developed,” said Institute President Cathy Pagano, CCMEP. “Because ultimately, ifwe want a certain outcome, we have to start at the beginning.We have to design [the learning opportunity] in such awaythatwecan measure those outcomes.” Five years ago, right around the time thatACCMEreleasedits
NO LONGER A ‘JOKE’: Institute for Continuing Healthcare Education President Cathy Pagano, CCMEP, said outcome reports for CME education have gotten much more sophis- ticated in order to focus on how the learning has affected physician performance.
latest accreditation criteria forCMEproviders, “outcomereports were a joke,” Pagano said. “But now they are really sophisti- cated.” She added: “It used to be that satisfaction and participation were enough. Fannies in the seats were all anybody cared about. Now we’ve taken it to [the idea that] knowledge is important; above knowledge is competence; and above that is per- formance.”
Measure for Measure The ways thatCMEproviders meas- ure changes in learners’ competence, performance, and/or patient out- comes — as a result of their pro- grams—are varied. “At one end of the spectrum is the simple survey evaluation,” Kopelow said. “At the other end … is the research-grade educational measurement kind of evaluation. And there’s everything in between.” Pagano’s Institute falls toward