Report on Proceedings of the 19th Annual Meeting of the Global Alliance for Medical Education, Coral Gables, Florida, USA, 18–20 May 2014

SHORT REPORT

Report on Proceedings of the 19th Annual Meeting of the Global Alliance for Medical Education, Coral Gables, Florida, USA, 18–20 May 2014

Ron Murray

Independent CME/CPD Consultant, Pickering, UK

Abstract

Participants from North, South, and Central America; Europe; Asia; and Australia attended the 19th annual meeting of the Global Alliance for Medical Education in Coral Gables, Florida, the United States between 18 and 20 May 2014. The educational and networking sessions focused on the impact of technology, research, and innovative approaches in continuing medical education and continuing professional development (CME/CPD). A series of invited presentations dealt with medical education research, web-based patient engagement tools, international professional communities, an integrated health information system supporting educational strategies, and the integration of Evidence-Based Medicine and Best Evidence Medical Education to improve outcomes. The invited presentations were supplemented by panel discussions, a competitive game on global CME/CPD knowledge, and abstract presentations on a range of projects being carried out in some of the countries represented at the meeting.

Keywords: continuing medical education, global, proceedings 2014, medical education research, continuing professional development

Received: 29 July 2014 Accepted: 26 August 2014 Published online: 19 September 2014

Journal of European CME (JECME) 2014. © 2014 Ron Murray. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported (CC BY 4.0) License (http://creativecommons.org/licenses/by/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material for any purpose, even commercially, provided the original work is properly cited and states its license.

Citation: Journal of European CME 2014, 3: 25586 - http://dx.doi.org/10.3402/jecme.v3.25586

 

Representatives from the Americas, Europe, Asia, and Australia attended the 19th annual meeting of the Global Alliance for Medical Education (GAME) in Coral Gables, Florida, the United States between 18 and 20 May and participated in a series of networking and educational sessions that focused on the impact of technology, research, and new educational approaches in continuing medical education and continuing professional development (CME/CPD).

Invited presentations covered the following topics:

  1. The theoretical basis of medical education research
  2. Web-based patient engagement tools
  3. International professional communities
  4. The use of an integrated health information system to support educational strategies
  5. The integration of Evidence-Based Medicine and Best Evidence Medical Education to confront the challenge of improving outcomes

These topics were supplemented by panel discussions, a competitive game on global CME/CPD knowledge, and abstract presentations on a range of projects carried out in some of the countries represented at the meeting.

Dr Melchor Sanchez Mendiola of the Faculty of Medicine of the National Autonomous University of Mexico in Mexico City provided a comprehensive, yet engaging, opening presentation that prompted participants to question their assumptions and reflect on various paradigms, including positivism, post-positivism, critical theory, and constructivism; ontologies such as realism (critical or historical) and relativism; epistemologies (objectivism and subjectivism); methodologies and conceptual frameworks related to medical education research as illustrated in Figure 1. He gave a strong endorsement to the use of a mixed method approach in medical education research and highlighted the fact that the field itself is now an area of study in various higher education degree courses.

Fig 1
Figure 1.  How a research paradigm can influence the design and implementation of medical education research.

To illustrate the importance of a research-driven educational intervention, Dr Frances Thorndike of the University of Virginia presented an overview of an Internet-based tool that addresses the medical issues associated with insomnia. The main components of the tool are shown in Figure 2. The technology platform (BeStudy Manager) on which the intervention tool is based has lent itself to use in a variety of other conditions ranging from diabetes to paediatric encopresis. The specific application for insomnia is undergoing clinical trials in Australia, Denmark, and Norway with plans for further testing in Germany. The technology platform is designed to allow flexible content management for either clinician education or patient intervention and, in Dr Thorndike’s opinion, highlights the potential of technology-delivered patient assessment and intervention tools in CME/CPD.

Fig 2
Figure 2.  Summary of Internet-based patient education tool for insomnia.

Dr Alvaro Margolis of Universidad de la República, Uruguay, continued the invited presentations with a description and discussion of network structure and behaviour among professional communities in relation to his experience in Latin America. His central theme was that, because “knowledge is just a click away,” the main reason professionals participate in conferences is to network and validate their current knowledge with peers and experts. His thesis continued with the notion that networks as shown in Figure 3 are one of the most valuable assets of a professional community and that technology now allows for radical innovations such as high impact courses, communities of practice, and hybrid congresses in CME as well as in clinical practice. Dr Margolis concluded that international audiences may benefit from online CME to create new communication links across borders, taking into consideration elements such as language, culture, and systems of care.

Fig 3
Figure 3.  Example of a network diagram.

Continuing the representation from Latin America, Dr Fernan Gonzalez Bernaldo de Quiros of the Hospital Italiano de Buenos Aires described how an integrated Health Information System (HIS) can support educational strategies for patients and health professionals. He outlined the initial evaluation of a component of a CME System integrated to an electronic health record (EHR) in an academic hospital in Argentina. Learning opportunities were linked to information system data reports but only 15% of the physician users accessed the links offered. A personal database of information accessed is present on the EHR, and a patient portal can also be used to provide information to physician users. Dr Quiros postulated that an integrated HIS can create a “learning health system” by expanding the focus from individual learning to learning from the system as a whole with the provision of indexed and contextualised information.

