Last year, hospitals helped to chip in some $1.5 billion toward providing continuing medical education to doctors, in the form of grants, registration fees or allocations from providers. But are they really getting their money's worth on such a sizeable investment?
A report from the American Hospital Association's Physician Leadership Forum looks to get to the bottom of that question. Last year, about 1,100 hospitals and health systems provided in-house continuing medical education, which generally is required for doctors to renew their licenses or retain membership in professional societies. And while CME programs have excelled at furthering the medical knowledge of doctors, strides must be made to better utilize such education for fostering the skills needed in this rapidly changing environment, the report suggests.
One key takeaway from the guide is that continuing medical education should be deployed thoughtfully to help build better doctors, says Elisa Arespacochaga, co-author of the report and director of the Physician Leadership Forum.
"There are a lot of pieces involved in health care today, and using CME only to advance medical knowledge isn't using that resource to the full breadth," she says. "We absolutely want doctors to continue advancing their medical knowledge and patient care." But, quality improvement, performance improvement, continuous learning, system-based practice design and understanding the continuum of care are among the many areas that hospitals can include in CME to be able to use it strategically, she adds.
Physicians have a lot on their plates nowadays, and it can be easy to forget what one has learned in a lecture with a long line of patients and a lengthy to-do list back at the hospital. That's why another key takeaway from the report, Arespacochaga says, is the need to integrate CME into doctors' daily activities, rather than pulling them away from their work. Examples of doing so could include providing credits for taking part in hospital-based improvement projects or partnering with community organizations to tackle local health needs. "It's something that's meaningful to your practice if you are getting credit for a quality improvement project within the hospital where you see your patients," she says.
In 2012, however, the report points out, more than half of hospital-based CME activities were delivered through "didactic sessions," while less than 2 percent came in the form of formal performance improvement. The other 30 percent, meanwhile, included rounds or institutional conferences. Other recommendations in the report, targeted toward the hospital and health system field, include:
- Using continuing medical education to advance the institution's strategic goals and engage physicians as partners to strengthen organizational competencies
- Considering the use of existing, nontraditional applications, such as online learning, to encourage improvement efforts and physician engagement in strategically oriented CME
- Developing physician champions
- Encouraging stronger links between CME and quality improvement
- Using a community health assessment and other available data to inform CME
- Encouraging interprofessional and team-based learning opportunities