Summary Slide Show of Online CME

Bernard Sklar, MD: Online Continuing Bernard Sklar, MD: Online Continuing Medical Education July 2009 Medical Education July 2009

Online CME – An UpdateOnline CME – An Update

Review of July 2009 Review of July 2009 Bernard M. Sklar, M.D., M.S.Bernard M. Sklar, M.D., M.S.www.cmelist.com/list.htmwww.cmelist.com/[email protected]@netcantina.com


Plan of PresentationPlan of Presentation

Results of Recent SurveysResults of Recent SurveysTypes of InstructionTypes of InstructionPhysician Use of CME and Online CMEPhysician Use of CME and Online CMEObstacles to Physician UseObstacles to Physician UsePredictionsPredictions


Master’s ThesisMaster’s Thesis

This review is based on the July 2009 This review is based on the July 2009 update of the database initially created for update of the database initially created for the master’s thesis, The Current Status of the master’s thesis, The Current Status of Online Continuing Medical Education Online Continuing Medical Education (June 2000). Find the thesis online at (June 2000). Find the thesis online at http://www.cmelist.com/http://www.cmelist.com/mastersthesismastersthesisThe June 2000 thesis was based on a The June 2000 thesis was based on a review of the CME literature and a survey review of the CME literature and a survey of online CME done in February 2000.of online CME done in February 2000.

http://www.cmelist.com/mastersthesis

http://www.cmelist.com/mastersthesis


How Was the Survey Done?How Was the Survey Done?

The original survey was done by searching The original survey was done by searching multiple search engines using the search multiple search engines using the search string “online + continuing + medical string “online + continuing + medical +education”+education”Following up leads from those searchesFollowing up leads from those searchesInformation from ACCMEInformation from ACCMEEmail from viewers and CME providersEmail from viewers and CME providers


Updating the DatabaseUpdating the Database

For the past several years, I have relied For the past several years, I have relied mostly on contacts from Online CME mostly on contacts from Online CME providers and users to add sites to my listproviders and users to add sites to my listI add 3-4 new sites each month (and I add 3-4 new sites each month (and remove those sites that are no longer remove those sites that are no longer functioning)functioning)This year I again searched the Internet for This year I again searched the Internet for “online + continuing + medical + “online + continuing + medical + education”education”


Description of the ListDescription of the List

Each entry shows the name and URL of Each entry shows the name and URL of the site, when it was last visited, how the site, when it was last visited, how many credit hours are available, who many credit hours are available, who awards the credit, the cost per unit, when awards the credit, the cost per unit, when the educational material was last updated, the educational material was last updated, a statement about financial support, and a a statement about financial support, and a description of the site and its contents.description of the site and its contents.


Thanks to VolunteersThanks to Volunteers

Although I visit most of the sites myself, Although I visit most of the sites myself, this last year a number of people this last year a number of people volunteered to help keep the List currentvolunteered to help keep the List currentYou will find their names and titles in the You will find their names and titles in the “Reviewed by…” section of each review at “Reviewed by…” section of each review at http://www.cmelist.com/list.htmhttp://www.cmelist.com/list.htmThanks to all!!Thanks to all!!


Extensive UpdatesExtensive Updates

I have been maintaining the list for about I have been maintaining the list for about twelve years, beginning in 1997. In 2008-twelve years, beginning in 1997. In 2008-2009 I had the assistance of volunteer 2009 I had the assistance of volunteer reviewersreviewersThe database is continually updated .The database is continually updated .From June 2008 through July 2009, we From June 2008 through July 2009, we visited and updated the review of each site visited and updated the review of each site on the list.on the list.


Database Created from ListDatabase Created from List

The database contains information about the The database contains information about the 300 sites offering CME in July 2009. This 300 sites offering CME in July 2009. This information includes the number of activities, information includes the number of activities, number of hours of instruction, types of number of hours of instruction, types of instruction, target audiences, cost to users, the instruction, target audiences, cost to users, the name of the accrediting organization and name of the accrediting organization and sources of financial support. The figures in this sources of financial support. The figures in this report are based on the 284 sites offering report are based on the 284 sites offering original CME. original CME.


