By Michael Gisondi, MD – Stanford University
My department hosted its 19th Symposium on Emergency Medicine in March 2018 on Kauai, Hawaii. The Symposium is a very successful continuing medical education (CME) conference that attracts attendees from the United States, Canada, New Zealand, Australia, and Asia. This was my first opportunity to lecture at our annual conference since returning to Stanford last year, and I spent much of the week reflecting on the question, “What elements make for a great CME conference?”
What is CME?
The Accreditation Council for Continuing Medical Education (ACCME, United States) defines CME as, “educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession.” The ACCME notes that its, “definition of CME is broad, to encompass continuing educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently.”
I asked Dr. Graham McMahon, President and Chief Executive Officer of the ACCME, to describe what makes for a wonderful CME conference experience.
“The best CME programs inspire curiosity, create engagement, deliver impactful, meaningful learning experiences, have opportunities for feedback and deliberate practice, are integrated with mechanisms to reinforce what was learned into practice, and are fun!”, said Dr. McMahon. He continued, “The material must be evidence-based, balanced, and free of commercial influence. Effective education uses intentional design to engage the learner in the effortful work of learning and changing without being administratively complex. Furthermore, an effective conference incorporates a variety of educational strategies that encourage dialogue and collaboration among peers, such as case studies, simulation, small-group problem-solving, and reflective exercises.” Graham McMahon, ACCME
Measuring the Value of CME in the United States
Government licensing agencies, hospital credentialing committees, and specialty certification boards mandate physicians to document on-going CME, often measured in ‘credit hours’ commensurate with the time spent in the educational activity. CME credits are accrued during time spent away from direct patient care and often at great financial cost. Taken in total, the CME Enterprise generates over $2.5 billion dollars in revenue in the US for 1,800 CME providers and their partner organizations who deliver sponsored educational programs. (Source, ACCME Annual Report) In 2016, a total 27 million healthcare providers participated in 1 million CME credit hours of instruction offered through 159,000 educational activities. The indirect costs of 27 million healthcare workers spending 1 million educational hours away from direct patient care are difficult to estimate, but also must be considered when assessing CME value.
Physicians commonly seek CME in one of five ways: (1) educational activities sponsored by their employer (e.g, regularly scheduled series), (2) journal or online educational materials (e.g., articles with question banks), (3) professional society meetings that offer CME credit hours to attendees, (4) special training or certification courses (e.g., Advanced Trauma Life Support), and (5) destination courses that combine travel or family vacations with educational content. Of these, regularly scheduled series such as local ‘grand rounds’ lectures are the most common type of CME, with the combination of enduring materials from journal or online sources a close second.
Various CME courses, #3-5 in my list above, result in approximately 2 million hours of physician instruction. These courses create choice for the educational marketplace in which the physician is a consumer, with the freedom to choose where to spend time and money. Physicians expect to see a return on their investment, but measuring the value of CME courses is more difficult than you might think. CME providers must remain accredited by the ACCME and therefore these institutions focus their metrics of success on the achievement of educational objectives. Education is the central mission of CME and obviously learning objectives must be met. However, consumers of any product care as much about the experience of obtaining or owning a product as they do about the purchased product itself. That’s Marketing 101. Therefore, physician consumers will balance both experience and education when deciding if the time and money spent on a CME activity was worth the expense.
Designing for Audience Experience
This brings me back to the title of this post, “The Experience of the Audience.” Curriculum design is more than writing learning objectives, it includes the design of the educational experience itself. Measures of experience include convenience, enjoyment, relationships, entertainment, engagement, caring, belonging, comfort… the list goes on. I asked Stanford Symposium attendees and course faculty members the same question I asked Dr. McMahon, “What makes for a wonderful CME conference experience?” Several instructive quotes are used with permission, with key design elements highlighted throughout.
“We can obtain the raw information online. But what makes an on-site conference experience uniquely valuable is the interpersonal interactions among both the attendees and the faculty. The opportunity to share experiences and to learn together with our colleagues, allows us to recharge our intellectual and our professional ‘batteries’. That experience and renewed enthusiasm cannot be obtained online.” Michael Bresler, Stanford
“A great CME conference is made up of eager conference participants who are actively engaged in an educational exchange with approachable, interesting faculty members. Seeing one-on-one, in-person interactions between audience members who are meeting each other, exchanging ideas, and learning together is something that doesn’t happen online.” Jan Shoenberger, University of Southern California (Guest Symposium Faculty)
“Other than the obvious – the fantastic venue and hotel – the format of the course matters. I enjoy short, engaging lectures with pertinent content. One of the best aspects: attendees from Canada, Australia, and elsewhere allow for networking with providers who have a different perspective on practice.” Nina Elliott, Harrisburg, Pennsylvania
“State the objectives and expectations on the brochure, with a schedule of diverse speakers that can meet those objectives while balancing learning and fun; Provide something extra special for enjoyment; Make attendees feel special, so that they know the organizers care about their experience.” Laleh Gharahbaghian, Stanford
“Location doesn’t hurt; The variety of presenters, especially for those just out of residency; I listen to a lot of podcasts, so there are people I recognize from the podcast community; And there is a large variety of content targeted toward the trenches vs. just esoteric literature — it is generalizable.” Liz Roeber, Fargo, North Dakota
“Leaving the conference feeling inspired. It’s usually not about what I learned at the conference, but feeling more energized and rejuvenated when I to go back to work.” Viveta Lobo, Stanford
“I’m not looking for didactics. Really it is the practical application. I can look things up on Up to Date, but here you can talk to a person who actually uses [the material]. Someone is putting all of the practical applications together.” R. Wayne Fukimo, Waimea, Hawaii
“An engaging and inquisitive audience combined with a relaxing setting makes for the ideal learning experience.” Matthew Strehlow, Stanford
“I believe the best conferences feature diverse speakers and combine entertainment with education.” Jessica Mason, UCSF Fresno (Guest Symposium Faculty)
“It was great reconnecting. I liked the clinical pearls, such as efficient treatment of bleeding fingertip avulsions or appropriate opioid dosing based on Cmax. Helping me improve my efficiency and quality of care is always welcome!” Buck Wallace, Sheridan, Wyoming
If you are planning a CME conference, remember the little things that have a big impact on experience. Schedule the day to maximize learning activities and destination attractions. Mix hands-on workshops with large group presentations. For didactic sessions, ensure comfortable seating, good lighting, excellent sound quality, and large font on well-designed slides. International conferences require speaker training and sometimes translation services. Ample coffee, healthy meals and snacks, and reliable WiFi are a must.
Design CME conferences with the needs of the audience in mind. The best CME courses achieve educational objectives while providing a high-quality consumer experience. Must-have design elements are those that enhance learner engagement, promote participant interactions, identify practical applications of the course material, and ensure enjoyment for the learner.
Feature image provided by the author