CME INDIA Presentation by Dr. N.K. Singh, MD, FICP, Director, Diabetes and Heart Research Centre, Dhanbad, Jharkhand, India. Editor, www.cmeindia.in.

Continued Medical Education.

(Based on a presentation at Diabetes India 2023 conference, 14th April, 2023, Indore. Author is especially thankful to Dr. Manoj Chawla and also to Dr. Banshi Saboo and Dr. Bharat Saboo for considering this unique topic)

CME (Continued Medical Education) holds significant potential as a tool for connecting the divide between medical knowledge and practice. As the healthcare industry is continuously evolving, healthcare professionals must keep up with these changes to offer optimal care to their patients. CME serves as a means for healthcare professionals to access the most up-to-date information and skills required to remain at the cutting edge of their field

The term CME has been largely replaced by CPD

• While CME refers to the specific educational activities that physicians participate in to maintain and improve their medical knowledge and skills, CPD is a broader term that encompasses all aspects of a doctor’s ongoing professional development, including not only medical knowledge and skills, but also areas such as communication, leadership, ethics, and professionalism.
• CPD recognizes that a doctor’s professional development is a continuous process that extends throughout their entire career, rather than a one-time event. In this way, CPD reflects the evolving nature of healthcare and the need for physicians to continually adapt and improve their practice to provide the best possible care for their patients.

The objectives of the Continuing Medical Education programme

• The aim is to offer health professionals and paraprofessionals at various levels of healthcare delivery systems, as well as those involved in biomedical research, the chance to enhance their knowledge, skills, and practices.
• Educational programs will be created and executed to cater to postgraduate students in different medical science specialties.
• Suitable self-learning materials will be designed, prepared, and shared with various target groups covered under the program.
• In response to the training needs and educational requirements, both print and non-print learning resources will be developed to ensure congruence with the program’s objectives

Key Issues

• Is there evidence to suggest that certain methods of delivering CME are more effective in achieving specific outcomes, such as imparting knowledge to physicians, changing physician attitudes, acquiring skills, changing physician practice behavior, or changing clinical practice outcomes?
• Do changes in knowledge, attitudes, skills, practice behavior, or clinical practice outcomes resulting from CME persist over a period of time equal to or greater than 30 days?
• What evidence exists from systematic reviews on the effectiveness of simulation methods in medical education beyond CME?
• Which characteristics of the audience, either alone or in combination with other characteristics, influence the effectiveness of specific educational techniques?
• Which external factors, either alone or in combination with other factors, enhance the effects of CME in changing behavior?
• What is the reported validity and reliability of the methods used to measure the effects of CME in terms of imparting knowledge, changing attitudes, acquiring skills, changing practice behavior, or changing clinical practice outcomes?

Benefits of CME

Research On CME Power

So far, there has been limited effort to comprehensively and systematically consolidate evidence on the effectiveness of CME and compare the effectiveness of various instructional designs for CME based on their impact on knowledge, attitudes, skills, practice behavior, and clinical practice outcomes.

(Broadly defined, synchronous e-learning is instructor-led, interactive, real-time teaching. Same time, common content, multiple participants like live video conferencing, webinars, interactive chats and discussion forums, etc., exemplify synchronous learning)

This study Concludes:

• Clinicians report that expense and travel time are the biggest barriers to CME.
• Time and money support is limited, and not increasing. Online search and email are the most frequently-used sources of information about CME.
•  Those who organize and market CME should explore options that reduce barriers of time and money, and creatively use online tools to publicize new offerings.

Study by Billy Jenkins et al

Study by Casebeer, L., Brown, J., Roepke, N. et al

How many CME points do I need in India?

• At a time when the only thing that is constant is change, Continuing Medical Education (CME) has proved to be very valuable for the medical fraternity in keeping pace with evolving science
• In April 2011, MCI passed a resolution on CME, by which it was made mandatory for all doctors to attend a minimum of 30 hours of CME every 5 years, failing which their registration to practice would be suspended.
• In India, CMEs are governed by The Medical Council of India and the corresponding State Medical Councils. In 2011, MCI made it mandatory for doctors to attend at least 30 hours of CMEs every five years
• All doctors / medical practitioners are required to gain  30 Credit Hours in five years (maximum 6 Credit Hours / year) by attending various conference / CME / workshop till the age of 65 YEARS and get their KMC Registration renewed once in 5 years.

Continuing Professional Development (C.P.D.) which will not be accredited

Moving Away from Counting Credit Points

Are we doing Excess?

Worth to PONDER

• It must be emphasized that while formal academic sessions in conferences and seminars are useful, one cannot underscore enough the importance of informal conversations.
•  Doctors tend to change their practice through professional exchanges or dialogues with their colleagues rather than as a consequence of attending formal educational sessions.
• Educational inputs need to be continuous and aimed at daily practice, rather than intermittent and targeted.
• The focus should be on encouraging reflection and deliberation on one’s own and other’s practice.
•  Informal opportunities to discuss and share experiences such as peer reviews, audit meetings and case discussions are equally useful

New Sensation, WhatsApp CME India

Final Points

• Overall, continued medical education is a powerful tool that helps healthcare professionals stay up-to-date with the latest advances in their fields, enhance their professional skills, and improve the quality of care they provide to their patients.
• By investing in CME, healthcare professionals can improve patient outcomes, advance their careers, and contribute to the overall improvement of healthcare

Thanksgiving for Continuous professional development (CPD)

References:

1. Wang, ZY., Zhang, LJ., Liu, YH. et al. The effectiveness of E-learning in continuing medical education for tuberculosis health workers: a quasi-experiment from China. Infect Dis Poverty 10, 72 (2021). https://doi.org/10.1186/s40249-021-00855-y
2. O’Brien Pott, M., Blanshan, A.S., Huneke, K.M. et al. Barriers to identifying and obtaining CME: a national survey of physicians, nurse practitioners and physician assistants. BMC Med Educ 21, 168 (2021). https://doi.org/10.1186/s12909-021-02595-x
3. Marinopoulos, Spyridon & Dorman, Todd & Ratanawongsa, et al, Eric. (2007). Effectiveness of Continuing Medical Education. Evidence report/technology assessment. 149. 1-69.
4. Billy Jenkins, Katrina Lester, Alex Noble, Helen Such, Barbara Yawn & Alison Scott (2023) Evaluating the Impact of Continuing Medical Education in the Interdisciplinary Team: A Novel, Targeted Approach, Journal of CME, 12:1, DOI: 10.1080/28338073.2022.2161730
5. Casebeer, L., Brown, J., Roepke, N. et al. Evidence-based choices of physicians: a comparative analysis of physicians participating in Internet CME and non-participants. BMC Med Educ 10, 42 (2010). https://doi.org/10.1186/1472-6920-10-42

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