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eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
eCME Presentation CBI Grants Meeting East Coast 2009
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eCME Presentation CBI Grants Meeting East Coast 2009

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  • 1. Presented to: 4 th Annual Forum on Educational Grants for the Bio/Pharmaceutical Industry September 15, 2009 Physicians Learning Online How eCME Plays a Role in Medical Education
  • 2. Disclosures <ul><li>William A. Mencia, MD </li></ul><ul><li>VP, Medical Affairs </li></ul><ul><li>Med-IQ </li></ul><ul><li>Med-IQ is an accredited medical education company </li></ul><ul><li>Med-IQ receives commercial support in the form of independent educational grants </li></ul><ul><li>Views/opinions are my own and not those of Med-IQ or its employees </li></ul>
  • 3. Today’s Goals <ul><li>1. What is eCME? </li></ul><ul><li>2. What is the role of eCME in medical education? </li></ul><ul><li>3. What is the educational value of eCME? </li></ul>
  • 4. Our eCME Mission <ul><li>Mission </li></ul><ul><li>As educators we wish to deliver education that brings measurable change in competency with the goal of improving performance and patient outcomes </li></ul><ul><li>Challenge </li></ul><ul><li>Create e-based education that is interesting, timely, demonstrates value, and is cost effective. </li></ul>
  • 5. Our eCME Mission?
  • 6. Our eCME Mission? <ul><li>Mission </li></ul><ul><li>As educators we wish to deliver education that brings measurable change in competency with the goal of improving performance and patient outcomes </li></ul><ul><li>Challenge </li></ul><ul><li>Create education that is interesting, timely, demonstrates value, and is cost effective. </li></ul>
  • 7. <ul><li>When we say eCME, what does that mean? </li></ul><ul><ul><li>Platforms: </li></ul></ul><ul><ul><ul><li>Computer-based instruction </li></ul></ul></ul><ul><ul><ul><li>Monographs / newsletters (html / pdf) </li></ul></ul></ul><ul><ul><ul><li>Websites </li></ul></ul></ul><ul><ul><ul><li>Case-based engines </li></ul></ul></ul><ul><ul><ul><li>Performance improvement </li></ul></ul></ul><ul><ul><ul><li>Mobile </li></ul></ul></ul><ul><ul><ul><li>Podcasts </li></ul></ul></ul><ul><ul><ul><li>Blogs </li></ul></ul></ul><ul><ul><ul><li>Social networking??? </li></ul></ul></ul><ul><ul><li>Live or enduring </li></ul></ul><ul><ul><li>Didactic or practice based </li></ul></ul><ul><ul><li>Passive or Interactive learning </li></ul></ul><ul><ul><li>Synchronous or asynchronous communication </li></ul></ul>
  • 8. What We Know About eLearning <ul><li>Many physicians report that the internet directly influences their clinical decision-making 1,2 </li></ul><ul><li>Wutoh 3 and Curran 4 showed equivalency between live and e-based activities in terms of knowledge gain </li></ul><ul><ul><li>Limited data regarding change in clinical practice / patient outcomes </li></ul></ul><ul><ul><li>Cook, Casebeer, and Lam-Antoniades – have studied this impact </li></ul></ul><ul><li>Changing the face of access to the physician learner </li></ul><ul><ul><li>In 2008, 300 Websites offered over 16,000 CME activities 5,6 </li></ul></ul><ul><ul><li>Easily accessible, available 24/7 </li></ul></ul><ul><ul><li>Can increase learner’s engagement in the education 7 </li></ul></ul><ul><ul><li>Offers ability to navigate to relevant research information 7 </li></ul></ul><ul><li>Creative CME platforms that employ recognized learning principles </li></ul><ul><ul><li>Enhance the learning environment / promote participation </li></ul></ul><ul><li>Podichetty VK, et al. Postgrad Med J. 2006;82:274-279. </li></ul><ul><li>Bennett NL, et al. J Contin Educ Health Prof. 2004;24:31-38. </li></ul><ul><li>Wutoh R, et al. J Contin Educ Health Prof . 2004;24:20-30. </li></ul><ul><li>Curran V, et al. Acad Med . 2006;81(suppl):S30-S34. </li></ul><ul><li>Sklar B: Continuing medical education list. [http://www.cmelist.com/list.htm]. </li></ul><ul><li>Casebeer L, et al. BMC Medicine . 2008;6:37-44. </li></ul><ul><li>Harden RM. J Contin Educ Health Prof. 2005;25:43-51. </li></ul>
