Bernard Sklar, MD: Online Continuing Medical Education December 2006 Online CME – An Update Review...

Bernard Sklar, MD: Online Continuing Bernard Sklar, MD: Online Continuing Medical Education December 2006Medical Education December 2006

Online CME – An UpdateOnline CME – An Update

Review of December 2006Review of December 2006

Bernard M. Sklar, M.D., M.S.Bernard M. Sklar, M.D., M.S.

www.cmelist.com/www.cmelist.com/list.htmlist.htm

[email protected]@netcantina.com


Plan of PresentationPlan of Presentation

Results of Recent SurveysResults of Recent Surveys

Types of InstructionTypes of Instruction

Physician Use of CME and Online CMEPhysician Use of CME and Online CME

Obstacles to Physician UseObstacles to Physician Use

PredictionsPredictions


Master’s ThesisMaster’s Thesis

This review is based on the December 2006 This review is based on the December 2006 update of the database initially created for the update of the database initially created for the master’s thesis, The Current Status of Online master’s thesis, The Current Status of Online Continuing Medical Education (June 2000). Find Continuing Medical Education (June 2000). Find the thesis online at the thesis online at http://www.cmelist.com/http://www.cmelist.com/mastersthesismastersthesis

The June 2000 thesis was based on a review of The June 2000 thesis was based on a review of the CME literature and a survey of online CME the CME literature and a survey of online CME done in February 2000.done in February 2000.


How Was the Survey Done?How Was the Survey Done?

The original survey was done by searching The original survey was done by searching multiple search engines using the search multiple search engines using the search string “online + continuing + medical string “online + continuing + medical +education”+education”

Following up leads from those searchesFollowing up leads from those searches

Information from ACCMEInformation from ACCME

Email from viewers and CME providersEmail from viewers and CME providers


Updating the DatabaseUpdating the Database

For the past several years, I have relied on For the past several years, I have relied on contacts from Online CME providers and contacts from Online CME providers and users to add sites to my listusers to add sites to my list

I add 3-4 new sites each month (and I add 3-4 new sites each month (and remove those sites that go offlineremove those sites that go offline

This year I also searched the Internet This year I also searched the Internet again for “online + continuing + medical + again for “online + continuing + medical + education”education”


Description of the ListDescription of the List

Each entry shows the name and URL of Each entry shows the name and URL of the site, when I last visited, how many the site, when I last visited, how many credit hours are available, who awards the credit hours are available, who awards the credit, the cost per unit, when the credit, the cost per unit, when the educational material was last updated, a educational material was last updated, a statement about financial support, a statement about financial support, a description of the site and its contents and description of the site and its contents and links to individual courses found at the links to individual courses found at the site.site.


Extensive UpdatesExtensive Updates

I have been maintaining the list for about I have been maintaining the list for about nine years, beginning in 1997nine years, beginning in 1997

The database was updated for my The database was updated for my master’s thesis in February 2000, and master’s thesis in February 2000, and every six months since. every six months since.

From March through December 2006, I From March through December 2006, I visited and updated the review of each site visited and updated the review of each site on the list.on the list.


Database Created from ListDatabase Created from List

The database contains information about The database contains information about the 300 sites offering CME in early the 300 sites offering CME in early December 2006. This information includes December 2006. This information includes the number of activities, number of hours the number of activities, number of hours of instruction, types of instruction, target of instruction, types of instruction, target audiences, cost to users, the name of the audiences, cost to users, the name of the accrediting organization and sources of accrediting organization and sources of financial support.financial support.


Growth of Sites, Activities and Hours IGrowth of Sites, Activities and Hours I

Date SearchedDate Searched Number of Number of SitesSites

Number of Number of ActivitiesActivities

Number of Number of Credit HoursCredit Hours

April 1997April 1997 1313 Not countedNot counted Not countedNot counted

December 1997December 1997 1818 Not countedNot counted Not countedNot counted

August 1998August 1998 6161 Not countedNot counted Not countedNot counted

May 1999May 1999 6868 Not countedNot counted Not countedNot counted

December 1999December 1999 8787 Not countedNot counted Not countedNot counted

February 2000February 2000 9696 18741874 30643064

August 2000August 2000 135135 36593659 56595659

December 2000December 2000 150150 35103510 55005500


June 2002June 2002 209209 1095210952 1826618266


Growth of Sites, Activities and Hours IIGrowth of Sites, Activities and Hours II

Date SearchedDate Searched Number Number of Sitesof Sites

Number of Number of ActivitiesActivities

Number of Number of Credit HoursCredit Hours


July 2003July 2003 253253 1134611346 2029920299

January 2004January 2004 271271 1239512395 2170021700

June 2005June 2005 283283 1496314963 2507525075



Explanation of calculations on next Explanation of calculations on next several slidesseveral slides

