In lieu of an abstract, here is a brief excerpt of the content:

291 Steven Minnick, Nancy L. Davis, Charles E. Willis, and Errol R. Alden chapter 25 Contemporary Developments in Continuing Medical Education and Continuing Professional Development ‘‘All experience is an arch wherethro’ gleams that yet untravel’d world, whose margin fades for ever and for ever when I move,’’ wrote Tennyson in his poem about the travels of the ancient Greek hero Ulysses. It is a passage that beautifully captures the transition from current experience to the untraveled world of the future always beyond our reach. This chapter explores some of the newer developments in continuing medical education (CME) and continuing professional development (CPD), developments that will likely serve as structural supports for the arch wherethro our current experience in CME and CPD, as part of its odyssey, will pass. From a general and conceptual perspective, change appears to be emanating from the following major trends: (1) changes occurring in physician specialty certification and recertification, credentialing , and licensure processes; (2) advances occurring in learning and communication technologies ; and (3) the movement by society, insurers , and the federal government toward transparency in health-care delivery. The first trend regards the emergence of a set of physician competencies , broader than just medical knowledge, that can be applied across the continuum of undergraduate , graduate, and continuing medical education and will form the framework of many of the future CME and CPD activities. Examples of the second trend include sophisticated technologies that extend beyond the lecture hall and printed page, creating opportunities to more fully explore the use of images, video, and sound; new and advancing clinical simulation capabilities; and real-time clinical information at the point-ofcare that also captures and records the associated physician learning for CME and CPD purposes. The emphasis on transparency for the third trend has increased the expectation to demonstrate improvement in the quality of health care and patient safety. When and where appropriate, these quality and patient safety goals o√er expanded opportunities for CME and CPD professionals. Examples include the Joint Commission’s set of national patient safety goals, various payerdriven quality-of-care initiatives, such as Medicare ’s heart failure index, and increased public reporting of hospital and physician quality-ofcare measures (the Leapfrog Group, etc.). With these trends in mind, this chapter will focus on three important developments in CME and CPD: performance improvement CME (PI CME), Internet point-of-care (PoC) learning, and the growing use of simulation in CME and CPD. PI CME In2001,theAmericanMedicalAssociation(AMA) convened a group to examine the quality improvement (QI) activities physicians were engaged in 292 emerging themes and forces in cme and to determine what construct would most e≈ciently and accurately permit CME credit to be awardedforparticipationintheseactivities.QIand better patient care have always been intended outcomes of CME; the trick was to determine how some form of QI CME could demonstrate improvement , especially if linked to clinical data and embedded in the physician’s practice. Why should physicians not be rewarded for activities that would have the most impact in their practice? Much of the literature signals that individual , frequently isolated, traditional CME activities have a limited e√ect on practice.∞ Yet, that is how the majority of CME has been delivered: remote from practice, usually lecture-based, and built around the global aggregation of perceived needs rather than developed with data abstracted from a physician’s practice. In the late 1990s, radiologist Robert Pyatt, MD, a hospital CME committee chairman, informed Dennis K. Wentz, MD, then director of the AMA’s Division of Continuing Physician Professional Development (CPPD), that he was awarding AMA Physician’s Recognition Award (PRA) Category 1 credit for physicians participating in quality assurance work. He had described his program at the Alliance for Continuing Medical Education (ACME) annual meeting. Pyatt found that while the program led to improved practice, it did not fit the standard criteria for assembling a CME activity, making credit dif- ficult to award under the current system. Wentz and others had a ‘‘long-standing dream that CME credit would be awarded for something doctors should be doing in their daily work.’’ So Wentz and Pyatt worked on a simple experiment, based on Pyatt’s program, that suggested something bigger was at hand. More work remained to describe this type of CME and to sort out a system for allocating CME credit for these activities. Wentz presented the concept to the CME Advisory Committee of the AMA Council of Medical Education, who liked the idea. The...

Share