Editor's Note
Searching for Relevance in a Sea of CME
The lights go down, the PowerPoint slides come up, and my head slowly falls. Like the response of Pavlov’s dogs, a reflex conditioned in medical school takes over—dark room, slides, and a monotone speaker prompt a quick catnap. I’m sure my education has suffered from the recurrence of this phenomenon, but it is, at times, irresistible and one reason I long ago stopped attending conferences to obtain my CME. Besides, such conferences are inefficient purveyors of information. Even the most spellbinding lecturer with designer graphics can impart only a few bits of information in an hour-long talk. So what is the best way to refresh a medical education? This month’s Minnesota Medicine looks at the state of the art of CME.
Physicians hear from many quarters that they need to keep up their CME. The Minnesota Board of Medical Practice insists that they get 75 AMA-approved CME credits every three years. Most specialty boards are mandating a recertification process that involves tests, quality improvement measures, and self-assessment. And, hopefully, all doctors have that little internal voice that says they should be lifelong students.
Yet many CME activities seem like mindless rule fulfillment, getting “credits” for the sake of credits, sometimes scrambling at the last minute to meet standards, and wasting time ingesting information that sticks about as long as an old Post-it note. Most physicians would like their refreshers to be not only refreshing but also relevant. The current requirements really don’t meet the needs of those certifying agencies that want to assure themselves and the public that doctors with their stamp of approval continue to be competent. The conferences in Hawaii and the multiple choice tests of the past don’t do the job.
So that is why educators are looking for new ways to capture physicians’ attention while infusing pertinent information to keep them current. Some are trying theatrics (p. 38). Food also seems to work (p. 8). But most educators have realized that what they need to do is figure out how to integrate ongoing education with practice, which means formalizing and measuring what physicians hopefully do every day (p. 14 and p. 24). When you encounter something you don’t know, look it up. If you make a mistake, figure out why you did and how not to repeat it. That is quality continuing medical education and quality medical practice.
Having given up on the PowerPoint presentations, I have tried online CME only to realize that drug-company sponsorship sullies the presentation. The regular offers from the New England Journal of Medicine that award CME credit for taking a test after reading each issue at first sounded attractive until I realized I would have to read and digest articles describing obscure metabolic abnormalities that I routinely skip. And for years, I slogged through each rendition of the American College of Physicians’ Medical Knowledge Self-Assessment (MKSAP), finally taking a long vacation when I became disenchanted with the mass of arcane knowledge I was pumping into my head. I have recently returned to the MKSAP and am progressing even more slowly than before, given my 62-year-old brain. As I wade through the modules, I will keep looking for refreshing relevance that will hopefully make me a better doctor.
Charles R. Meyer, M.D., editor in chief, can be reached at cmeyer1@fairview.org.