May 08, 2007
MM&M webcast clarifies proper role of CME lectures
To change physician behavior, education providers should move away from “talking-head” live lectures that don’t include interactive elements, said a panel of experts. The panel, speaking during MM&M’s CME webcast last week on the role of the didactic lecture in CME, concurred that live activities have a place within the context of available formats, as long as they are designed properly. “Lectures are an extremely efficient way of communicating basic and new information,” said Hilary Schmidt, PhD, associate VP, medical education, Sanofi-Aventis. But, she added, “style will make a big difference.” An educational activity designed to be interactive, with cases and tactics that cause learners to reflect on their own practice, makes the event “much more likely to effect a change in behavior,” she said. The webcast—titled “Do Live CME Events Still Work?”—was spawned when Tony Iacono, president, Access Medical Network, read Schmidt’s views on didactic lectures in MM&M’s August 2006 cover story. The article paraphrased Schmidt, whose doctorate is in cognitive psychology, as saying, “didactic programs have very minimal impact on physician behavior.” Iacono said he favored a discussion to “help clarify the issue and add some perspective on just where and when didactic formats are useful and on how they can be improved.” About 175 people signed up to hear the discussion (replay available at http://www.mmm-online.com/content/index.php?id=267). To make lectures more effective, Iacono suggested adding interactivity, reflective techniques, serial intervention and follow-up activities. Other types of learning activities may be more appropriate when the goal of the CME is to develop competence and performance. Indeed, the role of the lecture is to predispose physicians toward change, increase knowledge and awareness of issues and consolidate learning, said Jocelyn Lockyer, PhD, a third panelist. She and a colleague recently completed a meta-analysis looking at the impact of CME, published in the March issue of Journal of Continuing Education in the Health Professions. The analysis showed that CME interventions have a small to moderate effect on knowledge, performance and patient outcome. “There is some evidence that courses, even didactic lectures, do contribute to peoples’ learning and change,” said Lockyer, director, CME and professional development, University of Calgary. In choosing an intervention, course designers should consider mediating factors and the learner innovation they want to effect, she said. Schmidt added that finding applications “that are really innovative—where the instructional design is really well matched to the learning objectives,” is the biggest challenge facing commercial supporters today. “There are so many applications that rely heavily on ‘talking-head’ type lectures that don’t include the elements we have been discussing.” Part of the problem is that most CME providers “do not have adult-learning or educational design-savvy employees at this point,” said Iacono.