Dr Melchor Sanchez Mendiola returned to complete the roster of invited presentations by drawing many of the threads of the conference together in a presentation on Integrating Evidence into CPD towards improving outcomes. A plethora of evidence-based resources for CME/CPD was reviewed in addition to relevant applications of implementation and dissemination science. A comparison of Kirkpatrick and Moore’s outcome evaluation models was enhanced by the fact that Dr Donald Moore was one of the participants in the conference and was able to provide immediate input to the discussion. Dr Sanchez also emphasised how imperative patient care and best evidence were as the foundations for successful CME/CPD that leads to performance improvement in clinical practice and meaningful patient outcomes.

The panel discussions moderated by Dr Donald Moore provided very useful discussion and prompted many relevant audience questions that allowed clarification of some of the theoretical ideas promulgated in the invited presentations.

The presentations chosen from submitted abstracts also highlighted the diversity of CME/CPD being conducted in the global community. These presentations covered the following topics:

Russian for Healthcare Providers: A Novel Course in both Inter-Professional Education and Cultural Competency.

Daniel B. Topping, MD, University of Central Florida College of Medicine

This was a basic course in Russian language and culture provided for medical, nursing, and pharmacy students at Washington State University who interacted with more than 30,000 Russian speakers in the Spokane, WA area of northwestern United States.

Continuing Medical Education Credit Points – Disparity in India: A Case Study.

Vaibhav Srivastava MPharm, PGDBA, Insignia Communications

Discrepancies in the number of credit hours allocated to the same CME course by different state medical councils and even by the same medical council in different cities within a state, highlighted the absence of a centralised oversight system for CME/CPD in India. The fact that doctors from one state might have to spend two or three times as long compared with doctors from other states on the same CME programme has led to much disquiet and calls for some form of standardisation.

Improving Patient Care by Integrating a Quality Improvement Initiative into an EHR System

Dale Kummerle PharmD, Bristol-Myers Squibb

This presentation described a seemingly well-planned initiative based on sound gap analysis that did not come a full circle from the commercial supporter’s perspective. In this case a very low level of participation by network clinicians was reported and the following questions arose:

  • was enough done to engage the EHR audience?
  • is the integration of CME into an EHR really an effective method for addressing quality improvement?
  • does CME participation need to be mandatory? and
  • was the provider able to meet the stated deliverables outlined in the grant.

Some expectations of grant recipients by commercial supporters were also explained.

Improved Outcomes in CME Activities by Incorporating Patient Perspective

Tom Bregartner MBA, Quintiles Medical Education

This session highlighted the improved outcomes and positive impact on the participant experience that can be achieved by including the patient in the design and implementation of a CME activity. Patient-centric activities were shown to be more likely to positively affect participants’ knowledge than non-patient-centric activities. Moreover, the broad application of a patient-centric model across a wide range of therapeutic areas was promulgated.

Impact of Electronic Instructional Methods on Knowledge and Competence

Kathleen Geissel PharmD CCMEP, Medscape/WebMD

A meta-analysis was conducted on over 100 online CME-/CPD-certified activities posted on the Medscape platform between 2012 and 2013 to evaluate the instructional elements that demonstrated most impact on learner knowledge and competence. Preliminary results indicated that the following guidelines led to greater likelihood of success:

  1. Use case-based instruction
  2. Use multiple types of media
  3. If using text, make it case-based with interactive polling questions
  4. Keep the length between 17 and 36 minutes

International Chapters – Leveraging Local Organisations for Educational Dissemination

Connie Liu, American College of Cardiology

The efforts being made by the American College of Cardiology to conduct a global expansion initiative was outlined. With 10% of its members based outside the United States, an international affairs team has adopted a “Chapters” model for each country that has a minimum of 20 Fellows of the College. By enlisting the help of local cardiovascular societies, including chapter governors on an international assembly, and providing a series of benefits such as trainee membership, joint sessions, and discounts, the programme has expanded to 31 chapters. Challenges were also described such as disproportionate representation and variable performance by the chapters. Sustainability strategies such as an experts’ database, a gradual process of granting “chapters in formation” status and chapter consortia (e.g. Central America), were also listed as part of the implementation plan.

Anti-Bribery Procedures and Anti-Corruption Laws: Where Is Fair Market Value When You Need It?

Maureen Lloyd BSc, PwC LLP

This presentation challenged participants to consider ways to conduct the business of international CME/CPD within the confines of legislation such as the Foreign Corrupt Practices Act in the United States and the Bribery Act in the United Kingdom. Although industry supporters of CME/CPD have complex corporate policies addressing due diligence and documentation requirements, the question still remains as to how to develop grant awarding procedures with criteria and data points that can support the determination of funding and the concept of fair market value (FMV). With increasing access to emerging markets such as the BRIC countries (Brazil, Russia, India, China) where healthcare systems are regulated, operated, and financed by government entities, it was suggested that consistent metrics, methods, and evaluation criteria be developed and implemented to comply with external regulations and to determine whether costs and fees are reasonable for the support of CME/CPD programmes.

During the GAME business meeting, the introduction of Special Interests Groups was announced by Maureen Doyle-Scharff, the president of GAME, as well as the location of the 2015 meeting in Glasgow, Scotland. Full details on the organisation and its activities may be obtained from the GAME website: www.game-cme.org

Correspondence: Ron Murray, Independent CME/CPD Consultant, 17 Rosamund Avenue, Pickering, North Yorkshire YO18 8BZ, UK. ronmurrayuk@gmail.com

About The Author

Ron Murray
Independent CME/CPD Consultant
United Kingdom

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