In Summary….

In summary it seems to me that although there is a vast amount of data about CME out there, I am not sure how much of it is really useful. If I were to repeat this exercise again I would probably focus on one topic rather that the generalized topic of CME. I would love to explore the focus of commercially supported CME more as well as the barriers that companies express when attempting to provide CME
Overall it was a very though provoking exercise.

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On-Site to On-Line: Barriers to the Use of Computers for CE

On-Site to On-Line

This journal article really got my attention I guess because I am so computer friendly. I mean I started my own blog!  I was very curious to see what they would present as barriers to people not wanting to use online CME training

First off I have to laugh because I am not shocked that they only received 35 % of the surveys back that they sent out. I know that when I get a survey in the mail I may not have the time to fill it out right then, but I eventually do it as I KNOW IT IS AFFECTING SOMEONES RESEARCH! I guess I would want someone to do the same for me so I always make time to get them done. But recently I sent out surveys to patients that were on service and out of twenty, got 1, yes only 1 back! I was shocked.

The main barriers that were evaluated in terms of online CME barriers were the following:
-too difficult to use
-too expensive
-too time consuming
-prefer in-person instruction
-not interested
-don’t know what it is
-don’t know how to use it

I chose three of these that I wanted to comment on. First the facts that people prefer in-person instruction. This actually scored the highest of all of the barriers! I agree with this concept for the most part. I would too always like to have face to face meetings when learning new techniques, but I really feel like my hectic schedule does not always allow for that. I enjoy being able to participate in online activities at my own pace and when I have the time. I feel like when I am looking to reinforce an idea the online education works. When learning a new concept I would almost always prefer one on one or face to face teaching/learning. I would prefer this more multiple reasons-hands on interaction is available and the chance for question and answers.

The fact that people do not know how to use it did not really surprise me. I feel that a lot of older people, such as my father have the basic knowledge of computers that is needed to get through ‘daily’ activities, but not much else. So the idea that they do not know how to use the online portion of CME does make sense. This also goes hand in hand with it being too difficult to use I guess as well.

I would think that the time consuming issue would not exist as you can do this at your leisure, but I guess I was wrong. It makes me wonder if the same demographic or people who said it was too hard to use or didn’t know how to use it said it is too time consuming. Obviously if you are not familiar with something it would take longer to use.

Overall it was a good article and an easy read!

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Examining the Value of Commercially Supported CME

Examining the Value of Commercially Supported CME

By far, my most favorite article thus far. I think that I enjoyed this article for the sheer fact that it relates to my job specifically. The article talks about commercially supported CME and whether or not it enhances or detracts from the value of the actual education provided. It is funny, because in the last few years the commercial/national industry in pharmaceuticals, medical devices and other medical specialty companies has become more highly regulated. Many laws and guidelines have changes to tighten the amount of commercially supported CME and products that are given out. This to me could mean commercially supported dinners, seminars, lectures as well as freebies or promotional items that companies would give out related to their product or CME seminar.

The article starts off saying that this topic has been looked at with ‘much emotion, but little data’, which I can totally agree with. It has been the BUZZ for a few years and the ‘crack down’ that has occurred seems to be a bit over the top in my opinion. It is noted in several to many studies that CME does produce the following three outcomes more often then not-knowledge gain (of the individual learning), physician performance and patient outcomes. It also states that there is no support anywhere that states what effectiveness the support or funding has on these 3 outcomes.

The article looks at the value commercially supported CME has on those that are the ‘supporters’ of it. I took that at those who fund it as well as those who participate in the CME and to those that work directly with the product or device that the CME is presented on. It was shown that it provides research information, better knowledge of the product and off label uses that it can be used for. Without research data and applied knowledge how do we ever expect to expand and progress in the health care field? For instance-if the government came up with a new budget plan or software per say that would strengthen the economy would we not support it or allow them to show us this because it could promote judgment or bias? I think that if a drug, device or any other advancement in the medical community can enhance or save lives that it should be promoted and researched in any means possible.

We then look at the value that commercially supported CME has for physician and society directly. Firstly the increased amount of funding that these companies have allow for increased quality of CME-so why would we not allow it? Would you rather have your family physician get a post it note or a seminar of study on the recommended uses of a new drug that he plans on prescribing for you? I don’t know about you, but I would be OK with him attending a funded seminar if he will get the knowledge and expertise about something that will directly affect my life! Secondly the ACCME (rule makers) standards are there to prevent bias if followed correctly. Thirdly providers need to branch out and get more commercially supported CME from multiple sources in order to prevent bias or temptation to use only specific companies/drugs/devices. And lastly, the CME providers need to advocate for themselves more in order to show the public the value of the education they are providing, no matter where the funding comes from.

