CME as a Strategic Asset 2015 Murray Kopelow MD, MS (Comm), FRCPC Past President and CEO ACCME For non commercial educational use only. Page 1
Never before has there been such a call for physician learning and change Accredited Continuing Medical Education is perfectly positioned to step up and lead For non commercial educational use only. Page 2
Accredited CME in Support of U.S. Physician CPD Programs Hospitals Specialty The Profession Licensure Patient Care Medical Knowledge Practice-Based Learning and Improvement Interpersonal and Communication Skills Professionalism System-Based Practice For non commercial educational use only. Page 3
Our Reach Activities Hours of Education Physicians Non Physicians TOTAL 138,196 1,010,301 13,764,896 10,929,217 All Participants 24, 694, 113 New York Phoenix Los Angeles San Antonio Chicago San Diego Houston Dallas Philadelphia For non commercial educational use only. Page 4
Our Reach Activities Hours of Education Physicians Non Physicians TOTAL 138,196 1,010,301 13,764,896 10,929,217 All Participants 24, 694, 113 Kansas Idaho Montana Nevada Hawaii Delaware New Mexico Maine South Dakota Nebraska New Hampshire Alaska West Virginia Rhode Island North Dakota For non commercial educational use only. Page 5
Our Reach Activities Hours of Education Physicians Non Physicians TOTAL 138,196 1,010,301 13,764,896 10,929,217 All Participants 24, 694, 113 New Participants 2, 818 every hour 67, 655 every day 2, 057, 842 every month For non commercial educational use only. Page 6
Ballistic Trajectory Klass, D, Viewpoint: A Performance-Based Conception of Competence is Changing the Regulation of Physicians Professional Behavior, Academic Medicine, Vol. 82, No. 6 / June 2007 For non commercial educational use only. Page 7
Factors in Play 1.What we never knew. 2.What was not known at the time. 3.What should now be forgotten. Overuse, underuse and misuse For non commercial educational use only. Page 8
Practice is. Research practice Educational practice Executive practice...and Clinical practice Level of. Populations Communities Individuals For non commercial educational use only. Page 9
CPD as a Scholarly Pursuit CME as the Academy Discovery Integration Application 1997 I DON T KNOW..BUT I AM GOING TO FIND OUT! For non commercial educational use only. Page 10
DOES THIS WORK TO CHANGE PRACTICE? For non commercial educational use only. Page 11
JULY 2014 EFFECTIVENESS OF CONTINUING MEDICAL EDUCATION: UPDATED SYNTHESIS OF SYSTEMATIC REVIEWS RONALD M. CERVERO, PH.D. and JULIE K. GAINES, MLIS University of Georgia For non commercial educational use only. Page 12
We now have 39 systematic reviews that present an evidence-based approach to designing CME so that it is more likely to achieve the outcomes of improved physician performance and patient health outcomes. JULY 2014 EFFECTIVENESS OF CONTINUING MEDICAL EDUCATION: UPDATED SYNTHESIS OF SYSTEMATIC REVIEWS RONALD M. CERVERO, PH.D. and JULIE K. GAINES, MLIS University of Georgia For non commercial educational use only. Page 13
With this significant scientific evidence base in tandem with numerous reports of practical strategies for effective CME, reforming CME is less a knowledge problem than a political problem of changing the systems of which CME is an important constituent element. JULY 2014 EFFECTIVENESS OF CONTINUING MEDICAL EDUCATION: UPDATED SYNTHESIS OF SYSTEMATIC REVIEWS RONALD M. CERVERO, PH.D. and JULIE K. GAINES, MLIS University of Georgia For non commercial educational use only. Page 14
As this system continues to be negotiated amidst the struggle between the educational agendas and politicaleconomic agendas, it will be important to incorporate the insights from the scientific study of CME effectiveness. JULY 2014 EFFECTIVENESS OF CONTINUING MEDICAL EDUCATION: UPDATED SYNTHESIS OF SYSTEMATIC REVIEWS RONALD M. CERVERO, PH.D. and JULIE K. GAINES, MLIS University of Georgia For non commercial educational use only. Page 15
Something to fix? Educational solution? My learners involved? For non commercial educational use only. Page 16
Something to fix? Educational solution? Why does the gap exist? What to change? My learners involved? What is the practice gap? For non commercial educational use only. Page 17
Something to fix? Educational solution? My learners involved? What is the practice gap? Why does the gap exist? What to change? Were we effective? Problem Solved? For non commercial educational use only. Page 18
For non commercial educational use only. Page 19
CME as a Strategic Asset Rigorous measurement of the magnitude of particular problem Meticulous determination of all of the causes of the problem Focused interventions targeted to the most important causes Careful attention to sustaining effective interventions. For non commercial educational use only. Page 20
CME as a Strategic Asset Rigorous measurement of the magnitude of particular problem Meticulous determination of all of the causes of the problem Focused interventions targeted to the most important causes Careful attention to sustaining effective interventions. Professional Practice Gaps (C2) Needs that Underlie Practice Gaps (C2) Designed to Change Comp, Perf or PO s (C3) For non commercial educational use only. Page 21
