CME Advocate

#CMEchat 52 - Does CME work?

2012-04-12T11:59:14Z

If you have focused on CME for long enough you have undoubtedly been asked whether CME works, and as much as we would love to point our finger at the definitive source demonstrating it does, we still struggle mightily to find that definitive source. The reality is that the question really needs more specificity and the answer needs context. In the end the simple question, "does CME work?' doesn't yet have a simple answer...

Our topics for this week's chat were as follows:

T1) what is your initial response when asked (or challenged as to) whether CME works? #CMEchat

T2) what evidence do you use to demonstrate the ‘effect’ of medical education? #CMEchat

T3) more specifically, how do you explain the role of CME as it relates the overall quality of the healthcare system? #CMEchat

T4) to quiet naysayers and definitively prove CME works, what needs to change? (or what needs to be studied?) #CMEchat

T5) who are the best advocates for CME and the CME profession? And why? #CMEchat

The transcripts can be reviewed below or downloaded HERE:

From User Tweet

BrianSMcGowan 4 hours until #CMEchat: Today we seek out a definitive answer to the age-old question does CME work? Please join us!

BrianSMcGowan Medical education and technology - circa 1970 - t.co/vIZfQ43V #meded #CMEChat

BrianSMcGowan ~2.5 hours until #CMEchat: Today we seek out a definitive answer to the age-old question does CME work? Please join us!

BrianSMcGowan 1 hour until #CMEchat: Today we seek out a definitive answer to the age-old question does CME work? Please join us!

BrianSMcGowan about to start #CMEchat...that is if #TEDMED is not breaking twitter ;-)

CMEChat Welcome to #CMEchat. All discussions herein are assumed to be personal opinion & not that of current, past, or future employers.

CMEChat Rules for #CMEchat: 1. Introduce yourself. Location? Focus? Fave topics? What brings you here today?

CMEChat Rule 2. [try to] stay on the #CMEchat topic. A new question will be asked every 12 min or so. If you can, include T# in related responses.

CMEChat Rule 3. When writing, complete thoughts help followers outside chat learn from you. #CMEchat

CMEChat Rule 4. Please remember to use the #CMEchat hashtag so all of the #CMEchat participants can follow the #CMEchat discussion!!!!

CMEChat Rule 5. Periodically RT questions so those outside #CMEchat know what youâ€™re talking about & so they can chime in too

CMEChat Rule 6. On #CMEchat we aim to play nice. Sarcasm & irony welcome though. Really. Seriously. #laughingislearning

CMEChat Rule 7. A few mins before the end of #CMEchat, reintroduce yourself. Links, requests & shameless plugs welcome, too - #makingfriends

CMEChat As with each #CMEchat we will guide the convo with 3 or 4 topics, but the real learning and teaching lies in your tweets - please engage.

CMEChat As with each #CMEchat the archive will be available at t.co/2gCKw2QS and archived on t.co/4muKUnRH

theCMEguy Derek in Chestnut Hill. FINALLY a wednesday with no meetings... #cmechat

BrianSMcGowan GOOD Morning! #CMEchat tweeps...looking forward to an important conversation today!

meducate #cmechat Lawrence on Long Island, NY - multitasking as usual

BrianSMcGowan must be founder's day at #CMEchat ;-)

theCMEguy Drinking coffee and tweeting is tough... :-) RT @meducate: #cmechat Lawrence on Long Island, NY - multitasking as usual

meducate I was thinking the same thing #cmechat

rmtyner Michelle from Indiana #CMEchat

BrianSMcGowan seems like we will be missing out on Cookie monster here...but maybe @CMEHulk could stop by? #CMEchat

theCMEguy Sorry to miss your chat last week... RT @rmtyner: Michelle from Indiana #CMEchat

meducate If no one else joins #cmechat, should we hold off until next week?

BrianSMcGowan btw - last round of #SOCIALQI revision should be turned in by week's end...got the artwork comps yesterday ;-) #CMEchat

eLearningSara Sara Beth from DC (eLearning in MSS) - I always seem to have a meeting during #CMEchat, but not today! #woot

meducate @BrianSMcGowan #cmechat #socialqi congrats!