The last thing this researcher looks at is the value that commercially supported CME has on the leaderships roles of those involved. Briefly I think that these types of opportunities for career advancement that come from the CME can prove beneficial for all those involved. How can we say that increasing ones education and advancing their career is bad in any way shape or form-I don’t think that we can?

In summary I felt like this article did provide a fair argument for the support of commercially backed CME. I would love to hear what others have to say on this topic and I would love to hear someone’s rebuttal to this article as well.

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Presentation of Evidence in CME Programs

Presentation of Evidence in CME Programs

So I said that the last article I read was my least favorite…well this one beats it by far. I am not sure how these titles grab me and then I read the abstract and it sounds interesting, yet I continue to read and I am bored to pieces at first…
Starting off I will say that this article was at least a little more organized and easy to follow. Overall it looked at three basic questions related to CME:
1. How is research presented in CME conferences?
2. How well do learners who attend CME programs and speakers who teach in them understand relative and absolute terms?
3. What are the learners’ preferences about presentation of research data in CME programs?
First I had to start out by learning the difference between relative and absolute terms. I thought I understood until I continued to read and then I realized I needed to clarify. Relative values are subjective, depending on an individual. So someone’s cultural or personal views could persuade the relative value. Absolute value is what its, almost factual. Relative value changes and absolute value remains constant. (This was about as simple as I had to make it in order to understand it)
So the first questions analyzed that most information is presented in power point formats within these CME conferences. Two researchers then analyzed the slides to see what information was in relative terms versus absolute terms. They then watched the videotapes the corresponded to see if the ideas of absolute and relative values lines up with what was on the slides (power point). Over all analysis showed that most speakers presented in neither of the terms, but 84 percent in generalized terms.
The next questions was really a mostly even split for the most part it and it seemed that many of the attendees did understood what relative versus absolute terms were, but could not explain or teach it to someone else. More of the speakers had better confidence in knowing what the difference was as well as felt comfortable teaching or explaining t to others. I think that this is possibly the most important question analyzed. I mean how can someone teach someone something if they don’t know what it means? I am actually pretty surprised at how many people expressed they did not know the difference.
The next question showed many preferences from the learners and/or attendees. Some expressed that they liked to learn in anecdotal evidence. Other stated that they would like a statistic ‘refresher’ prior to certain CME conferences because of all of the evidence shown.
Overall the more I thought about the article afterwards while coming up with an outline for this response the more sense it made. I mean really this almost relates to the presentations that we will be doing in class. The researchers in this article looked at CME conferences, its speakers and attendees; to find out what the best approach to learning was for certain topics. It proved to be beneficial for them and I am sure that it will guide future CMR conferences and modes of presentation.

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Impact of Formal CME:Do Conferences, Workshops, Rounds and Other Traditional CE Activities Change Physician Behavoir or Health Care Outcomes?

Impact of Formal CME Article

Do conferences, workshops, rounds and other traditional continuing education activities change physician behavior or health care outcomes? This is the question that prefaced the journal article that I read by Davis, et al. This article examined the difference between real and ideal performance related to CME education outcomes. Supposedly physicians report on average 50 hours of CME per year yet the outcomes do not demonstrate this in physician performance and health care outcomes.
This article was actually very informative because it broke down all of the different types of CME that existed within the study. It looked at didactic CME, interactive CME and other variable effecting CME. It analyzed the positive and negative outcomes exhibited by its participants.
Overall I do not really have too much to say about this article. It showed that interactive/live CME techniques showed better physician outcomes and health care outcomes. This really does not come as a shock to me. Once you have the learner interested and engaged, knowledge absorption increases producing improved physician/healthcare related outcomes.
Other points of interest in this study looked at internal vs. external forces effecting physician learning. External focusing on the general practice or office environment and internal referring more to the physician participant. It found that physicians learning in self driven and that they develop their own priorities; clearly this is not knew knowledge. I think all human beings have internal and external forces that drive them to learning-workplace, peers, etc.
I felt that the material was hard to follow and very dry. It did not keep my attention. So far my least favorite article…thoughts anyone?

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Does continuing medical education in general practice make a difference?

Does CME in GP make a difference

Does CME in General Practice make a difference?

This article was from the British Medical Journal and was supposed to focus on noting whether or not CME makes a difference in general practice physicians. It was a lengthy article and I found myself having to read it twice to get all of the answers to the questions that my brain solicited. I decided to discuss some of the highlights of the article as I understood them to be and then to summarize the findings at the end.