Growth of Sites, Activities and Hours IGrowth of Sites, Activities and Hours I

Date SearchedDate Searched Number of Number of SitesSites

Number of Number of ActivitiesActivities

Number of Number of Credit HoursCredit Hours

April 1997April 1997 1313 Not countedNot counted Not countedNot countedDecember 1997December 1997 1818 Not countedNot counted Not countedNot countedAugust 1998August 1998 6161 Not countedNot counted Not countedNot countedMay 1999May 1999 6868 Not countedNot counted Not countedNot countedDecember 1999December 1999 8787 Not countedNot counted Not countedNot countedFebruary 2000February 2000 9696 18741874 30643064August 2000August 2000 135135 36593659 56595659December 2000December 2000 150150 35103510 55005500December 2001December 2001 197197 1202612026 1752317523June 2002June 2002 209209 1095210952 1826618266


Growth of Sites, Activities and Hours IIGrowth of Sites, Activities and Hours II

Date SearchedDate Searched Number Number of Sitesof Sites

Number of Number of ActivitiesActivities

Number of Number of Credit HoursCredit Hours

December 2002December 2002 229229 1148511485 1910519105July 2003July 2003 253253 1134611346 2029920299January 2004January 2004 271271 1239512395 2170021700June 2005June 2005 283283 1496314963 2507525075December 2006December 2006 300300 1574415744 2628726287July 2009July 2009 300300 1296812968 2066620666


Explanation of calculations on next Explanation of calculations on next several slidesseveral slides

Although the number of sites is now estimated at Although the number of sites is now estimated at 300, the number used for the following 300, the number used for the following calculations is 284.calculations is 284.This method counts only those sites which offer This method counts only those sites which offer original content and not the approximately 16 original content and not the approximately 16 those sites which only link to or those sites which only link to or re-package re-package content offered elsewherecontent offered elsewhere (Nothing wrong with (Nothing wrong with doing that, but I don’t want to count the same doing that, but I don’t want to count the same activity twice).activity twice).


Growth of large sites (offering more Growth of large sites (offering more than 100 Credit Hours)than 100 Credit Hours)

Date SearchedDate Searched Number Number of Sitesof Sites

Number of Number of HoursHours

% of % of SitesSites

% of % of hourshours

December 2001December 2001 1414 1458714587 77 8383

December 2002December 2002 1616 1540415404 88 8181

July 2003July 2003 2121 1638816388 1010 8080

January 2004January 2004 2525 1754917549 1111 8181June 2005June 2005 3434 2045620456 1313 8080December 2006December 2006 4040 2088420884 1414 7979July 2009July 2009 4444 1553415534 1515 7575


Size of Sites – July 2009Size of Sites – July 2009

No. of Credit-HoursNo. of Credit-Hours Number of Number of SitesSites

Number of Number of HoursHours

% of % of SitesSites

% 0f % 0f HoursHours

Greater than 100Greater than 100 4444 1458714587 1515 7575

50-9950-99 3131 20122012 1111 1010

25-4925-49 4040 14451445 1414 77

10-2410-24 7676 12361236 2727 55

5-95-9 4545 337337 1616 11

< 5< 5 4343 100100 1515 <1<1

TotalTotal 284284 2628726287 100100 100100


The Largest Sites July 2009 - IThe Largest Sites July 2009 - IName of SiteName of Site # of Activities# of Activities # of Hours# of HoursContemporary Forums-Online CE LibraryContemporary Forums-Online CE Library 13281328 23252325Audio DigestAudio Digest 990990 19801980Challenger Online Lecture HallChallenger Online Lecture Hall 5454 15601560CMEWeb 814814 12211221Medscape CME Center 850850 850850Virtual Lecture HallVirtual Lecture Hall 2828 502502Clinical Directors Network (CDN)Clinical Directors Network (CDN) 469469 469469Pri-Med OnlinePri-Med Online 300300 450450NetCE Continuing Education on the InternetNetCE Continuing Education on the Internet 5555 425425American Society for Clinical PathologyAmerican Society for Clinical Pathology 259259 332332RSNA (Radiological Soc North America) 300 300TheAnswerPage 5 300Practical Reviews Online (was JournalBytes) 88 264CardioVillage 10 250