BrianSMcGowan This is #CMEchat #52! moving into our second year of our regular wednesday meet ups...amazing!

theCMEguy @BrianSMcGowan Ooo...pics? #cmechat

meducate @BrianSMcGowan I remember sitting in an airline lounge in Berlin for #cmechat number 1...

BrianSMcGowan lets wait a few more minutes for straglers and lurkers to settle in #CMEchat

BrianSMcGowan @meducate - i remember being on a call w/ @theCMEguy as we launched week one...had a lot of angst back then... #cmechat

BrianSMcGowan helooooo Sara! welcome back to #CMEchat

theCMEguy @BrianSMcGowan @meducate Ha ha...I remember that. That's when I learned how much faster TweetDeck was then HootSuite #cmechat

CMEChat T1) what is your initial response when asked (or challenged as to) whether CME works? #CMEchat

theCMEguy #CMEchat? RT @aperch: Anne - The Methodist Hospital System - Houston

CMEChat small groups so far....please remember to use the hashtag #CMEchat to participate!

aperch RT @aperch: Anne - The Methodist Hospital System - Houston #cmechat

timclynch joining late #cmechat

theCMEguy T1: Yes #cmechat

BrianSMcGowan T1: so this might sound a bit odd, but when asked if CME works, my first response is, 'sometimes..' #CMEchat

timclynch RT @CMEChat: T1) what is your initial response when asked (or challenged as to) whether CME works? #cmechat

meducate #cmechat T1 I say that good CME can work

theCMEguy T1: Depends on what definition of "works" is... #CMEchat

BrianSMcGowan RT @eLearningSara: @briansmcgowan Thank you! I've added it to my calendar in hopes I can make it more often! #CMEChat

aperch +1 @briansmcgowan: T1: so this might sound a bit odd, but when asked if CME works, my first response is, 'sometimes..' #CMEchat

theCMEguy T1: Does "works" mean "improves patient outcomes"? #cmechat

meducate #cmechat T1 It also depends on the definitions of works, effectiveness, value, etc. There is a lot of good education that doesn't "work"

BrianSMcGowan T1 - ...but there is soo much bad CME out there and so much unmeasured CME out there....ratio may stll be 20:1 #CMEchat #ugh

rmtyner I agree - I say that CME can work! RT @meducate: #cmechat T1 I say that good CME can work

eLearningSara T1) I say I have proof! We have follow-up data that shows our docs were able to make changes in practice. #CMEchat

BrianSMcGowan @meducate - what do you mean by good education that doesn't work? #cmechat

theCMEguy @BrianSMcGowan Does "unmeasured" mean it doesn't work? Just means we can't give evidence it works #cmechat

timclynch RT @eLearningSara: T1) I say I have proof! We have follow-up data that shows our docs were able to make changes in practice. #cmechat

meducate @BrianSMcGowan T1 #cmechat That there are fundamental elements missing - content good but not appropriate for venue/medium for instance

BrianSMcGowan @theCMEguy - right unmeasured means we will never know...and it waters down the answer... #cmechat

theCMEguy @eLearningSara Nice! #cmechat

meducate #cmechat T1 I am looking at this as an enterprise; most providers have evidence that their CME shows effectiveness...

eLearningSara We don't have responses from all of our initiatives and are looking for ways to better measure the change in practice. #CMEchat

BrianSMcGowan t1: ...not sure we have moved the needle at all/enough to help folks have faith that this community has significant impact #CMEchat

CMEChat T2) what evidence do you use to demonstrate the â€˜effectâ€™ of medical education? #CMEchat

theCMEguy @meducate sort of depends on what you're looking at. If goal was to improve knowledge, and you have data that shows that...works! #cmechat

meducate @BrianSMcGowan T1 #cmechat A collective review of CME activities would be helpful...

meducate T2 #cmechat As opposed to the "affect"...?

theCMEguy @meducate @BrianSMcGowan Are you suggesting an outcomes data depot? Didn't we try that already? #cmechat

