Pulse
Learning Styles
No two physicians’ needs are quite the same when it comes to continuing medical education. It’s a good thing there are choices.
In Minnesota, all doctors have one very important reason to be interested in continuing medical education: earning the 75 credits they need to renew their licenses every three years. Beyond that, though, their motives for pursuing CME and their preferred method for doing so can vary widely. And they can change over the course of a career. Here’s a look at how four physicians who responded to an informal survey by Minnesota Medicine like to learn.
William Kimber
Cardiologist William Kimber, M.D., has never found pursuing CME a chore in part because his career has spanned a fascinating era in cardiology. “When I started, they were just shifting from six-week to three-week hospitalizations for patients with myocardial infarctions. It was a sin to do an angiogram, let alone an intervention, on someone who presented with acute myocardial infarction. We had no thrombolytics. In fact, we didn’t know what happened with an MI pathophysiologically. Now, a lot of that information has been teased out,” he says.
Throughout his career, which began in the 1970s, Kimber has looked for meetings on emerging interventional procedures and diagnostic techniques such as echocardiography that he could readily apply in his practice at North Memorial Medical Center in Minneapolis. Kimber says he always preferred going to meetings that were out of town, where he was better able to focus. “Whenever you are in town, people will call,” he says. Kimber often combined CME events with family vacations. “I found that if I went out of town to a nice place, my family could have a vacation, and I could have a vacation as well as get some CME,” he says.
Although Kimber is now living in a place where others go to vacation (he’s currently practicing cardiology in Bermuda) and does some of his CME work online and by attending weekly meetings there, he still prefers attending the larger “away” meetings because of the opportunities for interacting with the speakers and colleagues. “[Online education] doesn’t work as well as having people talk with me,” he says.
Patrick Irvine
Unlike Kimber, Patrick Irvine, M.D., of St. Paul, prefers online and journal-based CME. “It gives you flexibility,” he says. And he thinks taking a quiz helps him get more out of the material he reads. “CME should be more about learning than time spent,” he says. “There should be more to it than just going to a meeting and taking notes and getting credit.”
Irvine, who is board-certified in internal medicine and geriatrics but doesn’t see patients because he works as a consultant for health insurers and employer groups, says CME helps him keep current on clinical issues. “That [clinical perspective] is what I feel I can bring [to my clients],” he says. So he picks general medicine and geriatrics topics, sometimes focusing on the conditions that payers deal with the most such as asthma, diabetes, and heart disease.
Irvine says that although he routinely reads the articles in the journals he subscribes to and attends meetings, he doesn’t pay much attention to getting credit for those activities until he’s about a year away from needing to renew his license. “Then, methodically, I start going through journal programs,” he says. “If I were smart, as I read the articles, I’d finish the CME courses.”
Laura Lehmann
Laura Lehmann, M.D., who currently does volunteer work at the NIP Community Clinic in Minneapolis, is perhaps more diligent in her approach to CME. Studious by nature, she takes advantage of almost any opportunity she has to learn and earn credits for doing so.
She likes attending meetings, where she can ask questions. But since 1987, she’s also been listening to audio CME series about her fields—emergency medicine and internal medicine—using ever-changing technologies (cassette tapes, CDs, MP3s, podcasts). When an injury sidelined her emergency medicine career at Fairview Southdale Hospital in Edina about a decade ago, she even began writing the abstracts for the company that had provided her that commentary for so many years.
Lehmann, who is now hoping to practice in a primary care setting where she can work with Latino patients, says the quizzes that follow the journal-based and online CME offerings she does motivate her to learn. “I see the questions, and I think, I just read that. I can find the answer to that. And I want to know the answer to that. … These things affect my patients.”
Godela Iverson
For most of her career, infectious disease specialist Godela Iverson, M.D., of Moorhead, earned CME credits by attending conferences and grand rounds. Although it was convenient and paid for by her clinic, the topics were only sometimes relevant to her practice. “In general, we tended to have lectures on unusual diseases that you’d maybe never see. That was interesting for the academicians but not for practicing physicians,” she says, then correcting herself adds, “It was interesting but not helpful.”
She discovered what she considered a more useful way to learn when her clinic, part of the Innovis Health system, subscribed to UptoDate, the online resource that links current research with clinical problems. “You get continuing medical education when you need the information about a patient you have,” she says of UptoDate. “You can learn something that is relevant to the moment.” She says the subscription service was particularly helpful to her because new types of lab tests constantly are being developed for various infectious diseases.
Iverson, who is retired but is maintaining her license, now pays for her CME out of pocket and does most of her work online. The reason: “It’s cheap.”—Carmen Peota
What Else They Have to Say...
The Classroom Learners
“I enjoy going to conferences as my primary source of CME. I need to be out of the office to focus fully on learning.”
“Out-of-town meetings put on by local organizations are a pleasant way to earn CME credits and socialize with other local doctors/friends.”
“Out-of-town meetings give me an opportunity to travel, and webinars are great when I am unable to.”
“No interruptions, excellent speakers, adequate discussion opportunities, informal, nonthreatening atmosphere, the possibility of establishing longer-term relationships outside my usual medical/political spheres.”
“Formal out-of-town meetings offer new education, a chance for interaction with physicians, and a respite from practice or other routines.”
“I am a recently retired physician, and I want to keep my medical license. Cost concerns take priority, so now I choose in-town meetings. I would do more online, but all I see right now are thinly veiled infomercials by pharmaceutical companies. In the past (with a CME expense account), I enjoyed attending my specialty society annual meeting and other out-of- town meetings. Now the travel and housing expenses associated with these meetings make them less appealing.”
Online On My Time
“Online education provides an opportunity for concentrated reading without the distractions of actual meetings and provides patient-specific information that is retained much more efficiently than lectures.”
“Internet- or journal-based programs. Then I don’t have to plan ahead and pay the major fees the current CME programs often charge, especially in the health policy area, and it won’t interfere with my busy work or family schedules.”
“Online because it is point-of-care learning, which is practical and aids retention.”
“Online education because it is typically easy to fit into my schedule and also the most affordable.”
“Online education. It`s convenient, I can choose those areas I need, it`s cost-effective and easy to track credits received.”
“Online because all content is visual, which is my preferred learning method, and because it is easily accessible.”
Grand Ideas
“Grand rounds, because they are given by experts and stimulate discussion.”
“I am a hospital-based physician, so hospital-based grand rounds are easier. There is a history of high-quality programs that are of general interest. Programs are tailor-made to reflect the needs of this medical staff. No expensive fees or travel costs. Intimate atmosphere promotes interchange with speakers and audience.”
Specialized Appeal
“Specialty society meetings, as the information is more specific to my interests and perhaps presented in a way I enjoy more.”
“Specialty society meetings in state for convenience and for interacting with professional colleagues.”
“In-town meetings, journals, and specialty society meetings: the first two because of convenience and the last for specificity to my specialty.”
The Reader
“I get my CME from the Medical Letter, Medical Letter Treatment Guidelines, and the New England Journal of Medicine. I prefer this to going to conferences, which are much more costly and take me away from work. I also don’t like conferences where you get speakers who are supposed to be on the ‘cutting edge’ and then what they’re presenting and promoting doesn’t pan out.”