Knowledge -> competence, performance and outcomes

"Knowledge is clearly necessary but not in and of itself sufficient to bring about change in physician behavior and patient outcomes. Such didactic interventions should ... receive less credit than do more effective methods and perhaps no credit" (Davis 1999).

Existing CME and physician training and education:

• Is often passive and didactic
• Focuses on knowledge transfer
• Does not seek to directly enhance clinical skills or improve performance (IOM 2009)

ACCME (2008) asks us to focus instead on competence, performance and outcomes. Knowledge attainment as the focus of CME is no longer sufficient. Without a focus on skills training, practice does not change and patient care remains the same.

To effect practice gap and improve patient health outcomes, we need to effect simple improvements in physician competency and performance and attitudes.

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References

1. Davis D, O'Brien MA, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A.  Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA. 1999 Sep 1;282(9):867-74. PMID 10478694. http://jama.ama-assn.org/content/282/9/867.long
2. Accreditation Council for Continuing Medical Education; CME as a bridge to quality: Leadership, learning, and change within the ACCME System [monograph on the Internet]. Chicago, IL: 2008 Jan. Available from: http://www.accme.org/dir_docs/doc_upload/e2843247-7cae-40fe-a0eb-27a982b8fcc0_uploaddocument.pdf
3. Institute of Medicine. Redesigning Continuing Education in the Health Professions. Washington, DC: National Academies Press; 2009. Available at: http://www.nap.edu/openbook.php?record_id=12704