BrianSMcGowan t1/2: if 1 person learned something but 29 didn't, did 'it' work? if 30 learned something, but forgot it in 4 wks, did 'it' work? #CMEchat

BrianSMcGowan using an appropriate method overtime directed by the planned objectives... RT @carvicab: How do you measure a "good" CME? #cmechat

rmtyner @BrianSMcGowan T2 knowledge is important - but isn't behavior change/improve patient care what we are ultimately looking for? #CMEchat

theCMEguy @BrianSMcGowan If 30 leaned something and forgot it in 4 weeks, but did something with it during the first week, yes, it worked. #cmechat

BrianSMcGowan T2: the evidence that we should be using must be more than a bar chart - it needs a time component, needs a planned objective piece #CMEchat

aperch T1- If CME is avenue to bring awareness, then it should be recognized as effective. Hopeful this bring about change in practice. #cmechat

BrianSMcGowan t2 - @aperch @theCMEguy - then you would both agree that context is vital to any evidence base...#CMEchat

aperch Definitely @briansmcgowan: t2 - @aperch @theCMEguy - then you would both agree that context is vital to any evidence base...#CMEchat

theCMEguy @BrianSMcGowan @aperch Context is vital to everything we do in life... #cmechat

BrianSMcGowan t2 - ...a few data sets that we should all be using to level set the conversation, including the AHRQ study...this is our floor. #CMEchat

CMEChat T3) more specifically, how do you explain the role of CME as it relates the overall quality of the healthcare system? #CMEchat

BrianSMcGowan t3 - even if we cannot (or shouldn't) measure performance & outcomes for every prgrm, shouldn't we be able to connect the dots? #CMEchat

theCMEguy T3: So you're basically asking for ACCME's C21... #cmechat

aperch T2 - We all recognize end goal of practice change but got to start somewhere. Sometimes have to be happy with light-bulb moments. #cmechat

theCMEguy @BrianSMcGowan Why shouldn't we measure performance for every program? Seriously. #CMEchat

rmtyner T3 lifetime education is important for every profession and that CME does have an important role in healthcare #CMEchat

BrianSMcGowan @aperch - lightbulb for learners...but how do we connect (tell) the story more broadly to the medical community? #cmechat

rmtyner how do we build on the lightbulb moment - use the momentum and motivation? #CMEchat

CMEChat T4) to quiet naysayers and definitively prove CME works, what needs to change? (or what needs to be studied?) #CMEchat

BrianSMcGowan @theCMEguy - still seems like majority of CME is too disconnected from the practice of medicine to commonly measure performance #CMEchat

theCMEguy T4: Hardcore data showing patient care improved as direct result of CME. Not sure "connecting the dots" is enough #cmechat

rmtyner T4 the use of formative assessment #CMEchat

BrianSMcGowan t4: critical questions to answer: how does the CME community effectively address real-time questions/needs? #CMEchat

JediPD """It is the content"" methinks

""It is the content"" he says

That lingers

Simmelwies with hand-washing proof that saved lives...etc. #CMEChat"

JediPD That was a fly on the wall comment. Sorry #CMEChat

aperch @briansmcgowan Help hosp and MD leaders to connect dots to lay bread crumb trail. Light bulb=knowledge to lead to enhanced practice.#cmechat

BrianSMcGowan @JediPD - and yet handwashing is still well below 'guideline recommendations' and still leads to disease and death.. #CMEChat

theCMEguy @JediPD Exactly! The handwashing example is excellent. It's something concrete people can latch onto. #cmechat

BrianSMcGowan @JediPD - please wash your hands on the way out of the chat.... #CMEChat

theCMEguy @aperch @briansmcgowan If CME is battling a "perception" problem, is focus on Knowledge changing going to be enough? #cmechat

BrianSMcGowan t4 - what is 2012 was the year of cognitive dissonance and all we did is eye opening (motivational) programs? #CMEchat

JediPD That is what "studies" will have one believe. The knock on that knock is glove use, sterility in surgical procedures. #CMEChat

meducate @BrianSMcGowan T4 #cmechat That makes me uncomfortable...

