The ACCME just released an updated synthesis of published systematic reviews regarding the effectiveness of CME. You can find it here. In short, the authors offer the following conclusions (this is pulled verbatim from the report on p. 14):
- CME does improve physician performance and patient health outcomes;
- CME has a more reliably positive impact on physician performance than on patient health outcomes; and
- CME leads to greater improvement in physician performance and patient health if it is more interactive, uses more methods, involves multiple exposures, is longer, and is focused on outcomes that are considered important by physicians.
Yes, there are issues of validity, heterogeneity, standardization and good-ole-fashioned publication bias in CME research, but that aside, there’s enough evidence out there to comfortably assume CME can positively affect physician performance and patient health. While that’s good news, we can’t ignore the next question: Why is it effective?
To borrow another section from this report (p. 15):
The authors of the systematic reviews make clear that the research regarding mechanisms of action by which CME improves physician performance and patient health outcomes is in the early stages and needs greater theoretical and methodological sophistication. Several authors make the argument that future research must take account of the wider social, political, and organizational factors that play a role in physician performance and patient health outcomes.
The third bullet point above shines some light on these “mechanisms of action”, but the recipe for effective CME is still vague. For example….How do I make my activity more interactive? More importantly, what qualifies as interactive in the first place? If multiple exposures is better, how many, and at what intensity? How effective are these “mechanisms of action” across various physician audiences? Do oncologists and internists learn the same way? What internal and external (e.g., practice environment) factors are influential?
There’s several careers worth of research questions here. Anyone funding?