June 01, 2008
Medical meetings: Is Live CME Still Effective?
The CME experts unanimously agree that, yes, lectures are useful, but educators must combine instructional design with learning objectives to reap maximum benefit.
Research shows that live lectures are the most heavily funded of all CME media and the one most beloved by healthcare professionals. But there remains a need for clarity around their proper use, according to Anthony Iacono, president, Access Medical Network.
Speaking on the subject during a recent MM&M webcast, Iacono cited a 1999 article published in the Journal of the American Medical Association by Dave Davis, MD, where Davis was quoted as saying that didactic lectures were shown not to change physician behavior. Davis recently clarified his comments, suggesting they had been misinterpreted to mean that live lectures don't work. In addition, commercial supporters may at times feel compelled to support live meetings at association events “to show a presence if nothing else.” For these reasons, Iacono said, “it's important not to confuse their role and to discuss how to make them more effective.”
When there is a need to convey basic and new information, lectures can be quite valuable, Hilary Schmidt, PhD, associate VP, medical education, Sanofi-Aventis said during the webcast. “A didactic lecture is likely to play a more significant role in addressing a knowledge gap than a competence or performance gap.”
In the latter cases, additional mediums are also needed (web, print media, podcasting). Schmidt urges that regardless of the medium, educators should include self-reflection and follow-up tactics.
“For example,” she added, “Healthcare professionals might not have the basic knowledge that's required to close a gap. A physician might not screen for depression because they are unaware of the incidence and prevalence of depression in the patient population that they work with. In that case, a lecture would actually be a fairly effective place to address a knowledge gap.”
Jocelyn Lockyer, PhD, director, CME and professional development, University of Calgary, stressed that learning is mediated by the type of intervention and level of interactivity, as well as by the number of participants and number of sessions. Lower numbers of participants and more sessions, of course, yield a higher retention of information.
However, the role of the lecture is not to produce major change.
“For most physicians, it consolidates learning and often validates what they already know,” Lockyer said. “It rarely leads to profound changes. Lectures can be helpful, they're one of the pieces of the puzzle but we as educators really need to think about what our goals and intents are, the educational methods that are available, the learning tasks, and the greater context.”
Schmidt counters that lectures can be “an extremely efficient way of communicating basic and new information.” However, she also stresses that style can make all the difference. “A lecture can put you to sleep. Even the really good ones can be forgotten 24-48 hours after the event.”
Lectures above all should be easily understood, and easy to remember at a time when the information will be most relevant. Injecting interactivity and reflective techniques, as well as follow-up activities that build on the learning, will certainly help drive behavior change.