meducate @JediPD May the force be with you #cmechat

CMEChat T5) who are the best advocates for CME and the CME profession? And why? #CMEchat

JediPD @meducate And with you. #CMEChat

BrianSMcGowan t5: if someone was to present the CME community to congress, or the AMA, or AAMC, or the IHI - who shld carry the torch? #CMEchat

aperch @thecmeguy Focusing on knowledge not enough. Cannot forget that there is value in knowledge on the learning spectrum. #cmechat

theCMEguy T5: Wow, loaded question...#cmechat

rmtyner talk about cognitive dissonance MT @BrianSMcGowan: t5:...to congress, or the AMA, or AAMC, or the IHI - who shld carry the torch? #CMEchat

meducate #cmechat T5 All stakeholder in the CME continuum should have a role in advocacy

beth333SP #CMEChat Joining late, but need to know, what is the definite answer to "Does CME work?" Recall the Hitchhiker's Guide to the Galaxy...42?

theCMEguy Well played #runforoffice RT @meducate: #cmechat T5 All stakeholder in the CME continuum should have a role in advocacy

BrianSMcGowan @meducate - SHOULD yes, but 'could' is a huge limiting factor given the challenges we've identified with our evidence base... #cmechat

BrianSMcGowan @beth333SP - or is it rolling rock's 33? #CMEChat

meducate @BrianSMcGowan T5 #cmechat I didn't say it would be easy

theCMEguy @beth333SP I believe the answer was: "blue" #cmechat

BrianSMcGowan t5 - does anyone want to take a shot at naming one person who should be the advocate for CME? #CMEchat

theCMEguy T5: Fine. Damon Marquis. As head of ACEHP, it SHOULD be him. Not sayiing it IS. #cmechat

rmtyner T5 i have a top five listâ€¦ but not sure i want to name names! #CMEchat

theCMEguy Hint? RT @rmtyner: T5 i have a top five listâ€¦ but not sure i want to name names! #CMEchat

CMEChat Thx for participating in #CMEchat. Discussions herein are assumed 2 b personal opinion & not that of current, past, or future employers.

CMEChat As we get wrap up, please vote for the tweet of the day (#TOTD) seen during this week's #CMEchat.

CMEChat The real impact of the #CMEchat lies in your action - please engage others to participate & take action on things your have learned! Gâ€™day!

rmtyner TOTD RT @theCMEguy: Well played #runforoffice RT @meducate: #cmechat T5 All stakeholder in the CME continuum should have a role in advocacy

beth333SP #CMEChat the answer was 42: to "Ultimate Ques of Life, the Univ & Everything" which begs the question, what was the question? Like blue too

theCMEguy T5: I'm changing my vote to @beth333SP #cmechat

#CMEchat 51 - Exploring Gender in CME and Medical Education

2012-04-07T12:19:32Z

Thanks go out to Michelle Tyner (@rmtyner) for stepping in as guest moderator and taking on a topic that few know better than she - Exploring Gender in CME and Medical Education.

Tough enough to guest moderate without a painfully throttled Twitter experience, but she made it through along with a great group of participants, including a few new faces.

The topics for this week:

T1 Current research shows that gender bias remains in #meded, what role can CME play in reducing bias in education? #CMEchat
T2 How do you increase the number of female thought leaders when the definition of the doctor is still more male and female #CMEchat
T3 The gender bias in education translates to patient care & what do you think about gender specific CME to address performance? #CMEchat

You can review the transcript below or download it HERE:

From User Tweet

BrianSMcGowan #CMEchat in 23rd hours with @rmtyner. Looking at #meded and gender differences in learning and teaching. Tomorrow 11 am edt!

theCMEguy @rmtyner Good luck today! Hoping my meeting ends soon so I can chime in... #CMEchat

rmtyner Welcome to #CMEchat. All discussions herein are assumed to be personal opinion & not that of current, past, or future employers.

rmtyner Rules for #CMEchat: 1. Introduce yourself. Location? Focus? Fave topics? What brings you here today?

