A public-private institution, launched by the Department of Health and Human Services, would be the best way to raise standards and quality for continuing health education, according to a report issued by the Institute of Medicine.
There are serious flaws in the way that continuing education for physicians and other health professionals is “conducted, financed, regulated, and evaluated,” concluded the authors of the report “Redesigning Continuing Education in the Health Professions.” They added, “The science underpinning continuing education for health professionals is fragmented and underdeveloped.”
Because of that, “establishing a national interprofessional continuing education institute is a promising way to foster improvements in how health professionals carry out their responsibilities,” the authors said. The report was sponsored by the Josiah Macy, Jr. Foundation.
The 14-member Institute of Medicine committee that produced the report proposed the creation of a public-private entity that would involve the full spectrum of stakeholders in health care delivery and continuing education.
That new entity, which would be called the Continuing Professional Development Institute (CPDI), would look at new financing mechanisms to help avoid potential conflicts of interest.
The institute also would develop priorities for research in continuing health education and recognize effective education models.
The medical community must move from a culture of continuing medical education (CME) to one of “continuing professional development … stretching from the classroom to the point of care, shifting control of learning to individual practitioners, and [adapting] to the individual's learning needs,” said committee chair Dr. Gail Warden.
“We believe that academic institutions need to be much more engaged than they have been in continuing education,” Dr. Warden, president emeritus of the Henry Ford Health System, Detroit, said during a teleconference.
New Report for Old CME Model?
CME vendors had mixed reactions to the committee's report.
Rick Kennison, D.P.M., president and general manager of PeerPoint Medical Education Institute, said that he agreed with the committee's recommendations in the area of traditional CME. Those types of programs, such as live meetings and society annual meetings, “are didactic in nature [and] don't meet the needs of participants as learners, and there is conflict and bias associated with them.”
A large problem with the report is that the committee reviewed CME as it used to be, Dr. Kennison said. “There have been a lot of changes in CME in the course of the last few years that were completely overlooked by the committee.”
Some CME vendors have moved to performance-improvement CME, which is a goal outlined in the report. This approach involves “direct learning by the participant—self-directed learning—in which the participant uses metrics and supplies data to help determine change and improvement in patient care.
The Institute of Medicine report, “Redesigning Continuing Education in the Health Professions,” is available online at
My Take
Examine Effectiveness, Cost of CME
The proposed institute could have a dramatic effect on CME requirements. Through the establishment of a professionally inclusive public-private institute, research on the effectiveness of CME models could inform the health professional community about how best to develop educational programs and continuing professional competencies.
Several institutions have embraced the newest standards of the Accreditation Council for Continuing Medical Education. Their modified programs involve active learning and outcomes evaluation, and avoid potential conflicts of interest associated with financial support by the pharmaceutical and medical device industries. However, in an era of economic constraints, particularly for primary care providers, new standards developed by any organization must consider not only educational efficacy but also efficiency and cost.
BARBARA SCHUSTER, M.D., is campus dean of the Medical College of Georgia/University of Georgia Medical Partnership, Athens. She reports no relevant conflicts of interest.