The Largest Sites July 2009 - IIThe Largest Sites July 2009 - IIName of SiteName of Site # of Activities# of Activities # of Hours# of HoursSullivan Group (The)Sullivan Group (The) 9898 216216theheart.orgtheheart.org 210210 210210CME InstituteCME Institute 200200 200200CMELectures.org 130130 195195Oncologist (The) 195195 195195Harvard Online CMEHarvard Online CME 4343 181181Drexel MCP Hahnemann Virt Grand RoundsDrexel MCP Hahnemann Virt Grand Rounds 115115 172172MedRisk OnlineMedRisk Online 3636 169169Johns Hopkins Advanced Studies CoursesJohns Hopkins Advanced Studies Courses 100100 166166American Acad Ped PREP Self-Ass OnlineAmerican Acad Ped PREP Self-Ass Online 33 156156Neurology (J American Acad Neurology) 100 150Washington University (St Louis) 149 147Childrens of Minnesota Grand Rounds 143 143FreeCME 67 140


The Largest Sites July 2009 - IIIThe Largest Sites July 2009 - IIIName of SiteName of Site # of Activities# of Activities # of Hours# of HoursNEJM Weekly CME ProgramNEJM Weekly CME Program 140140 140140American Acad of Orthopaedic Surgery OKOAmerican Acad of Orthopaedic Surgery OKO 6666 137137JAMA & ArchivesJAMA & Archives 130130 130130Ohio State University Center for CME 129129 129129ACP Medicine Online Version 11 120120CMEDownloadCMEDownload 120120 120120Epocrates Mobile CMEEpocrates Mobile CME 120120 120120Texas Heart InstituteTexas Heart Institute 9292 118118American Acad Allergy Asthma Immunology American Acad Allergy Asthma Immunology 6868 115115Cleveland Clinic Cleveland Clinic 134134 112112McGill CME 111 111American Psychiatric Association 69 105PedsEducation.org 165 105PeerView Press Online CME 103 103


The Largest Sites July 2009 - IVThe Largest Sites July 2009 - IVName of SiteName of Site # of Activities# of Activities # of Hours# of HoursAmerican Academy Ped Online CoursesAmerican Academy Ped Online Courses 3737 100100CE CentralCE Central 5050 100100


Fee Structure – Free SitesFee Structure – Free Sites

There has been a modest increase in the There has been a modest increase in the number of sitesnumber of sites offering free CME – from offering free CME – from 168 sites (59%)in December 2006 to 180 168 sites (59%)in December 2006 to 180 sites (63%) in July 2009.sites (63%) in July 2009.There has been a larger increase in the There has been a larger increase in the number of free credit-hoursnumber of free credit-hours – from 5740 – from 5740 (21%) in December 2006 to 7066 (34%) in (21%) in December 2006 to 7066 (34%) in July 2009.July 2009.


Fee Structure – Pay for Credit SitesFee Structure – Pay for Credit Sites

There has been very little change in the There has been very little change in the median fee for a paid credit hour. The bulk median fee for a paid credit hour. The bulk of the fee instruction (about 62%) of the fee instruction (about 62%) continues to cost $5 to $15 per credit hourcontinues to cost $5 to $15 per credit hour


Fee Structure by Site July 2009Fee Structure by Site July 2009Dominant or Average FeeDominant or Average Fee Number of SitesNumber of Sites % of Sites% of Sites

FreeFree 180180 6363

<$5 per hour<$5 per hour 1212 44$5 per hour$5 per hour 66 22$6-9 per hour$6-9 per hour 1111 44$10 per hour$10 per hour 1212 44

$11-14 per hour$11-14 per hour 33 11$15 per hour$15 per hour 2525 99

$16-19 per hour$16-19 per hour 33 11

$20 per hour$20 per hour 1111 44$21-24 per hour$21-24 per hour 33 11$25 per hour$25 per hour 55 22