Although the number of sites is now Although the number of sites is now estimated at 300, the number used for the estimated at 300, the number used for the following calculations is 286following calculations is 286This method counts only those sites which This method counts only those sites which offer original content and not those sites offer original content and not those sites which only link to or which only link to or re-package content re-package content offered elsewhereoffered elsewhere (Nothing wrong with (Nothing wrong with doing that, but I don’t want to count the doing that, but I don’t want to count the same activity twice)same activity twice)


Growth of large sites (offering more Growth of large sites (offering more than 100 Credit Hours)than 100 Credit Hours)

Date SearchedDate Searched Number Number of Sitesof Sites

Number of Number of HoursHours

% of % of SitesSites

% of % of hourshours

December 2001December 2001 1414 1458714587 77 8383


July 2003July 2003 2121 1638816388 1010 8080

January 2004January 2004 2525 1754917549 1111 8181

June 2005June 2005 3434 2045620456 1313 8080



Size of Sites – December 2006Size of Sites – December 2006

No. of Credit-No. of Credit-HoursHours

Number of Number of SitesSites

Number of Number of HoursHours

% of % of SitesSites

% 0f % 0f HoursHours

Greater than 100Greater than 100 4040 2088420884 1414 7979

50-9950-99 3333 21632163 1212 88

25-4925-49 4646 16431643 1616 66

10-2410-24 8080 12011201 2828 55

5-95-9 3939 273273 1414 11

< 5< 5 4848 123123 1717 11

TotalTotal 286286 2628726287 100100 100100


The Largest Sites Dec 2006 - IThe Largest Sites Dec 2006 - IName of SiteName of Site No. of ActivitiesNo. of Activities No. of HoursNo. of Hours

eMedicine CMEeMedicine CME 63916391 95869586

ChallengerChallenger 4040 28002800

CMEWebCMEWeb 856856 12841284

ArcMesa Educators 9797 350350

JournalBytes (All Specialties)JournalBytes (All Specialties) 108108 346346

McGill Cont Medical EducationMcGill Cont Medical Education 346346 346346

Oncologist (The)Oncologist (The) 318318 318318

Clinical Directors NetworkClinical Directors Network 300300 300300

FreeCMEFreeCME 179179 300300

Rad Soc North America 300 300

TheAnswerPage 5 300

NetCE 32 250

CardioVillage 10 231

PriMed Online 173 220

Ohio State University 205 205


The Largest Sites Dec 2006 - 2The Largest Sites Dec 2006 - 2Name of SiteName of Site No. of ActivitiesNo. of Activities No. of HoursNo. of Hours

CME Institute (Psychiatry)CME Institute (Psychiatry) 200200 200200

Johns Hopkins Adv Study coursesJohns Hopkins Adv Study courses 100100 166166

CMELectures.orgCMELectures.org 110110 165165

Pediatrix UniversityPediatrix University 110110 165165

Audio DigestAudio Digest 7373 146146

Amer Soc Clin Path Check SampleAmer Soc Clin Path Check Sample 145145 145145

NEJM Weekly CME ProgramNEJM Weekly CME Program 140140 140140

BioCritiqueBioCritique 271271 135135

JAMA & ArchivesJAMA & Archives 130130 130130

MedRisk OnlineMedRisk Online 2727 127127

University of WisconsinUniversity of Wisconsin 6262 126126

ACP Medicine Online VersionACP Medicine Online Version 11 120120

Amer Acad Ped Self AssessmentAmer Acad Ped Self Assessment 33 120120

Epocrates Mobile CMEEpocrates Mobile CME 120120 120120


The Largest Sites Dec 2006 - 3The Largest Sites Dec 2006 - 3Name of SiteName of Site No. of ActivitiesNo. of Activities No. of HoursNo. of Hours