CME as a Strategic Asset Rigorous measurement of the magnitude of particular problem Meticulous determination of all of the causes of the problem Focused interventions targeted to the most important causes Careful attention to sustaining effective interventions. Professional Practice Gaps (C2) Needs that Underlie Practice Gaps (C2) Designed to Change Comp, Perf or PO s (C3) Analyze for Change (C11) Change Practice (C16) QI Systems (C21) For non commercial educational use only. Page 22
FACTORS IN PLAY. For non commercial educational use only. Page 23
Intervening variables The Strategic Value of Accredited CME as a Bridge to Quality Elements of the system that need to be engaged For non commercial educational use only. Page 24
CME changes things one person at a time Murray Kopelow, 2105 For non commercial educational use only. Page 25
Probability of a Behavior Habit Intention Motivation Facilitating Conditions Triandis Theory of Social Behavior in Winzenberg, T and NHigginbotham, BMC Education, 14 December 2003 For non commercial educational use only. Page 26
Probability of a Behavior Habit Intention Motivation Facilitating Conditions Triandis Theory of Social Behavior in Winzenberg, T and NHigginbotham, BMC Education, 14 December 2003 For non commercial educational use only. Page 27
Probability of a Behavior Habit Intention Motivation Facilitating Conditions + + Social Factors Affect towards behavior Value of perceived consequences of behavior Intention Mom: When will my baby sleep through the night? Barb: When you want your baby to sleep through the night. = Triandis Theory of Social Behavior in Winzenberg, T and NHigginbotham, BMC Education, 14 December 2003 For non commercial educational use only. Page 28
Probability of a Behavior Habit Intention Motivation Facilitating Conditions Motivation Facilitating Conditions Triandis Theory of Social Behavior in Winzenberg, T and NHigginbotham, BMC Education, 14 December 2003 For non commercial educational use only. Page 29
WILL THIS ALWAYS WORK TO CHANGE PRACTICE? For non commercial educational use only. Page 30
It is the young physicians ACCME Member Organization Executive April 25, 2014 For non commercial educational use only. Page 31
~900,000 For non commercial educational use only. Page 32
250,000 50% 45% 200,000 40% 35% # 150,000 100,000 30% 25% 20% 15% % of Total 50,000 10% 5% 0 Less than 30 30 39 40 49 50 59 60 69 70+ Unknown Physician Age 0% For non commercial educational use only. Page 33
250,000 50% 200,000 @ ~50% in 20 years 45% 40% 35% # 150,000 100,000 30% 25% 20% 15% % of Total 50,000 10% 5% 0 Less than 30 30 39 40 49 50 59 60 69 70+ Unknown Physician Age 0% For non commercial educational use only. Page 34
Digital Native It is now clear that as a result of this ubiquitous environment and the sheer volume of their interaction with it, today s students think and process information fundamentally differently from their predecessors. Marc Pensky, 2001 For non commercial educational use only. Page 35
To ensure quality [CPD] opportunities, [We] require that accredited CPD providers approve group learning activities A CME/CPD ACCREDITOR For non commercial educational use only. Page 36
To ensure quality [CPD] opportunities, [We] require that accredited CPD providers approve group learning activities A CME/CPD ACCREDITOR The Polarized Crowd Tight Crowd Broadcast Network Support Network How are we going to approve this? For non commercial educational use only. Page 37
People who learned like this.. should be careful when they design systems for people who learn like this For non commercial educational use only. Page 38
A Competency Subject K vs. C vs. P In 2014 My Professional Practice Gap For non commercial educational use only. Page 39
A Competency Subject K vs. C vs. P Community Location Media In 2014 My Professional Practice Gap In 2035 My Professional Practice For non commercial educational use only. Page 40
reforming CME is less a knowledge problem than a political problem of changing the systems of which CME is an important constituent element. Cervero and Gaines, Effectiveness of Continuing Medical Education: Updated Synthesis of Systematic Reviews, 2014` For non commercial educational use only. Page 41
In the future Think and Say. Yes we can help with that. I have an educational solution CME can be a strategic asset We are part of the solution CME is effective in changing practice For non commercial educational use only. Page 42
Accredited Continuing Medical Education is perfectly positioned to step up and lead. For non commercial educational use only. Page 43
You are perfectly positioned to step up and lead For non commercial educational use only. Page 44
You are perfectly positioned to step up and lead and don t ever let anyone tell you differently For non commercial educational use only. Page 45
Thank You For non commercial educational use only. Page 46