>$25 per hour>$25 per hour 77 33


Hourly Fee Structure July 2009Hourly Fee Structure July 2009Dominant or Average FeeDominant or Average Fee No of HoursNo of Hours % of Hours% of Hours

FreeFree 70667066 3434

<$5 per hour<$5 per hour 26242624 1313$5 per hour$5 per hour 628628 44$6-9 per hour$6-9 per hour 18751875 99$10 per hour$10 per hour 22952295 1111$11-14 per hour$11-14 per hour 9090 11$15 per hour$15 per hour 35413541 1717

$16-19 per hour$16-19 per hour 354354 22

$20 per hour$20 per hour 11841184 66$21-24 per hour$21-24 per hour 412412 22$25 per hour$25 per hour 452452 22

>$25 per hour>$25 per hour 142142 11


Financial Support Summary: Financial Support Summary: There has been very little change in There has been very little change in

relative percentages of financial support relative percentages of financial support since December, 2001.since December, 2001.

As the number of free sites and activities As the number of free sites and activities increases, the number of fee sites and increases, the number of fee sites and

activities decreasesactivities decreases


Financial Support July 2009Financial Support July 2009

Source of SupportSource of Support No. of SitesNo. of Sites % of Sites% of Sites

Commercial CompaniesCommercial Companies 146146 5151

University/Medical SchoolUniversity/Medical School 8686 3030

GovernmentGovernment 3333 1212

Medical/Specialty AssociationMedical/Specialty Association 6161 2121

FoundationFoundation 2222 88

User Fees/Partial or CompleteUser Fees/Partial or Complete 104104 3737


Primary Care and Specialty SitesPrimary Care and Specialty Sites

Family Practice and Internal Medicine Family Practice and Internal Medicine content continues to dominate the Primary content continues to dominate the Primary Care sites (about 40% of all sites).Care sites (about 40% of all sites).Among the Specialty Sites, Cardiology, Among the Specialty Sites, Cardiology, Psychiatry, Infectious Disease/HIV, and Psychiatry, Infectious Disease/HIV, and Oncology content appear most frequently Oncology content appear most frequently (about 20% of sites for each specialty).(about 20% of sites for each specialty).Many sites offer instruction for more than one specialty groupMany sites offer instruction for more than one specialty group


Specialty – Primary Care July 2009Specialty – Primary Care July 2009

No. of SitesNo. of Sites % of All Sites% of All Sites

Primary Care SitesPrimary Care Sites 217217 7676

including:including:

Family PracticeFamily Practice 108108 3838

Internal MedicineInternal Medicine 9393 3333

PediatricsPediatrics 4242 1515Obstetrics/GynecologyObstetrics/Gynecology 2727 1010

Multiple Specialties (>6)Multiple Specialties (>6) 3333 1212


Subspecialties July 2009Subspecialties July 2009

Subspecialty sitesSubspecialty sites Number of SitesNumber of Sites % of Sites% of SitesOncologyOncology 3030 1111CardiologyCardiology 2828 1010Infectious Disease/HIVInfectious Disease/HIV 2424 88PsychiatryPsychiatry 1919 77SurgerySurgery 1919 77GastroenterologyGastroenterology 1818 66RadiologyRadiology 1616 66Anesthes/Pain ManagementAnesthes/Pain Management 1313 55NeurologyNeurology 1414 55EndocrineEndocrine 1212 44RheumatologyRheumatology 1010 44


Sites by Specialty-July 2009- OtherSites by Specialty-July 2009- Other

36 sites (12%) offer subjects of interest to 36 sites (12%) offer subjects of interest to many specialists: ethics, legal, practice many specialists: ethics, legal, practice management, risk management, tobacco management, risk management, tobacco cessation, addiction, alcoholism, genetics, cessation, addiction, alcoholism, genetics, basic sciencebasic scienceMany other specialties are included at 8 or Many other specialties are included at 8 or fewer sitesfewer sites


““Portal” Sites July 2009Portal” Sites July 2009

• These two sites offer no original CME activities, These two sites offer no original CME activities, but do offer convenient starting places for a but do offer convenient starting places for a large number of activities:large number of activities:

• CE Medicus offers access without fee to about CE Medicus offers access without fee to about 3000 activities (probably about 4000 hours) 3000 activities (probably about 4000 hours) produced by about 11 content providers. produced by about 11 content providers. Instruction is free.Instruction is free.