Johns Hopkins Adv Study JournalJohns Hopkins Adv Study Journal 3636 117117

American Psychiatric AssociationAmerican Psychiatric Association 1717 116116

Amer Acad Peds Other CoursesAmer Acad Peds Other Courses 1414 114114

Children’s Minnesota Grand RoundsChildren’s Minnesota Grand Rounds 110110 110110

Washington Univ St LouisWashington Univ St Louis 106106 110110

Anesoft Medical SimulationAnesoft Medical Simulation 66 106106

EMed Home Concert programEMed Home Concert program 33 105105

DiabetesConnect.orgDiabetesConnect.org 9999 103103

The heart.orgThe heart.org 100100 100100


Fee Structure – Free SitesFee Structure – Free Sites

There has been a leveling off in the There has been a leveling off in the number of sites offering free CME – from number of sites offering free CME – from 177 sites (70%) to 168 sites (59%) in 177 sites (70%) to 168 sites (59%) in December 2006.December 2006.

There has been a similar leveling off in the There has been a similar leveling off in the number of free credit-hours – from 5075 number of free credit-hours – from 5075 hours (20%) in June 2005 to 5740 (21%) hours (20%) in June 2005 to 5740 (21%) in December 2006.in December 2006.


Fee Structure – Pay for Credit SitesFee Structure – Pay for Credit Sites

There has been very little change in the There has been very little change in the median fee for a credit hour. The bulk of median fee for a credit hour. The bulk of the fee instruction (70-80%) continues to the fee instruction (70-80%) continues to cost $5 to $15 per credit hourcost $5 to $15 per credit hour


Fee Structure by Site Dec 2006Fee Structure by Site Dec 2006Dominant or Average FeeDominant or Average Fee Number of SitesNumber of Sites % of Sites% of Sites

FreeFree 168168 5959

<$5 per hour<$5 per hour 1515 55

$5 per hour$5 per hour 88 33

$6-9 per hour$6-9 per hour 1414 55


$11-14 per hour$11-14 per hour 44 11


$16-19 per hour$16-19 per hour 33 11


$21-24 per hour$21-24 per hour 44 11


>$25 per hour>$25 per hour 1010 33


Hourly Fee Structure Dec 2006Hourly Fee Structure Dec 2006Dominant or Average FeeDominant or Average Fee No of HoursNo of Hours % of Hours% of Hours

FreeFree 57405740 2222

<$5 per hour<$5 per hour 12031203 55

$5 per hour$5 per hour 1004210042 3838

$6-9 per hour$6-9 per hour 24482448 99


$11-14 per hour$11-14 per hour 7878 11

$15 per hour$15 per hour 43844384 1717

$16-19 per hour$16-19 per hour 304304 11


$21-24 per hour$21-24 per hour 272272 11


>$25 per hour>$25 per hour 230230 11


Financial Support Summary: Financial Support Summary: There has been very little change in There has been very little change in

relative percentages of financial relative percentages of financial support since December, 2001.support since December, 2001.

As the number of free sites increases, As the number of free sites increases, the number of fee sites decreasesthe number of fee sites decreases


Financial Support Dec 2006Financial Support Dec 2006

Source of SupportSource of Support No. of SitesNo. of Sites % of Sites% of Sites

Commercial CompaniesCommercial Companies 152152 5151

University/Medical SchoolUniversity/Medical School 9898 3333

GovernmentGovernment 3333 1111

Medical/Specialty AssociationMedical/Specialty Association 6666 2222

FoundationFoundation 1313 44

User Fees/Partial or CompleteUser Fees/Partial or Complete 118 118 (approximate)(approximate)

4141


Primary Care and Specialty SitesPrimary Care and Specialty Sites

Family Practice and Internal Medicine Family Practice and Internal Medicine content continues to dominate the content continues to dominate the Primary Care sites (about 40% of sites).Primary Care sites (about 40% of sites).