  • 9. Impact of eLearning <ul><li>Cook et al. JAMA. 2008;300:1181-1196. </li></ul><ul><ul><li>Meta-analysis of 201 published studies comparing eLearning to no intervention or non-Internet intervention </li></ul></ul><ul><ul><li>Effect measured in terms of knowledge, skills, changes in behavior, and patient care </li></ul></ul><ul><ul><li>Internet-based learning strong positive impact vs. non-intervention </li></ul></ul><ul><ul><li>Similar effectiveness to non-Internet instruction </li></ul></ul><ul><li>Lam-Antoniades et al. J Contin Educ Health Prof . 2009;29:44-51. </li></ul><ul><ul><li>Smaller review of 15 published studies comparing eLearning to no intervention or non-Internet intervention </li></ul></ul><ul><ul><li>eLearning stronger results than lecture or small-group interactive interventions </li></ul></ul><ul><ul><li>Multi-component eCME effective in changing practice patterns </li></ul></ul><ul><ul><li>Interventions based on flat text showed limited effectiveness </li></ul></ul><ul><ul><li>No activities focused on impact on patient outcomes </li></ul></ul><ul><li>Casebeer et al. BMC Medicine. 2008;6:37-44. </li></ul><ul><ul><li>Internet-based case vignettes improve physicians ability to make evidence-based clinical choices </li></ul></ul><ul><ul><li>Provides valuable insights on future research in eLearning </li></ul></ul>
  • 10. Is eCME Compatible with Learning Theories <ul><li>Adult Learning (Andragogy) </li></ul><ul><ul><li>Knowles theory; adults self-directed, responsible for their decisions, learn experientially, approach learning as problem-solving, and learn best when topic relates to practice. </li></ul></ul><ul><li>Behavioral Learning </li></ul><ul><ul><li>Changes behavior; challenging and requires reinforcement over time. Focuses on controlling physician performance through external stimuli: audits, feedback, reminder systems, monitoring systems. </li></ul></ul><ul><li>Cognitive Flexibility </li></ul><ul><ul><li>Emphasis is on a case study approach involving context-dependent and realistic situation that apply directly to medical education. Helps develop decision-making, reasoning, and problem-solving skills. </li></ul></ul>
  • 11. Is eCME Compatible with Learning Theories (cont’d) <ul><li>Communities of Practice </li></ul><ul><ul><li>Formed by people who share a concern, problem, or interest that interact on an ongoing basis to increase their knowledge and expertise. </li></ul></ul><ul><li>Experiential Learning </li></ul><ul><ul><li>Commonly referred to as “see one, do one, teach one”. This requires numerous skills including auditory/visual, communication, and manual skills for procedures or techniques. Developing experiential learning interventions requires creativity and innovation on the part of the planners. </li></ul></ul><ul><li>Knowledge Translation </li></ul><ul><ul><li>Timely and effective process of integrating best evidence into the routine practices of patients, practitioners, health care teams and systems, in order to effect to optimal healthcare outcomes and to optimize health care and health care systems. </li></ul></ul><ul><li>Reflective Practice </li></ul><ul><ul><li>At an individual level, reflection is combination of new information with personal awareness to achieve understanding. </li></ul></ul>
  • 12. Stretching Exercise <ul><li>An educational need is identified for primary healthcare professionals to provide comprehensive care of patients with diabetes including: lifestyle modification strategies, SMBG, initiation of therapy, transition to insulin, management of comorbidities, prevention of complications, and referrals management with other specialists. </li></ul><ul><li>If an eCME strategy were to be designed to cover the above, what are the key components of such a grant request… </li></ul><ul><li>Providers perspective </li></ul><ul><li>Commercial supporters perspective </li></ul>
  • 13. Key Challenges <ul><li>For the Provider </li></ul><ul><li>Heavy competition for eCME attention </li></ul><ul><li>Participation/reach </li></ul><ul><li>Keeping costs down </li></ul><ul><li>Creating interactivity, engaging the learner </li></ul><ul><li>Demonstrating that design can actually impact physician behavior </li></ul><ul><li>Data – measuring practice change and patient outcomes </li></ul><ul><li>For the Supporter </li></ul><ul><li>Reaching the right audience </li></ul><ul><li>Meaningful participation </li></ul><ul><ul><li>In number </li></ul></ul><ul><ul><li>In duration of participation </li></ul></ul><ul><li>Does educational design match stated goals </li></ul><ul><li>Budget </li></ul><ul><li>Outcomes strategy specific to design </li></ul><ul><li>Data – measuring practice change and patient outcomes </li></ul>
  • 14. Summary <ul><li>eCME can be composed of different types of educational platforms </li></ul><ul><li>More healthcare providers seeking Internet as primary source for information and education </li></ul><ul><li>eLearning is an effective tool for increasing knowledge and competency, changing practice behavior, and improving patient outcomes </li></ul><ul><li>Learning theory does not need to take a backseat </li></ul><ul><li>Multicomponent, interactive models better than flat, text-based education </li></ul>
  • 15. &nbsp;

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