• Doctor’s Guide also has no CME of its own, but Doctor’s Guide also has no CME of its own, but offers descriptions of over 2000 activities (free offers descriptions of over 2000 activities (free and fee) with links to those coursesand fee) with links to those courses


Large Sites where Hours cannot be countedLarge Sites where Hours cannot be counted

American College of Cardiology - CME content is interspersed American College of Cardiology - CME content is interspersed through the Cardiosource site and cannot readily be counted; but through the Cardiosource site and cannot readily be counted; but there are probably several hundred hours.there are probably several hundred hours.Medical Rounds is a Canadian site which does not offer US CME Medical Rounds is a Canadian site which does not offer US CME credit. However, many Canadian medical schools have contributed credit. However, many Canadian medical schools have contributed to several hundreds of lectures to this series. All talks were originally to several hundreds of lectures to this series. All talks were originally presented at grand rounds of quality educational institutions or at presented at grand rounds of quality educational institutions or at accredited medical meetings.accredited medical meetings.MedPage Today - Each day, important medical events and studies MedPage Today - Each day, important medical events and studies are summarized and presented in the form of news stories as brief are summarized and presented in the form of news stories as brief (0.25 hours) CME activities. In addition there are links to about 38 (0.25 hours) CME activities. In addition there are links to about 38 longer CME activities in a variety of specialty areas. Each of these longer CME activities in a variety of specialty areas. Each of these longer activities offers 1.0-2.5 credits.longer activities offers 1.0-2.5 credits.


Types of InstructionTypes of Instruction

The one major change in types of instruction is The one major change in types of instruction is the rapid increase of podcasting (up from 5 sites the rapid increase of podcasting (up from 5 sites in December 2006 to 23 sites in July 2009.in December 2006 to 23 sites in July 2009.Text (with or without graphics) remains the Text (with or without graphics) remains the dominant mode, followed by slide-audio or slide-dominant mode, followed by slide-audio or slide-video lectures, case-based interactive and video lectures, case-based interactive and question-and-answer instruction.question-and-answer instruction.For definitions of these and other types of online For definitions of these and other types of online instruction, see Types of Online CME Instruction instruction, see Types of Online CME Instruction DefinedDefined


Types of Instruction July 2009 ITypes of Instruction July 2009 I

Instruction TypeInstruction Type Number of SitesNumber of Sites % of Sites% of SitesText onlyText only 8989 3131Text-and-graphicsText-and-graphics 5757 2020Slide-audio LectureSlide-audio Lecture 8686 3030Slide-video LectureSlide-video Lecture 6969 2424GuidelinesGuidelines 33 11Question-and-answerQuestion-and-answer 1010 44Case-Based-InteractiveCase-Based-Interactive 4848 1717


Types of Instruction July 2009 IITypes of Instruction July 2009 II

Instruction TypeInstruction Type Number of Number of SitesSites

% of Sites% of Sites

CorrespondenceCorrespondence 00 00

GamesGames 88 33JournalJournal 2020 77Journal with multiple subjectsJournal with multiple subjects 1515 55Board Review/Self-AssessmentBoard Review/Self-Assessment 66 22

Streaming VideoStreaming Video 1212 44

Self-Directed Search (POS)Self-Directed Search (POS) 11 <1<1

Text-AudioText-Audio 1313 55Podcast (Audio and/or Video)Podcast (Audio and/or Video) 2323 88


Sites I Could Not ViewSites I Could Not View

There are a number of proprietary sites, e.g., staff model HMOs, There are a number of proprietary sites, e.g., staff model HMOs, like Kaiser-Permanente, where access to instruction is limited like Kaiser-Permanente, where access to instruction is limited to staff members of that organization. Those sites are not to staff members of that organization. Those sites are not reviewed in this report.reviewed in this report.