Cardiology, Psychiatry, Infectious Cardiology, Psychiatry, Infectious Disease/HIV, and Oncology content Disease/HIV, and Oncology content appear most frequently (about 20% of appear most frequently (about 20% of sites for each specialty).sites for each specialty).Many sites offer instruction for more than one specialty groupMany sites offer instruction for more than one specialty group


Specialty – Primary Care Dec 2006Specialty – Primary Care Dec 2006

No. of SitesNo. of Sites % of Sites% of Sites

Primary Care SitesPrimary Care Sites

including:including:

Family PracticeFamily Practice 108108 3636

Internal MedicineInternal Medicine 9797 3232

PediatricsPediatrics 3737 1212

Obstetrics/GynecologyObstetrics/Gynecology 2828 99

Multiple Specialties (>6)Multiple Specialties (>6) 3535 1212


Subspecialties Dec 2006Subspecialties Dec 2006

Subspecialty sitesSubspecialty sites Number of SitesNumber of Sites % of Sites% of Sites

including:including:

CardiologyCardiology 2727 99

Infectious Disease/HIVInfectious Disease/HIV 2424 88

PsychiatryPsychiatry 2020 77

OncologyOncology 2020 77

RadiologyRadiology 2020 77

EndocrineEndocrine 1616 55

SurgerySurgery 1313 44

NeurologyNeurology 1212 44

Pulmonary-Critical CarePulmonary-Critical Care 1010 33

GeriatricsGeriatrics 88 33

UrologyUrology 88 33


Sites by Specialty-Dec 2006- OtherSites by Specialty-Dec 2006- Other

36 sites (12%) offer subjects of interest 36 sites (12%) offer subjects of interest to many specialists: ethics, legal, to many specialists: ethics, legal, practice management, risk practice management, risk management, tobacco cessation, management, tobacco cessation, addiction, alcoholism, genetics, basic addiction, alcoholism, genetics, basic sciencescience

Many other specialties are included at 5 Many other specialties are included at 5 or fewer sitesor fewer sites


Five “Different” Sites Dec 2006- IFive “Different” Sites Dec 2006- ICE Medicus CE Medicus has no CME of its own, but offers has no CME of its own, but offers access without fee to about 6100 activities (about access without fee to about 6100 activities (about 9000 hours) produced by 20 content providers. 9000 hours) produced by 20 content providers. Instruction is free.Instruction is free.Doctor’s Guide Doctor’s Guide also has no CME of its own, but also has no CME of its own, but offers descriptions of over 2000 activities (free offers descriptions of over 2000 activities (free and fee) with links to those coursesand fee) with links to those coursesDigiscriptDigiscript contains many hundreds of audio and contains many hundreds of audio and video slide lectures recorded at medical video slide lectures recorded at medical meetings. The yearly charge is $400. Somemeetings. The yearly charge is $400. Some activities offer CME and others do not. The site is activities offer CME and others do not. The site is searchable by medical topic and by sponsoring searchable by medical topic and by sponsoring organization. You may have to pay an additional organization. You may have to pay an additional fee for CME credit by any given sponsor.fee for CME credit by any given sponsor.


Five “Different” Sites June 2005 IIFive “Different” Sites June 2005 II•Challenger now requires subscribers to buy a CDROM for each course. Once you purchase that CD, you have unlimited access to the website corresponding to that course. Thus, it is no longer “pure” online CME; I have included the number of Challenger’s courses and hours in this report for sake of consistency.

• American College of Cardiology Self-Selected CME allows subscribers to earn credits for reading parts of articles of interest.


Email Reminders Dec 2006Email Reminders Dec 2006

It is becoming increasingly common It is becoming increasingly common for the larger sites to send email for the larger sites to send email reminders on request of the users reminders on request of the users about their new courses. At least 55 about their new courses. At least 55 sites are doing this regularlysites are doing this regularly


Types of InstructionTypes of Instruction

There has been little recent change in the There has been little recent change in the proportion of instruction types. (But see my proportion of instruction types. (But see my comments about podcasts and point-of-comments about podcasts and point-of-service models below.) service models below.) Text (with or without graphics) remains the Text (with or without graphics) remains the dominant mode, followed by slide-audio or dominant mode, followed by slide-audio or slide-video lectures, case-based interactive slide-video lectures, case-based interactive and question-and-answer instruction.and question-and-answer instruction.For definitions of these and other types of For definitions of these and other types of online instruction, seeonline instruction, see Types of Online CME Instruction DefinedTypes of Online CME Instruction Defined


