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Integrate top content from pharma with CME best practice for universal reward

Play-doh being pushed through a shape cutter with 'Pharma' imprinted on its endHow to conduct a 'good' needs assessment and identify educational gaps, how to create good learning content to address these needs and how to measure outcomes, were all questions posed at the recent European Continuing Medical Education (CME) Forum in London. However, the Forum's scope became much wider as each of the stages of CME programme development and implementation was explored.

The contentious subject of the role of pharma as a supporter and/or provider of CME was also debated. As in the US, there are those who are opposed to any sort of pharma involvement, who state that it is impossible for pharma to be involved without introducing bias. On the one hand, pharma is seen primarily as a product- and sales-driven business. On the other hand, people are becoming more aware of the possible support and positive contribution that pharma can afford CME as an education provider, especially as the business model shifts, from necessity, to a more customer-driven one.

Obvious solutions to this ongoing problem are not clear yet. However, it is no longer good enough for pharma, and pharma-related education providers, to step back and wait until there is a consensus, firm guidelines on the nature of this relationship or a clear 'how-to' printable document. If pharma is to be involved in shaping the future of CME guidelines and practices in Europe, and to promote itself as a necessary stakeholder, everyone needs to get on board and engage.

This seems like a mammoth undertaking but, as with any large challenge, if it is broken up into small tasks, it will become more manageable. One key contribution that pharma can make to good CME practice is to ensure content of the highest quality, based on genuine customer needs; content that has a measurable, positive impact on clinical practice and, ultimately, on better patient care. One of the solutions touched on at the Forum was that of observing the principles of adult learning in the development of good learning content. Those that think adding another discipline to aid engagement with CME makes CME provision too complicated for pharma to deliver should reconsider.

Behaviour changes
We all learn, every day, even if we are not aware of it. In this age of mass media, spewing information at us via technology, we learn, and unlearn, and learn again with new knowledge. This knowledge, if deemed appropriate, changes the way we behave and practice in our day-to-day environment. What makes some knowledge result in positive change in practice and some not?

Consider global warming as an issue. Reflect on your own understanding of it and how, even in the tiniest way, your behaviour has changed in relation to this 'new' knowledge that has come to the fore in recent years. Is it slight change? For example, do you now switch off lights in unused rooms more often? Do you no longer leave your computer monitor on standby? Do you wash clothes at 30°C? Do you use energy-efficient light bulbs?

Or is it larger change? Do you drive a hybrid or green car? Do you have a house powered by solar energy or a wind turbine?

Where has this change in behaviour come from and how is it related to this new knowledge that you have acquired from multiple sources over the last few years? What has influenced this change in behaviour? Is it that you trust a particular source of information, such as an acclaimed scientist? Have you been convinced by news reports and award-winning documentaries? Is it fear for the future, or your children's future, or peer-pressure? There are so many factors involved in how and why a person changes behaviour and practice. We have all experienced it; it is how we function as human beings.

Thus, with a little reflection on the issues, we can adapt our provision of content for CME programmes to create content that is relevant, meets objectives, provides tangible solutions that can be implemented and, as a result, leads to changes in both behaviour and practice.

How does this translate practically in the two main strands of CME programmes, namely 'live' and eCME (e-learning)?

Look at the nature of knowledge provision in this technological age. It comes from a multitude of sources: scientific publications, conference and meeting presentations, news networks, industry-related press, lay press, peer-to-peer and other personal communications, our own experience, formal or accredited education, either classroom-based or online, blogs, tweets, the list goes on.

We take all of these formats and methods into account when developing a communications strategy for product promotion, but do we really take them that seriously when looking at CME provision? Or is getting accreditation on one of these formats primarily a box-ticking exercise?

Box-ticking is not going to improve pharma's reputation as a provider of good-quality, unbiased CME. Pharma needs to lead the way in good CME practice, which includes the provision of excellent learning content.

Furthermore, education needs to be differentiated from information provision and communication and not treated as though it is the same thing with some learning objectives bolted on. It needs to be well thought-out, designed and developed based on a genuine needs assessment and with clear outcome measurements in mind. Education needs and learning objectives can be significantly different from product communication objectives. This is not always the case, but it is often true, and for valid reasons.

Additionally, there are not merely one or two delivery formats that can be used to supply good quality learning. The needs assessment should also take into account the best method, or methods, for implementing a learning programme.

Understanding how people's methods of learning and information filtering have changed, then catering for the different preferences of each learner, promotes a blended learning approach to programme development.

Therefore, reuse of content from other communication initiatives and programmes, such as conference presentations, is useful, but it should be appropriate to the educational context, and the inclusion of such materials must be factored in at the planning stage, prior to any activities taking place or any materials being developed. Currently, the model of conference video plus learning objectives is being accredited, but is it a responsible approach to raising standards in CME and establishing pharma's profile as the education good guy?

So, what is the position with 'proof of behaviour change' or, in business language, return on the financial investment in supporting CME initiatives currently, especially in light of the additional investment and effort that are being proposed? Will we ever be able to measure a causal relationship between a CME programme and a change in medical practice accurately?

Considering the access we all have to such a wide variety of knowledge sources, it is difficult to attribute causality, and change takes time.

In the meantime, however, we can take one small step at a time to raise the standard of the CME that we support and develop, and progress towards making pharma integral to the continuing education of European healthcare professionals.

The Author
Cally Fawcett is founder and director of Delta Kn

To comment on this article, email

24th March 2010


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