Point of Care/Self Study Point of Care/Self Study

I count only one site currently offering I count only one site currently offering “Point of Care” CME (also called “self-“Point of Care” CME (also called “self-directed study”); this is the College of directed study”); this is the College of Family Physicians of CanadaFamily Physicians of CanadaThe several other sites seem to have The several other sites seem to have abandoned the effortabandoned the effort


Sites that have closed ISites that have closed I

About 110 sites disappeared between About 110 sites disappeared between December 2008 and July 2009, either December 2008 and July 2009, either because credit expired or without with an because credit expired or without with an explanationexplanation


Sites that have closed IISites that have closed II

The most significant closure, numerically, The most significant closure, numerically, is is eMedicineeMedicine, whose CME has been folded , whose CME has been folded into Medscape. I had been attributing 6391 into Medscape. I had been attributing 6391 activities and 9586 hours to activities and 9586 hours to eMedicineeMedicine..The closure of The closure of eMedicine eMedicine has led to a has led to a major decline in the overall number of major decline in the overall number of activities and hours and likewise to a activities and hours and likewise to a major decline in the number of activities in major decline in the number of activities in the “$5 to 10 per hour” fee bracketthe “$5 to 10 per hour” fee bracket


CME Participation by Location Based on CME Participation by Location Based on ACCME Figures for 2008ACCME Figures for 2008

Live meetings and conferences accounted for 40% of Live meetings and conferences accounted for 40% of “physician-participants”“physician-participants”Home study CME (“enduring materials”) and journals Home study CME (“enduring materials”) and journals accounted for 20.4% of physician-participantsaccounted for 20.4% of physician-participantsOnline CME accounted for almost 41% of physician-Online CME accounted for almost 41% of physician-participants participants


Physician Usage of Online CMEPhysician Usage of Online CME

Physician usage of online CME is increasing, and now Physician usage of online CME is increasing, and now accounts for almost 41% of all CME accounts for almost 41% of all CME According to ACCME:According to ACCME:1997: 1997: 13,115 physician-13,115 physician-participantsparticipants (0.34%) (0.34%)1998: 37,879 physician-1998: 37,879 physician-participantsparticipants (1.03%) (1.03%)1999: 79,536 physician-1999: 79,536 physician-participantsparticipants (1.79%) (1.79%)2000: 181,922 physician-2000: 181,922 physician-participantsparticipants (3.57%) (3.57%)2001: 230,055 physician-2001: 230,055 physician-participantsparticipants (4.44%) (4.44%)2002: 329,110 physician-2002: 329,110 physician-participantsparticipants (6.08%) (6.08%)2004: 895,120 physician-2004: 895,120 physician-participantsparticipants (14%) (14%)2005: 1,368,335 physician-2005: 1,368,335 physician-participantsparticipants (18%) (18%)2006: 2,184,460 physician-2006: 2,184,460 physician-participantsparticipants (26%) (26%)2007: 2,673455 physician-2007: 2,673455 physician-participantsparticipants (30.7%) (30.7%)2008: 4,365,013 physician-2008: 4,365,013 physician-participantsparticipants (40.9%) (40.9%)


Some important caveats about the numbersSome important caveats about the numbers

The numbers I have quoted in this and all The numbers I have quoted in this and all previous reports are quoted in “physician-previous reports are quoted in “physician-participants.” This term is not explained at the participants.” This term is not explained at the ACCME site, but it is certainly not the same as ACCME site, but it is certainly not the same as “credit-hours” earned.“credit-hours” earned.The numbers I have quoted in this and all The numbers I have quoted in this and all previous reports are based on the reports of the previous reports are based on the reports of the 725 providers certified directly by the ACCME 725 providers certified directly by the ACCME and NOT on the reports of the 1600 providers and NOT on the reports of the 1600 providers accredited by the State Medical Societies (those accredited by the State Medical Societies (those 1600 providers provide a very small amount of 1600 providers provide a very small amount of online CME)online CME)