Types of Instruction Dec 2006-ITypes of Instruction Dec 2006-I

Instruction TypeInstruction Type Number of SitesNumber of Sites % of Sites% of Sites

Text onlyText only 8686 2929

Text-and-graphicsText-and-graphics 6565 2222

Slide-audioSlide-audio 6767 2222

Slide-videoSlide-video 5656 1919

GuidelinesGuidelines 55 22

Question-and-answerQuestion-and-answer 1010 33

Case-Based-InteractiveCase-Based-Interactive 5757 1919


Types of Instruction Dec 2006-IITypes of Instruction Dec 2006-II

Instruction TypeInstruction Type Number of Number of SitesSites

% of Sites% of Sites

CorrespondenceCorrespondence 44 11

GamesGames 44 11

JournalJournal 1818 66

Journal with multiple subjectsJournal with multiple subjects 1212 44

Board Review/Self-AssessmentBoard Review/Self-Assessment 55 22

Streaming VideoStreaming Video 1414 55

Self-Directed Search (POS)Self-Directed Search (POS) 33 11

Text-AudioText-Audio 55 22

Pod castPod cast 55 22


More about Question & Answer InstructionMore about Question & Answer Instruction

Only 10 sites (3%) feature Q&A, BUT the number of hours is relatively large (3545)Challenger - 2800 hoursTheAnswerPage – 300 hoursAm Acad Pediatrics Self-Assessment – 120 hoursEMedHome Concert – 105 hoursAm Acad Orthopedic Self-Assessment – 75 hoursOrthopedics Hyperguide – 50 hoursEcore Family Practice – 40 hoursMedical Letter – 26 hoursMedical Education Opportunities – 20 hoursInteractive Testing in Psychiatry – 7 hours

Total about 3545 hours (13 % of all CME hours)


Sites I Could Not ViewSites I Could Not View

There are a number of proprietary sites, e.g., staff model HMOs, There are a number of proprietary sites, e.g., staff model HMOs, like Kaiser-Permanente, where access to instruction is limited like Kaiser-Permanente, where access to instruction is limited to staff members of that organization. Those sites are not to staff members of that organization. Those sites are not reviewed in this report.reviewed in this report.


PodcastsPodcasts

I only counted five sites offering podcasts, I only counted five sites offering podcasts, but I may have missed some sites that but I may have missed some sites that added podcasts after my visitadded podcasts after my visit

I believe that podcasting will catch on I believe that podcasting will catch on quickly because the technology is easy to quickly because the technology is easy to apply and because most younger doctors apply and because most younger doctors and many older ones have I-Pods or other and many older ones have I-Pods or other portable playersportable players


Point of Care/Self Study Point of Care/Self Study

I counted only three sites offering “Point of I counted only three sites offering “Point of Care” CME, but I believe some have been Care” CME, but I believe some have been added since my count.added since my count.

I know that some providers (Skolar, I know that some providers (Skolar, MerckMedicus) have given up the effortMerckMedicus) have given up the effort

Time will tell; it’s a great idea, but may be Time will tell; it’s a great idea, but may be too awkward to use in practicetoo awkward to use in practice


Sites that have closedSites that have closed

About 44 sites offering about 800 credit About 44 sites offering about 800 credit hours disappeared between July 2005 hours disappeared between July 2005 and November 2006and November 2006

In about half the cases, this was planned In about half the cases, this was planned because credit expiredbecause credit expired

In the other half, the site disappeared, In the other half, the site disappeared, sometimes with an explanation and sometimes with an explanation and sometimes withoutsometimes without


CME Participation by Location Based on CME Participation by Location Based on ACCME Figures for 2005ACCME Figures for 2005

Live meetings and conferences accounted for 52% Live meetings and conferences accounted for 52% of “physician-registrants”of “physician-registrants”

Home study CME (“enduring materials”) and Home study CME (“enduring materials”) and journals accounted for 30% of physician-registrantsjournals accounted for 30% of physician-registrants

