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Putting our house in order

Will the gCMEp’s four Core Principles on CME result in the highest standards?

At its best, CME in Europe is a glorious thing: it showcases how all stakeholders in the medical education process – be they clinical or industry – can come together for the good of patients and communities to improve standards of care. It underscores the common goals of all interested parties and establishes the potential of industry to truly contribute to society. At its worst, industry-sponsored CME appears as an undercover marketing manoeuvre by unscrupulous pharmaceutical companies and their agencies.

Recent developments suggest that if these worst case scenarios continue to be tolerated, then everyone stands to lose. Unless we find a way to consistently ensure the highest of operating standards in European CME, then its future could look very different. So how does good CME practice differ from bad CME practice, and how can everyone doing it today be sure they are doing it well?

To address this question, a focused and disappointingly orderly pack of leading education providers involved in European CME programme development set off together in November 2009 to hunt for an implementable solution. Following the Second Annual European CME Forum (2ECF), this newly hatched team began to piece together a coherent way forward, with input from the CME and pharma communities.

The Good CME Practice (gCMEp) Group, as it formally became, has spent the best part of two years refining its Core Principles, through a potent interpolation of iterative internal debate and broad external consultation. Starting with a hefty set of seven Core Principles at the outset, the gCMEp guidance has now slimmed down to a svelte set of four, following the mantra that less really is usually more. The consultation outcomes and full guidelines, along with supporting tools, will be formally published in 2012. However, the gCMEp group is publically unveiling its Core Principles at 4ECF, November 2011.

To whet your appetite, briefly, the principles emphasise the imperative for appropriate and balanced education that is delivered in a transparent manner and demonstrated to be effective in achieving its pre-determined educational goals. These “easy to say" words are, however, underpinned by more substantially elaborated methodologies.

For example, for education to be considered appropriate, clear learning objectives should be derived from “a coherent and objective process that has identified performance gaps and unmet educational needs". The education must be designed to “positively reinforce existing good practice and effect a sustained change in daily clinical practice". Once the education has taken place, its effectiveness at meeting those objectives must be measured: checking learners were satisfied is not evidence that an intervention has actually worked.

Throughout, transparency and balance are critical for safeguarding the quality and reputation of CME. Robert Maynard Hutchins, renowned 20th century educational philosopher, said: “Education is a continuing dialogue, and a dialogue assumes different points of view."

Balance should thus be pervasive: from content development, to faculty selection and review procedures. Vitally, content must be free from any sponsor input and “reflect the full clinical picture within the framework of the learning objectives". The learner, meanwhile, should understand clearly the terms of the funding, as well as any conflicts of the faculty or organisations involved.

So, where to from here? Just enough time for a closing question: if good CME is appropriate, effective, transparent and balanced, how's your CME doing?

Alisa-PearlstoneThe Author

Dr Alisa Pearlstone is scientific director of PCM Scientific, CME division of PCM Healthcare, and a member of the gCMEp group. or on 020 7531 6693

10th November 2011


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