Conference on Education, Informatics and Cybernetics: icEIC 2011

Conference on Education, Informatics and Cybernetics: icEIC 2011 (www.2011conferences.org/iceic), to be held on November 29th - December 2nd, 2011 in Orlando, Florida, USA

Relationships between Education/Training and Information/Communication Technologies (ICT) are continuously increasing, sometimes in unexpected ways, with original ideas, innovative tools, methodologies and synergies.

Education (cognitive development) and training (performance in a specific skill) are different but highly related notions. They have common means to achieve their objectives as it is the case of, for example, teaching, learning and e-learning. ICT are supporting both of them with an increasing frequency and effectiveness in more and more activities and domains.

Accordingly, the main purpose of icEIC 2011 Organizing Committee is to bring together researchers, innovators, professionals and practitioners from the three areas in order to 1) provide an intellectual platform to share their knowledge and experiences in a multi- and inter-disciplinary intellectual climate, 2) support the bridging process between education/training and ICT communities, and 3) foster interdisciplinary communications among the related domains.

More information here: www.2011conferences.org/iceic

Do physicians know what they don't know?

I work in the field of continuing medical education or CME. I always find it interesting to survey physicians and to study whether they really know what they don't know. In other words, are most physicians aware of their knowledge gaps or are they simply too busy to think about what they may not know? Some physicians recognize and admit that they may not be current on the latest practice guidelines for a specific disease or condition. This is especially true when new clinical breakthroughs are announced at major medical meetings.

So, how do we tell physicians about their own knowledge gaps? After all, they're so busy and many of them don't participate in surveys or continuing medical education activities about certain topics. How do we tell them that they don't know something? Do patients need to play a more proactive role in printing out some of the latest abstracts so they can bring them for their physicians? When my dad went to see his endocrinologist, he always had 3 or 4 articles that he would print and show his physician. Most of the time, his physician was grateful for the information. I think my dad enjoyed the fact that he could teach his doctor something about medicine.

Given that physicians are often so busy with their clinical workload, how do they stay current on all the latest developments that occur in the complex world of health care?  I talk about this with my wife all the time since she's a busy family physician.

Evolving continuing medical education requirements

Every year, some states seem to change their requirements related to continuing medical education (CME) and physician re-licensure (license renewal). You can find the 2010 requirements for each state by clicking on this AMA website link titled, "Continuing Medical Education for Licensure Reregistration." (PDF will open)

If you're a physician, do you live in a state where CME is mandatory? It still amazes me that certain states (like Colorado, Indiana, New York, and Vermont) do not have any CME requirements for re-licensure. Wow! How long will that last? While other states are mandating that physicians complete up to 100 hrs every two years, some are saying that physicians are not required to complete any CME activities. It doesn't really make sense, does it? After all, whether you're a physician in Pennsylvania or New York, you'll still be seeing very similar patients and using the same types of medical and surgical therapies to treat diseases.

As CME requirements continue to evolve, I'm sure we'll look back someday and marvel at the fact that some states had no CME requirements for relicensure.

NAAMECC endorses conduct of code for commercially supported CME

FOR IMMEDIATE RELEASE                        CONTACT: Anna Trott
October 13, 2009                                            NAAMECC: 205-824-7612

NAAMECC ENDORSES CONDUCT CODE FOR COMMERCIALLY SUPPORTED CME

In support of management best practices for certified continuing medical education (CME) activities developed with educational grant support provided by pharmaceutical and other company grant funding, the North American Association of Medical Education and Communication Companies (NAAMECC) today endorsed a new Code of Conduct for Commercially Supported CME.

The new Code was developed by a collection of volunteers with input from accredited and non-accredited CME providers, multiple funding organizations, and pro-bono legal counsel. Officially titled the “Code of Conduct for Commercially Supported CME,” the document addresses appropriate interactions and management practices when commercial interests provide CME grant funding, including:

•    Independence: Providers and commercial interests are reminded to follow all relevant rules, regulations and guidelines, including those promulgated by the ACCME, FDA, and Health and Human Services Office of Inspector General. In addition to supporting full separation of CME grant-making functions from sales and marketing functions within commercial organizations, the Code goes further to state “Providers should not engage in discussions with supporters’ marketing and sales personnel regarding educational priorities, strategies, or grants.”
•    Conflict of Interest (COI) Disclosure and Resolution: Referencing several professional organizations and societies that have outlined specific COI recommendations, the Code states “It is not practical nor realistic to entirely prevent conflict of interest; rather it should be aggressively identified, disclosed, and resolved.”
•    Bias: To promote quality control, the Code advises all accredited and non-accredited education providers to “have mechanisms in place to identify potentially biased content and to ensure that all patient care recommendations are evidence based and in the best interests of the public.”
•    Financial Policies: The Code addresses budgeting, payment terms, and appropriate use of funds, including the development and use of Fair Market Value (FMV) calculations for “all expenses including faculty honoraria and include estimates of these costs at FMV in all budgets.” 

In endorsing the Code of Conduct for Commercially Supported CME, the NAAMECC Board encouraged other organizations dedicated to CME best practices to review and endorse the Code for the benefit of their members and affiliates.

About NAAMECC:
NAAMECC is the leading advocacy and education organization for medical education companies and their educational partners. NAAMECC provides member companies and the medical education professionals they employ with cutting-edge information and expert contacts to achieve success in CME.

Should CME be mandatory for physicians?

