Good CME practice

Rebecca Aris interviews Dr Edwin Borman

Consultant Anaesthetist and UEMS

In our medical communications focus month we speak with Dr Edwin Borman about what he considers to be good CME practice.

What constitutes good CME practice? We asked Dr Edwin Borman, consultant anaesthetist and secretary general of the Union Europeenne des Medecins Specialistes (UEMS) – the European organisation that represents consultants throughout Europe.

In this interview Dr Borman shares his criteria for good CME practice and what changes he would like to see to the accreditation process.

Interview summary

RA: How have you seen CME accreditation change over the course of your career?

EB: It’s changed profoundly, it used to be the case that accreditation was hardly even considered, and around 20 years ago it was considered that there were some advantages to be had in having some mechanism of confirming the quality of a meeting, and the concept of accreditation increasingly started to be implemented at national level.

It was only in 2001 that at a European level accreditation was introduced at an international level, and since then we’ve seen progressive developments, initially it started only for conferences, and symposia, but in 2008 accreditation was introduced for what are known as e-learning materials, CD-ROMs, DVDs, websites, and more recently we’re now seeing the tightening up of accreditation for live educational events, conferences, symposia, workshops etc.

RA: In your opinion what constitutes good CME practice?

EB: I think the best CME is CME that’s actually focused on improving the quality of care for patients, but in order to achieve that you really do have to go through quite a number of significant steps.

It’s going to be doctors, and changing their practice or reinforcing the good elements of their practice that will now ensure the improvements in the quality and safety of patient care. So my first criterion would be an aim towards improving quality and safety of patients care.

Secondly identifying the needs of the doctors as learners and making sure that the CME will deliver outcomes that will achieve that with the first aim – patient care – in mind.

My third quality criterion is the actual quality of the CME event. Some meetings or  e-learning materials are considerably more interesting and interactive, and develop a degree of enthusiasm in the learners than the more stereotypical old fashioned ones where you just sit in a lecture theatre and you listen to the talking expert up at the front.

So my three criteria would be number one improvement in patient care, number two identifying and addressing the needs of the learner, and three making sure that it’s delivered in an interesting and interactive way.

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“…the best CME is CME that’s actually focused on improving the quality of care for patients…”

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RA: How can the distinction between education and promotion be clarified in CME?

EB: This is an extremely contentious and also remarkably difficult issue. The way that I feel that this can best be addressed is by absolute openness and transparency about the funding mechanisms and about the intent of a CME event.

If the event is clearly identified as being put on by a pharmaceutical company or a medical devices company, it’s perfectly reasonable for doctors to attend, but they really do need to understand that a significant component of that meeting will be promotion.

Having said that the quality of CME frequently may be extremely good, and often we find that many of these meetings are very carefully thought out and do provide very good education. But that’s separate from meetings in which the promoting companies are not involved in terms of establishing the programme for the event, determining who the speakers are, or having any influence on the content. The purely educational meeting would be one in which while it may ultimately have received some funding from a company either pharmaceutical or medical devices, is has very definitely been developed independently of any attempt to influence content or speakers.

RA: Could you please tell me more about the new UEMS criteria?

EB: I would describe the new criteria as a revolutionary change in accreditation of live educational events throughout Europe, largely because for Europe as a whole they introduce criteria that go well beyond what currently occurs in many countries.

For some countries they’ve already reached this level, but it’s about bringing up the general standard as opposed to only making sure that those who are already good deliver at a good standard.

The focus is much more on many of the points that I described earlier around good CME practice, namely that:-

• There is a real focus on the needs of the learner.

• The educational methods are appropriate, interactive and supportive of good learning.

• There is openness and transparency in terms of the funding of the meetings.

• There is independence in terms of the development of the programme, and of the project as a whole.

So in many European countries this will be a significant change.

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“…we’re looking at a continuing evolution in terms of the developments of standards.”

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RA: Finally what changes would you like to see in CME accreditation?

EB: I’d like to see the new criteria for live educational events introduced, and applied throughout Europe. That’s going to be the major challenge for the next five years. Part of that challenge is about raising the general standard.

The second challenge that I will be looking to see achieved is that the need for everyone to improve the quality of CME is accepted, and for everyone to take the elements of openness and transparency seriously.

There is scope for further developments, and what we’ll be looking for. What the UEMS has made absolutely clear is that we’re looking at a continuing evolution in terms of the developments of standards. So probably in around five years’ time we’ll be looking to raise the standards even further, and to encourage even better practice in CME.

RA: Thank you very much for your time Edwin.

EB: Thanks Rebecca.

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About the interviewee:

Dr Edwin Borman is a Consultant Anaesthetist at NHS – University Hospitals Coventry and Warwickshire NHS Trust.

What changes would you like to see in CME accreditation?