Changes and Trends IChanges and Trends IFor the first time since 1997, there has been a For the first time since 1997, there has been a reduction in the number of online CME activities and reduction in the number of online CME activities and hours available. This is mostly explained by the hours available. This is mostly explained by the disappearance of the 9586 hours formerly provided disappearance of the 9586 hours formerly provided by by eMedicineeMedicine. . About 100 sites have vanished since December About 100 sites have vanished since December 2006, and about 100 new sites have appeared during 2006, and about 100 new sites have appeared during that that There has been a significant increase in the number There has been a significant increase in the number of free CME hours (7066 vs. 5740) over the past 2 ½ of free CME hours (7066 vs. 5740) over the past 2 ½ years. There has been little change in the specialty years. There has been little change in the specialty groups targeted. There are considerably more slide-groups targeted. There are considerably more slide-audio and slide-video lectures and a large increase in audio and slide-video lectures and a large increase in podcasts.podcasts.


Changes and Trends IIChanges and Trends II

The number of physician-participants for online CME The number of physician-participants for online CME went up from went up from 181,922 (3.57%) in 2000 to 230,055 181,922 (3.57%) in 2000 to 230,055 (4.44%) in 2001 to 329,110 (6.08%) in 2002 to (4.44%) in 2001 to 329,110 (6.08%) in 2002 to 899,390 (14%) in 2004 to 1,368,335 (18%) in 2005 to 899,390 (14%) in 2004 to 1,368,335 (18%) in 2005 to 2,184,460 (26%) in 2006 to 2,673,455 (30.7%) in 2,184,460 (26%) in 2006 to 2,673,455 (30.7%) in 2007 and to 4,365,013 (40.9%)2007 and to 4,365,013 (40.9%)The number of physicians registering for online CME The number of physicians registering for online CME has quintupled in the past seven years.has quintupled in the past seven years.Return to beginning of the Sklar Report, if desired, or Return to beginning of the Sklar Report, if desired, or just keep going downjust keep going down


Why is Online CME use Still Low? IWhy is Online CME use Still Low? I

I think we can soon retire this section. The 2008 ACCME figures I think we can soon retire this section. The 2008 ACCME figures show that online CME accounts for 40% of “physician-show that online CME accounts for 40% of “physician-participants.” Other ways of calculation this ratio are participants.” Other ways of calculation this ratio are somewhat less glowing, but still, the trend is obviously somewhat less glowing, but still, the trend is obviously upwardsupwardsMy points about the “low” use of Online CME are still pertinent, My points about the “low” use of Online CME are still pertinent, BUT much less so than just a few years ago:BUT much less so than just a few years ago:Some physicians remain uneasy with computers and the Some physicians remain uneasy with computers and the Internet Internet Some physicians are still unaware of online CME or don’t know Some physicians are still unaware of online CME or don’t know how to find ithow to find itMuch live CME, especially at the hospital, is convenient, free Much live CME, especially at the hospital, is convenient, free and offers collegial interactionand offers collegial interactionMany doctors still find attending their yearly specialty meeting Many doctors still find attending their yearly specialty meeting satisfying and sufficientsatisfying and sufficient


Why is Online CME Use Why is Online CME Use Still Still Low? IILow? II

These observations remain true, BUT, again, to a These observations remain true, BUT, again, to a lesser extent tan in past years:lesser extent tan in past years:A series of “gates” for the user to pass throughA series of “gates” for the user to pass throughNavigation: Download and install plug-insNavigation: Download and install plug-insRegistration hassleRegistration hassleFear of giving out license, DEA, credit cardFear of giving out license, DEA, credit cardPaying in advance for content you can’t viewPaying in advance for content you can’t viewGet content free, leave without payingGet content free, leave without payingEach site has a different procedure and Each site has a different procedure and passwordpassword


Why Choose One Online CME Site Over Why Choose One Online CME Site Over Another?Another?