One thing the article states is how much scrutiny is placed on CME presently. I would say this must be based on all of the different types and offerings that are available. Supposedly it has become something the medical community and government have been looking into related to the ‘enormous changes’ it has undergone as of late. Accreditation processes have been now placed into effect for some programs to assure quality assurance. As far as this goes I cannot say that it is a bad idea at all. I think quality assurance is a crucial part of any evaluation process. It keeps things current and makes sure that changes are either needed or not to maintain efficacy.

Another point the article discusses is that as far as general practice physician and the CME they do should be based on the actual work that they do. In essence to me this makes sense. Why would you have a physician who works in GP participating in CME that specializes in urology or neurology? It would make more sense for them to be at the pinnacle of the GP ‘game’ rather then focusing on specialties that they would rarely come into contact with-and when they did they would most likely refer to specialist anyway.

Needs assessment was also a huge topic in this journal. It only makes sense for a needs assessment to be done when looking at what types of education one may need, but I guess after reading this I was able to see some of the down falls that could also be noted. This article talks about how needs assessment should not be based on self-assessment. It shows that self assessment would not really illustrate the educational needs of the physician. Is this because they do not want to admit they need additional training? Do they not have the time? These were some of the questions that arose in my mind while reading. I can definitely think of some physicians I have been in contact with who would not admit they need additional training or education solely based on pride.

I am someone who lives out of my planner so this next thought really didn’t come as a huge shock to me. Towards the end of the journal the topic of reminders for physicians came up. This article stated that there was evidence of change when reminders were used for the staff involved in the CME the material that they learned was used and more effectively retained. Since I live out of my planner and with post-its, not a shocking idea to me. I think most people in the world live with the philosophy-‘out of sight, out of mind’. I know that I have so many things going on in my work, school and personal life that without reminders I would forget everything. You will also see these types of reminders with nursing care. Almost everytime we have an in-service in the hospital there is some poster made that is placed centrally to remind us all of the knowledge/information that was given to us.

Lastly, at the end of the article, they briefly touched on the purpose of the study/article. One of the last topics talks about how this article was based on general practice, but that the study really didn’t look into GP as a specialized category. This is when I had to re-read multiple times. so you are telling me that we titled and based the article on GP, but that we really did not do anything GP specific? Kind of frustrating. I would love to see what other get form this article as well. Thanks for reading, I look forward to your comments.

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The Growth, Characteristics, and Future of Online CME

The Growth, Characteristics, and Future

Here is the first article that I will be reading and posting. Please click the link to review the article and keep posted for comments/discussions.

Online CME has become a HUGE part of CME as well as general continuing education.

This article looks at the growth of online CME among physicians, but also looks at some of the downfalls that it may have. I think that online CME is can be categorized as a fairly ‘new’ addition to the world of CME. Although the internet is widely used today I think that online CME is just starting to take off. This article talk about the really phases that online CME is in as well as analyzes the different types of online CME that exists.

When I think about online CME, I cannot think of a better way to obtain additional education. For me the online component is what makes is so desirable. If I look at my life and what I do on a day to day basis, online CME sometimes would be the only choice that I had to obtain additional training or education. Working two jobs, volunteering in the community and having and extremely active social life doesn’t leave tons of room for school or education, but the option of online education makes this possible for many other individuals such as myself. I can review and research things on my own time at my own pace. Attending conferences or CME sessions may not always fit into the schedule of a busy physician, but online CME courses gives them the opportunity to still obtain additional education and training within a schedule that conforms to their lifestyle. I think that that is the ultimate benefit that online CME provides.

Although there seems to be many beneficial notes to online CME, I also concur that there can be a negative to this aspect of continuing education. Obtaining all of the training/information online takes away from the personal contact that one might obtain my attending a course or workshop. There may not be someone to answer a question that arises unless there is an online LIVE chat at the time. Yes, I am sure that most online CME allow for a Q & A or comment section, but how apt will physicians be to take the time to contact the provided of the course? I am would think less likely than they would to just raise their hand and ask a question in a live forum.

I tend to think that many people may not absorb the information as well in an online CME than they would in a conference type environment. This also goes back to the type of learner that one may be. Some visual, some auditory and some both; I would think that one would choose the type of learning environment that suits them best.

In summary I think this article touches on the value and growth of online CME. I agree with the many benefits that this type of CME has to offer, but often wonder if traditional CME will ever be able to be completely replaced. I tend to think that there will always be traditional CME available for those who prefer it and would tend to think that all forms of CME will continued to be used by physicians and other healthcare professionals.

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