In the world of rapidly changing medicine, how often should physicians participate in continuing medical education (CME)? Did you know that some states actually don't require physicians to complete any CME activities? Most states require a certain number of CME credits for relicensure, but most state medical boards are not actually checking to ensure that physicians are up-to-date on their CME requirements. They simply have a box that you check that indicates that you have met the CME requirements for relicensure. In the event that you were audited, you would need to show proof of your CME participation.

What's especially interesting is that certain states require CME in specific topic areas such as:

• medical ethics
• HIV/AIDS
• risk management
• pain management
• cultural competency
• domestic violence
• end-of-life care
• medical error prevention
• bioterrorism
• geriatrics
  
• prescribing controlled substances
• and more

You'll notice that the only topic that relates to a specific diseases is HIV/AIDS. Does it really make sense for every physician to take CME courses in these specific areas? For instance, if I'm a pathologist, do I really need to learn about domestic violence? What if I'm a radiologist?

Well, in my opinion, these CME requirements are reasonable, so as long as physicians don't complain too much, I don't think that state medical boards will be making any significant revisions in the near future. 

Moore's 7 Levels of CME Outcomes Measurements

In the world of certified CME (continuing medical education), outcomes measurements have become a critical component. It is an ACCME (Accreditation Council for Continuing Medical Education) requirement to measure outcomes in all certified CME activities.

Donald E. Moore Jr., PhD from Vanderbilt University School of Medicine has outlined a framework for the assessment of continuous learning and traditionally this has been presented as a pyramid consisting of 6 different levels:

1. Participation
2. Satisfaction
3. Learning
4. Performance
5. Patient health
6. Population health

Moore DE. A framework for outcomes evaluation in the continuing professional development of physicians. In: Davis D, Barnes BE, Fox R, eds. The Continuing Professional Development of Physicians: From Research to Practice. Chicago, Ill: American Medical Association; 2003.

Earlier this year, Moore published a paper titled, "Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities." Here, he makes some modifications to this six-level framework and we now have 7 levels for CME outcomes measurements. The main changes are:

• Level 3 is now broken up to 3A and 3B

• 3A = Declarative knowledge

• 3B = Procedural knowledge

• Competence was a new addition and became Level 4 (shifting everything else up)
• Performance is now Level 5 (used to be Level 4)
• And Level 6 “population health” was renamed “community health”

So, here’s the new 7-level pyramid for CME outcomes measurements:

1. Participation
2. Satisfaction
3. Learning
3A = Declarative knowledge
3B = Procedural knowledge
4. Competence
5. Performance
6. Patient health
7. Community Health

Moore DE Jr, Green JS, Gallis HA. Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities.J Contin Educ Health Prof. 2009 Winter;29(1):1-15.

AAN is in Seattle

The American Academy of Neurology (AAN) is having its 61st annual meeting in Seattle this year. The theme this year is: "Better Practices, Better Outcomes." The meeting began over the weekend (April 25) and will run until May 2. Doctors still love to attend major national meetings to get thier continuing medical education (CME). I love Seattle. In fact, Seattle is probably one of my favorite cities because of all the outdoor activities that are available in that area. Mount Rainier is such a great park and I think I could spend weeks backpacking throughout the Cascades Range.

American Board of Quality Assurance and Utilization Review Physicians

How do you pronounce ABQAURP? It stands for the American Board of Quality Assurance and Utilization Review Physicians. They offer Health Care Quality and Management (HCQM) Certification through an online study course and then a certification exam. Once certified, you can hang a certificate that says, "Diplomate of the American Board of Quality Assurance and Utilization Review Physicians, Inc." The ABQAURP is the only Health Care Quality and Management organization with an exam developed, administered, and evaluated through the National Board of Medical Examiners (NBME). So, you may want to learn more if you have an interest in working in quality improvement, utilization management, managed care, risk management, case management and workers' compensation. 

National Faculty Education Initiative

Have you heard of the NFEI? Well, if you're not very connected in the world of certified CME, then you probably haven't.

The Alliance for CME and Society for Academic Continuing Medical Education (SACME), in collaboration with the Association of American Medical Colleges (AAMC), and endorsed by AHME, launched the National Faculty Education Initiative (NFEI). This program provides online training on the differences between Certified CME and Promotional Activities. Sound basic? Well, you may be surprised to know that many clinicians don't really understand all the rules and regulations concerning certified CME or promotional education.

If you'd like to learn more, then take a look at the website:
http://www.nfeinitiative.org

The World of Medical Education

The world of medical education can be broken down in so many different ways.

First: professional vs. consumer health education

If professional, then: promotional vs. certified continuing education (or certified CME/CE)

Let's talk a bit more about professional health education since we all know about WebMD and Revolution Health.

The world of promotional education is governed by strict FDA guidelines. Plus, don't forget the PhRMA code. There is no off-label discussion within a promotional activity. Also, speakers are recruited directly by the pharma/biotech/device company. The content does not need to be fair-balanced and there is no governing body that certifies those activities for any type of continuing education credit.

In the world of certified CME/CE, the rules are completely different. Here, you can discuss off-label use of medications. As a faculty speaker, you are to have no communications with the pharma/biotech/device company. Also, you don't get paid directly from a drug company. The educational content must be fair-balanced and the ACCME acts as a governing body to provide rules and regulations regarding certified CME (the CE for nurses and pharmacists are governed by other bodies). The PhRMA code has rules regarding CME.

Surprisingly, many healthcare professional are not aware of the distinction between non-certified medical education and certified medical education. Since the rules are constantly changing, it's important to stay updated on the latest guidelines and codes. The PhRMA code just got revised and the ACCME guidelines are constantly in flux.