rmtyner Rule 2. [try to] stay on the #CMEchat topic. A new question will be asked every 12 min or so. If you can, include T# in related responses.

rmtyner Rule 3. When writing, complete thoughts help followers outside chat learn from you. #CMEchat

rmtyner Rule 4. Please remember to use the #CMEchat hashtag so all of the #CMEchat participants can follow the #CMEchat discussion!!!!

rmtyner Rule 5. Periodically RT questions so those outside #CMEchat know what youâ€™re talking about & so they can chime in too

rmtyner Rule 6. On #CMEchat we aim to play nice. Sarcasm & irony welcome though. Really. Seriously. #laughingislearning

rmtyner Rule 7. A few mins before the end of #CMEchat, reintroduce yourself. Links, requests & shameless plugs welcome, too - #makingfriends

rmtyner As with each #CMEchat we will guide the convo with 3 or 4 topics, but the real learning and teaching lies in your tweets - please engage.

rmtyner As with each #CMEchat the archive will be available at t.co/mk8YqOJ8 and archived as a pdf on t.co/EJaXZJWT

rmtyner T1 Current research shows that gender bias remains in #meded, what role can CME play in reducing bias in education? #CMEchat

greyelmy T1 we talk about disparities in healthcare but it is important to remember and address diversity as well which includes gender #CMEchat

rmtyner @greyelmy #CMEchat there are definitely disparities in healthcare but what do you think about the inequities for women in #meded

greyelmy I am receiving these very slow today FYI. It may be on my end. #CMEchat

drerikbrady T1 - As with any key issue, covering gender bias in the needs assessment is the best way to get it addressed in the content. #CMEchat

aCMEstory We dissect learner preferences by practitioner type and specialty, region, etc. Why not gender? #CMEchat

greyelmy T1 are you referring to women not being rep as learners in CME programs (male based learning styles, wmn's concerns not addressed)? #CMEchat

rmtyner @aCMEstory learning prefs are important - some of the major implications are result of gender bias against the women during #meded #CMEchat

rmtyner @greyelmy my research thus far has focused on GME and academic medicine still a lot of concerns about the bias during #meded #CMEchat

spelletier t1 what is the gender bias in #meded? Topics covered? Gender of faculty? Gender of learners? Diff in care 4 diff genders? #cmechat

spelletier Me too RT @greyelmy: I am receiving these very slow today FYI. It may be on my end. #cmechat

rmtyner T1 gender bias in #meded ranges from sexual harassment - gender discrimination - impacts professional identity of female physicians #CMEchat

rmtyner T1 #CMEchat the long-term effects are somewhat unknown - issues include loss of self-esteem & PTSD t.co/P4vwZFNv

aCMEstory Equalize female faculty educator participation in CME. More female thought leaders in prominent positions within our programs #CMEchat

rmtyner @aCMEstory #CMEchat ABSOLUTELY but there is a big issue with the glass ceiling for women in academic medicine

rmtyner T2 how do you increase the number of female thought leaders when the definition of the doctor is still more male and female #CMEchat

rmtyner T2 hidden curriclum can be detrimental to gender equity in medicine t.co/XTwlopMN #CMEchat

greyelmy T2 yes CME can counter the bias but real change comes from addressing the systemic inequities. CME in parterships with institutes? #CMEchat

rmtyner T3 The gender bias in education translates to patient care â€“ what do you think about gender specific CME to address performance? #CMEchat

spelletier t2 and 2 Do CME providers actively seek female faculty to serve as role models/thought leaders? Should they? #cmechat

drerikbrady My ? as well... @spelletier: Me too RT @greyelmy: I am receiving these very slow today FYI. It may be on my end. #cmechat T1

rmtyner @spelletier that is a great question - what are the criteria when choosing faculty, esp for a women's issue activity #CMEchat

greyelmy @rmtyner it is a very male-centric system down to its roots #CMEchat

rmtyner @greyelmy that is very true - many like to tout the statistic that over 50% of the med students are female #CMEchat

