Challenge Accepted
April 2008
Kathleen Marley-Matts, managing director of Quintiles Medical Education, discusses the challenges and opportunities in providing objective CME programming.
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It’s not out of the question to say that the media-fueled public opinion of the continuing medical education (CME) industry is quite low. The pharmaceutical industry itself, of course, has received some negative media coverage over the last few years. And chief among the media’s focus is pharma’s support of CME. There are more than a handful of stories that focus on the presumption that pharma somehow controls what third-party companies do in terms of CME. As a result, it’s not unusual to find a layperson that has a relatively one-sided view of this important professional activity.
Pharma has responded to these criticisms in the only way that it really could—to revise vital internal processes. So, what used to be a very simple process by which pharma distributed CME grant money has now been turned into a complex process that is generally conducted online without a lot of human contact. It’s a relatively sterile process at this point, particularly in big pharma. Although lessening pharma’s perceived influence on CME activities is important, the end result is troubling because both the pharmaceutical industry and the medical education industry are businesses. And with the paranoia level so high, the business component is what’s largely sacrificed in the public eye. So from the perspective of a CME provider, the challenge is to develop new methods to deliver high-quality medical education, while earning the confidence and trust of physicians and their patients.
Patient-Centered Metrics
At Quintiles, we are working on a model that directly speaks to a deficiency in medical education the Josiah Macy Jr. Foundation pointed out following a November 2007 conference. One of the recommendations resulting from the conference was to use some patient information in the process of educating clinicians. We’ve addressed this by developing a new educational model that takes patient-solicited information and surveys into account, and then folds that information into the learning process for physicians. In essence, it’s disease education that not only draws on clinical data and practical experience, but also takes into account what patients think. Ultimately, we want to approach CME through a new model, as opposed to the staid, accepted paradigm that dominates large-scale CME programs.
The Macy Foundation pointed out the kinds of creative challenges that everybody in this industry should be focused on. For example, we should experiment—and I do mean experiment because it will be a trial-and-error process—with new metrics for assessing the success of CME programs. How can we quantify what we’re doing? And will the grantor actually be satisfied with how we’ve chosen to quantify it? So I envision that as a give-and-take, back-and-forth process, but one that is very important.
Sequential Learning
Everybody on all sides of the equation needs to explore the long-term sequential learning package. You want participants who are not just going to dabble in what you’re doing, but people who are going to dive in and really learn something. And the big questions then become: Is it possible to learn something at one activity? Doesn’t it need to be reinforced? And the answer is probably yes. Repetition is a good thing. So, sequential learning over the long range is something that I believe we’ll move toward on a grand scale. We also can certainly make better use of the Web in offering interactive programs.
We are already working on incorporating dialogue and collaboration as part of our educational methods, an idea that the Macy Foundation touched upon. That’s a critical step that can be accomplished a number of ways. It’s been happening for years at larger meetings and conferences, in which smaller breakout sessions are run concurrently. In this way, the whole event becomes a large, rotational learning opportunity.
So I think we are really trying to find the right point in physicians’ and health care providers’ daily routines to determine the optimal time to educate them. It’s much easier to say, “Well, they’re all going to be at a society meeting in one place, and you know that learning will take place there.” But what the Macy Foundation seems to suggest is that there are many other venues where the learning may have a better opportunity to stick and mean something. The challenge for us as CME providers, therefore, is to continue developing new educational models that are still novel, yet show promise.
Developing new CME models comes with one major caveat—the system and climate in which we operate will most certainly change again. Right now, it’s a world of “What ifs?” It seems that everybody is trying to figure out where the CME industry is going, and what the next step may be. It’s much better, however, to spend your energy on dealing with the current environment and how to elevate the role of CME within this environment. With this in mind, it’s time we start rolling up our sleeves and stop wringing our hands.
The ultimate goal of CME, of course, is to keep physicians aware of what’s going on in biopharmaceutical R&D and what therapies may eventually be available to care for their patients. And there’s really no better way to let them know these things than through an independent educational format.
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