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Advancing Continuing Medical Education.

Physicians are facing enormous pressure in a rapidly changing health care environment and look to the education community to help them stay current with advances in medicine and provide optimal care. Most clinicians feel increasing time constraints as they seek to balance professional and family responsibilities and seek efficiency in their learning. Clinicians expect highquality, relevant, and effective education that is independent of commercial bias and expect that when possible their participation meets the variety of expectations of the state licensing boards, specialty certification, hospital credentialing, and other regulatory requirements. Accredited continuing medical education (CME) has a key role in supporting physicians’ continuing professional development. CME can meaningfully change attitude, knowledge, skills, and performance; the effects of education on patient outcomes has been more difficult to demonstrate because of the complexity of the intervening variables.1 The Accreditation Council for Continuing Medical Education (ACCME), its accreditation criteria, and the CME delivered by accredited organizations have evolved substantially over the last 15 years. Although educational planners now base their activity construction and pedagogy on assessment of needs that underlie problems in practice and are required to measure outcomes of their educational interventions, much of the evolution may not be visible to the learner. Often, CME has been considered to encompass only lectures and knowledge but now increasingly is designed to improve skills and performance, and many activities aim to specifically affect patient outcomes. Of the more than 140 000 learning activities offered by accredited organizations each year, approximately 60% are designed to achieve improvements in physician performance, with 40% measured for those changes. Thirty percent are designed to improve patient outcomes; 13% measure those changes.2 Despite these improvements, many clinicians express frustration at the pace of change in CME. Accredited CME could be more flexible and innovative in meeting both practice-based needs and public health imperatives. CME can and should offer a rapid response to close competency gaps for practicing physicians and can provide valuable opportunities for quality improvement in clinics and hospitals.3 CME educators should embrace the advances in educational technology to maximize retention using adaptation, repetition, and personalization.