aCMEstory T3: IME, #Nursing & womens health CME have traditionally had the most female faculty. But we aren't represented as well in Onc, CV #CMEchat

spelletier @rmtyner but if you specify female faculty for women-issue activities, u risk making that topic a CME "pink ghetto" #cmechat

rmtyner @spelletier true there is a way to strike a balance #CMEchat hate going to meeting about women's health where all the faculty are men #fail

spelletier @rmtyner with so many women coming into med, maybe it will naturally evolve to be more inclusive? Next gen not as tolerant of bias #cmechat

rmtyner @spelletier current research shows that this is not the case - hidden curriculum too powerful #CMEchat

spelletier @aCMEstory Curious--resistance from whom? #cmechat

rmtyner @spelletier the # of female med students has been >50% for over 15 years #CMEchat

rmtyner Thx for participating in #CMEchat. Discussions herein are assumed 2 b personal opinion & not that of current, past, or future employers.

rmtyner As we get wrap up, please vote for the tweet of the day (#TOTD) seen during this week's #CMEchat.

spelletier @rmtyner I'm getting depressed now! If pop shifts don't make a diff, outing that hidden curriculum has 2 b key. #cmechat

rmtyner @spelletier the hidden curriculum is the key - and so hard to define and address #CMEchat

rmtyner @spelletier don't be depressed - i believe the more people understand about the detriments of gender bias that change can happen #CMEchat

rmtyner The real impact of the #CMEchat lies in your action - please engage others to participate & take action on things your have learned! Gâ€™day!

NicoleMAnzuoni Can you explain a bit more what you mean by hidden curriculum? #CMEchat

rmtyner @NicoleMAnzuoni the hidden curriculum - informal teaching that occurs; the students learn from the teachers outside of the class #CMEchat

rmtyner @aCMEstory @spelletier it is getting better more and more reseach is being done on mentoring and tenure #CMEchat

rmtyner thanks to everyone for sticking with this week's chat - i know that it was painfully slow! #CMEchat

greyelmy Thanks for a great topic and the two articles you sent out. Good conversation today! #CMEchat

rmtyner Thank you! @greyelmy i will be sending out more links to refs this afternoon #CMEchat

aCMEstory Thanks for gender-centric discussion, @rmtyner. Got me thinking abt education on hidden curricula of gender bias. #CMEchat

rmtyner @aCMEstory always around for more discussion - i live and breath this right now #CMEchat

NicoleMAnzuoni Got it. Thanks. Interesting chat today. #CMEchat

spelletier Can we do this topic again on a day when Twitter isn't dragging its feet? #cmechat

rmtyner @spelletier sure i can talk to @BrianSMcGowan about it - there was an additional topic that we didn't even get to #CMEchat

rmtyner @NicoleMAnzuoni thanks for joining Nicole - nice to see a new face on #CMEchat

#CMEchat 50 - Ask Your Most Pressing Questions (part 2)

2012-03-28T21:00:09Z

Small group celebrating our golden #CMEchat...but that just made it that much more personal!

Here are our general topics:

T1) connecting traditional CME to real-life, systems-based barriers --- what are your most pressing questions/ideas #CMEchat

T2) supporting behavior change (motivation x ability x triggers) --- what are your most pressing questions/ideas #CMEchat

T3) 'knowing your audience' (ie. assessment) à what are your most pressing questions/ideas #CMEchat

The conversation can be viewed below or downloaded HERE:

From User Tweet

BrianSMcGowan Two hours until #CMEchat - please join us for our 50th chat! Today we focus on pressing questions connecting learning to behavior change!

BrianSMcGowan 20 mins until #CMEchat - please join us for our 50th chat! Today we focus on pressing questions connecting learning to behavior change!

ElinSilveous RT @BrianSMcGowan: 20 mins until #CMEchat - please join us for our 50th chat! Today we focus on pressing questions connecting learning to behavior change!

drerikbrady +1 @thecmeguy: The Unspoken Casualties Of Reducing Industry Support Of CME t.co/kM3Xr6jK "Probably" isn't good enough #cmechat