Online CME accounted for about 18% of physician-Online CME accounted for about 18% of physician-registrantsregistrants


Physician Usage of Online CMEPhysician Usage of Online CME

Physician usage of online CME is increasing, and Physician usage of online CME is increasing, and now accounts for about 18% of all CME now accounts for about 18% of all CME According to ACCME:According to ACCME:1997: 1997: 13,115 physician-registrants (0.34%)13,115 physician-registrants (0.34%)1998: 37,879 physician-registrants (1.03%)1998: 37,879 physician-registrants (1.03%)1999: 79,536 physician-registrants (1.79%)1999: 79,536 physician-registrants (1.79%)2000: 181,922 physician-registrants (3.57%)2000: 181,922 physician-registrants (3.57%)2001: 230,055 physician-registrants (4.44%)2001: 230,055 physician-registrants (4.44%)2002: 329,110 physician-registrants (6.08%)2002: 329,110 physician-registrants (6.08%)2004: 895,120 physician-registrants (14%)2004: 895,120 physician-registrants (14%)2005: 1,368,335 physician-registrants (18%)2005: 1,368,335 physician-registrants (18%)


Changes and Trends IChanges and Trends I

There is a gradual upward trend in the numbers There is a gradual upward trend in the numbers of sites, courses and hours (about 5% increase of sites, courses and hours (about 5% increase over the past 18 months)over the past 18 months)Some of that upward trend is “new”; some is Some of that upward trend is “new”; some is accounted for by counting sites not previously accounted for by counting sites not previously found; about 44 sites offering about 800 hours found; about 44 sites offering about 800 hours have discontinued operationhave discontinued operationThere has been a small increase in the number of There has been a small increase in the number of free CME hours (5740 vs. 5074) over the 18 free CME hours (5740 vs. 5074) over the 18 months. There has been little change in the months. There has been little change in the specialty groups targeted, types of instruction or specialty groups targeted, types of instruction or the sources of financial support.the sources of financial support.


Changes and Trends IIChanges and Trends II

Number of physician-registrants for online CME Number of physician-registrants for online CME went up from went up from 181,922 (3.57%) in 2000 to 230,055 181,922 (3.57%) in 2000 to 230,055 (4.44%) in 2001 to 329,110 (6.08%) in 2002 to (4.44%) in 2001 to 329,110 (6.08%) in 2002 to 899,390 (14%) in 2004 to 1,368,335 (18%) in 2005.899,390 (14%) in 2004 to 1,368,335 (18%) in 2005.

The number of physicians registering for online The number of physicians registering for online CME has tripled in the past three years.CME has tripled in the past three years.


Why is Online CME use Still So Low? IWhy is Online CME use Still So Low? I

Pretty soon I hope to eliminate the ”Why is Online Pretty soon I hope to eliminate the ”Why is Online CME Use so low?” portion of this report.CME Use so low?” portion of this report.My points about the “low” use of Online CME are My points about the “low” use of Online CME are still pertinent, BUT much less so than just a few still pertinent, BUT much less so than just a few years ago:years ago:Some physicians are still uneasy with computers Some physicians are still uneasy with computers and the Internet and the Internet Some physicians are unaware of online CME or don’t Some physicians are unaware of online CME or don’t know how to find itknow how to find itMuch live CME, especially at the hospital, is Much live CME, especially at the hospital, is convenient, free and offers collegial interactionconvenient, free and offers collegial interactionMany doctors still find attending their yearly Many doctors still find attending their yearly specialty meeting satisfying and sufficientspecialty meeting satisfying and sufficient


Why is Online CME Use Why is Online CME Use Still Still So Low? IISo Low? II

These observations remain true, BUT, again, These observations remain true, BUT, again, to a lesser extent tan in past years:to a lesser extent tan in past years:A series of “gates” for the user to pass A series of “gates” for the user to pass throughthroughNavigation: Download and install plug-insNavigation: Download and install plug-insRegistration hassleRegistration hassleFear of giving out license, DEA, credit cardFear of giving out license, DEA, credit cardPaying in advance for content you can’t viewPaying in advance for content you can’t viewGet content free, leave without payingGet content free, leave without payingEach site has a different procedure and Each site has a different procedure and passwordpassword


Why Choose One Online CME Site Over Why Choose One Online CME Site Over Another?Another?