““Look and Feel” Look and Feel” Your specialty’s “official” siteYour specialty’s “official” sitePrice (lower is better; free is best)Price (lower is better; free is best)Preference for Type of InstructionPreference for Type of InstructionEmail reminders (the more frequent the better)Email reminders (the more frequent the better)The CME is part of a larger medical site which The CME is part of a larger medical site which offers additional services for doctors (“one-stop-offers additional services for doctors (“one-stop-shopping”)shopping”)Help with CME reportingHelp with CME reportingRecommendation by colleagues, medical groupRecommendation by colleagues, medical groupSpecial arrangements with physician groupSpecial arrangements with physician group


What do Physicians Want?What do Physicians Want?

Do physicians really want online CME?Do physicians really want online CME?(I believe that, with usage now at 40%, the (I believe that, with usage now at 40%, the answer is YES)answer is YES)What do they like and dislike?What do they like and dislike?(According to most studies, lectures are (According to most studies, lectures are still the preferred mode of instruction) still the preferred mode of instruction)


A Long Term SolutionA Long Term Solution

I believe that:Eventually, CME will be integrated with the physician’s daily practice lifeSystems will be developed which allow a computer program to “know” when a physician is making a mistake or needs additional informationThe system will present instruction on the spot to help the physician do the right thing


Other Problems to SolveOther Problems to Solve

Another problem will be to prove that a given CME Another problem will be to prove that a given CME activity actually improves physician performance.activity actually improves physician performance.For now, CME providers and evaluating groups will need For now, CME providers and evaluating groups will need to settle for some lesser measure, such as the difference to settle for some lesser measure, such as the difference in scores between pre-tests and post-tests, or in scores between pre-tests and post-tests, or statements by “experts” that the course will correct the statements by “experts” that the course will correct the deficiency.deficiency.


Opportunities for ResearchOpportunities for Research

More sophisticated (and expensive) methods of More sophisticated (and expensive) methods of evaluation exist, such as reviewing physician charts or evaluation exist, such as reviewing physician charts or interviewing patientsinterviewing patientsThis is a great opportunity for research. This is a great opportunity for research.


Conclusions IConclusions I

The number of online CME activities and credits has The number of online CME activities and credits has leveled off. Online CME continues to become nicer to leveled off. Online CME continues to become nicer to look at, with more graphics, lots more audio and video, look at, with more graphics, lots more audio and video, and a bit more interactive programming. Podcasts are and a bit more interactive programming. Podcasts are growing rapidly in popularity.growing rapidly in popularity.


Conclusions IIConclusions II

The percentage of “physician-participants” for online The percentage of “physician-participants” for online CME about 40%CME about 40%Barriers to usage are coming downBarriers to usage are coming downThere is very little proof that any kind of standalone There is very little proof that any kind of standalone CME, whether live, home study or online, and regardless CME, whether live, home study or online, and regardless of mode of instruction, is useful in changing physician of mode of instruction, is useful in changing physician practicepracticeResults of most studies indicate that a coordinated set of Results of most studies indicate that a coordinated set of educational interventions will be needed to accomplish educational interventions will be needed to accomplish behavior changebehavior change


Conclusions IIIConclusions III

The future lies in the integration of medical practice, The future lies in the integration of medical practice, quality assessment and user-specific CMEquality assessment and user-specific CMEThe challenges and opportunities are greatThe challenges and opportunities are great


Important URLsImportant URLs

Master’s thesis: Master’s thesis: www.cmelist.com/mastersthesis/www.cmelist.com/mastersthesis/

My home page: www.cmelist.comMy home page: www.cmelist.com

Online CME list: www.cmelist.com/list.htmOnline CME list: www.cmelist.com/list.htm

Definitions of types of online CME instruction: Definitions of types of online CME instruction: www.cmelist.com/Instruction_Types_defined.htmwww.cmelist.com/Instruction_Types_defined.htm

ACCME Annual Report 2008ACCME Annual Report 2008


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Date post:	16-Apr-2017
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Summary Slide Show of Online CME

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