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AAMC Releases Report on Conflict of Interest Guidelines Malpractice Update: States Say Federal Help Needed To Deal With Spiraling Costs Image Guided Surgery: Making "X-Ray Vision" A New Reality Medical Schools Branch Out: Regional Medical Campuses on the Rise Computer-Based MCAT Gets a Test in London "A Day in the Life of a Medical Student" A Word From the President
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A Word From the President:Transforming CME
Satisfying that demand is, of course, the aim of what we have come to call continuing medical education (CME). Ironically, this component of the continuum of medical education, which is unquestionably the longest and arguably the most important, is far and away the least effective. As currently structured, CME is meeting neither professional nor, more important, public expectations. The dominant model of continuing medical education, with its reliance on talking heads and canned, generic lectures and presentations, is at best a relic of a distant, slower-paced past. This “prepackaged” approach to CME is a prime example of passive, teacher-directed education that studies of adult learning have shown conclusively is much less effective than active, student-directed education. Not surprisingly, therefore, evidence abounds that the traditional methods employed in most CME offerings have limited, if any, ability to produce sustained changes in physicians’ actual practice behavior. But that is not the only indictment of contemporary CME. Of perhaps even greater concern is the degree to which commercial entities have co-opted CME and its venues and converted them into highly effective means for marketing their products and services. Indeed, the pervasive influence of the pharmaceutical industry, device manufacturers, and other for-profit outfits on CME has raised significant concerns regarding its ability to satisfy the legitimate learning needs of practitioners. Current “standards” for safeguarding CME from the distorting influence of financial conflicts of interest are, in my view, wholly inadequate to the task. Until continuing medical education is once again seen by the leaders of academic medicine to be an inherent obligation of the profession itself, rather than a commodity to be obtained from any willing provider, physicians and the public alike will continue to be denied the benefits of a trulyeffective means forassuring continued physician competence.In recognition of the need to fundamentally transform CME, the AAMC took formal action over a year ago by calling for a new vision to guide our efforts in this critical arena. According to this vision, restoring credibility and trust in CME as a vehicle for enhancing patient care requires that the continuing professional development of individual physicians must be driven not by “top-down” purveyors of standardized courses, but by the ongoing, “bottom-up” assessment of a given doctor’s actual performance in practice. Research supports the assertion that optimal CME should be highly self-directed, should incorporate individually tailored content, and should both ease the burdens of practice and improve the quality of what physicians do regularly on behalf of their own patients. Clearly, individual physicians must have the means and the motivation to assess their performance before these goals can be met. Modern information technologies now at our disposal offer the real opportunity to provide the necessary means, but a lot of work remains to be done to convert this opportunity into reality. Similarly, much work remains to be done to motivate practitioners to engage in new, more transparent methods for providing assurance to the public that their practices continue to reflect high professional standards throughout all stages of their careers. On both counts, academic medicine has pivotal roles to play. Medical schools and teaching hospitals offer the ideal laboratories for developing, validating, and disseminating new, IT-empowered assessment tools and educational methods for individual physicians that are accessible within the work setting. Likewise, academic societies and their respective certifying boards are not only the ideal, but arguably the only source of expertise needed to define the specialty- and subspecialty-specific attributes required to maintain clinical competence. Moreover, these respected professional organizations are in the best position to identify — and in most cases provide — the most appropriate kinds of CME for acquiring those attributes. Strong leadership will surely be needed to overcome inertia and dislodge the well-ensconced special interests that now distort the true purpose of CME. Like Humpty Dumpty, CME has fallen into fragmented disrepair. But in the Wonderland of modern technology, and with enough academic Alices willing to suspend disbelief, we just might have a chance to bring the new vision of CME out of the looking glass and into reality.
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Contact Us © 1995-2008 AAMC Terms and Conditions Privacy Statement |
Effective
health care requires continuous learning on the part of those who
deliver it. Indeed, a central tenet of medical education understood
by physician educators for centuries is that the study of medicine
is a lifelong pursuit. To be sure, the conferring of the M.D. degree,
the successful completion of an accredited residency program, and
the granting of a license indicate that an individual has met the
requirements of the profession to commence the independent practice
of medicine. But the continually changing landscape of healthcare
delivery and the inexorable march of scientific knowledge and technology
demand that those who have earned the privilege to commence the
practice of medicine work continually to merit the right to remain
in practice. 