““Look and Feel” Look and Feel” Your specialty’s “official” siteYour specialty’s “official” sitePrice (lower is better; free is best)Price (lower is better; free is best)Preference for Type of InstructionPreference for Type of InstructionEmail reminders (the more frequent the better)Email reminders (the more frequent the better)The CME is part of a larger medical site which offers The CME is part of a larger medical site which offers additional services for doctors (“one-stop-additional services for doctors (“one-stop-shopping”)shopping”)Help with CME reportingHelp with CME reportingRecommendation by colleagues, medical groupRecommendation by colleagues, medical groupSpecial arrangements with physician groupSpecial arrangements with physician group


What do Physicians Want?What do Physicians Want?

Do physicians really want online CME?Do physicians really want online CME?

(I believe that, with usage now at 18%, the (I believe that, with usage now at 18%, the answer is YES)answer is YES)

What do they like and dislike?What do they like and dislike?

(According to most studies, lectures are (According to most studies, lectures are still the preferred mode of instruction) still the preferred mode of instruction)


A Long Term SolutionA Long Term Solution

I believe that:Eventually, CME will be integrated with the physician’s daily practice lifeSystems will be developed which allow a computer program to “know” when a physician is making a mistake or needs additional informationThe system will present instruction on the spot to help the physician do the right thing


Other Problems to SolveOther Problems to Solve

Another problem will be to prove that a given CME Another problem will be to prove that a given CME activity actually improves physician performance.activity actually improves physician performance.

For now, CME providers and evaluating groups will For now, CME providers and evaluating groups will need to settle for some lesser measure, such as the need to settle for some lesser measure, such as the difference in scores between pre-tests and post-difference in scores between pre-tests and post-tests, or statements by “experts” that the course will tests, or statements by “experts” that the course will correct the deficiency.correct the deficiency.


Opportunities for ResearchOpportunities for Research

More sophisticated (and expensive) methods of More sophisticated (and expensive) methods of evaluation exist, such as reviewing physician charts evaluation exist, such as reviewing physician charts or interviewing patientsor interviewing patients

This is a great opportunity for research. This is a great opportunity for research.


Conclusions IConclusions I

The number of online CME activities and credits is The number of online CME activities and credits is growing rapidly. Online CME is becoming nicer to growing rapidly. Online CME is becoming nicer to look at, with more graphics, lots more audio and look at, with more graphics, lots more audio and video, and a bit more interactive programmingvideo, and a bit more interactive programming


Conclusions IIConclusions II

The percentage of CME hours earned online has risen The percentage of CME hours earned online has risen to about 18%to about 18%

Barriers to usage are coming downBarriers to usage are coming down

There is very little proof that any kind of standalone There is very little proof that any kind of standalone CME, whether live, home study or online, and regardless CME, whether live, home study or online, and regardless of mode of instruction, is useful in changing physician of mode of instruction, is useful in changing physician practicepractice

Results of most studies indicate that a coordinated set of Results of most studies indicate that a coordinated set of educational interventions will be needed to accomplish educational interventions will be needed to accomplish behavior changebehavior change


Conclusions IIIConclusions III

The future lies in the integration of medical practice, The future lies in the integration of medical practice, quality assessment and user-specific CMEquality assessment and user-specific CME

The challenges and opportunities are greatThe challenges and opportunities are great


Important URLsImportant URLs

Master’s thesis: Master’s thesis: www.cmelist.com/mastersthesis/www.cmelist.com/mastersthesis/

My home page: My home page: www.cmelist.comwww.cmelist.com

Online CME list: Online CME list: www.cmelist.com/list.htmwww.cmelist.com/list.htm

Definitions of types of online CME instruction: Definitions of types of online CME instruction: www.cmelist.com/Instruction_Types_defined.htmwww.cmelist.com/Instruction_Types_defined.htm

ACCME Annual Report 2005ACCME Annual Report 2005


Questions or Comments?Questions or Comments?

Send email to Send email to [email protected]@netcantina.com

Bernard Sklar, MD: Online Continuing Medical Education December 2006 Online CME – An Update Review...

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