Continuous Professional Development: Raising the Bar for Pediatricians

Physicians are increasingly accountable to patients and institutions for proof that they are maintaining medical competence in a rapidly changing health care environment.1 An essential factor in the professional development of physicians is a lifelong commitment to learning. Changes in clinical practice and advances in research have created new educational needs for physicians during the past 2 decades. Coupled with expanded learning methodologies, these needs have prompted unique approaches to traditional continuing medical education (CME). Criticism exists that the current structure of CME may be ineffective in altering physician performance with its distant, disconnected, and teacher-centered approach to education.1–8 In a systematic review of the usefulness of CME strategies, Davis et al6 found that CME in North America is concentrated mostly in formal interventions (eg, conferences) that have limited impact in changing physician performance and/or health care outcomes. They attribute this ineffectiveness in part to the fact that most CME strategies are not individualized to the physician-learner.6 Physicians are expected to learn specific knowledge and skills presented in different formats by experts and then to incorporate this learning into their own practices at a later time. Content in CME activities, especially delivered by lectures, often is not immediately relevant to a participant’s clinical practice. Evidence has shown that if the new knowledge is not directly relevant to the physician, then it is less likely that he or she will be able to integrate it in a way that ultimately enhances patient outcomes.2 There are important aspects to CME that may have value for participants, including confirmation of medical knowledge and reinforcement of good clinical practice. The methods to obtain CME chosen by practitioners are also shifting, as constraints of time and money are becoming increasingly influential in determining CME preferences. As clinical productivity … Reprint requests to (T.C.S.) Lucile Packard Children’s Hospital, Department of Pediatrics, 725 Welch Rd #5731, Palo Alto, CA 94304. E-mail: theodore.sectish{at}medcenter.stanford.edu