Pri-Med, a brand owned and operated by M|C Communications and a leading provider of professional education solutions to a community of over 300,000 U.S.-based clinicians, recently published a new white paper entitled, “How Will the Open Education Movement and Current Healthcare Trends Transform the Future of Professional Medical Education?”
The paper explores how the radical pace of change in technology and healthcare, and new trends transforming higher education, are impacting post-graduate professional medical education. Through the paper, Pri-Med highlights the need for all stakeholders in the post-graduate medical education continuum to partake in dialogue about the most appropriate and effective models for educating today’s primary care physicians (PCPs).
“A great deal of research and focus regarding educational innovation in medicine has been focused on the medical school years. Yet, until now, there hasn’t been an equal focus on physicians’ learning beyond their medical school, internship, residency and fellowship training, and into their 30+ years of active practice between graduation and retirement,” said Marissa Seligman, PharmD, CCMEP, Chief, Clinical & Regulatory Affairs and Compliance Officer, M|C Holding Corp, and Senior Vice President, pmiCME, the accreditation division of M|C Holding Corp, which owns M|C Communications and the Pri-Med brand.
“Technology, personalized education needs and virtual, on-demand learning may serve crucial roles in determining the path forward in professional medical education. We hope this white paper sparks industry-wide discussion that will advance our understanding of how professional medical education needs to evolve in the current environment and into the future.”
According to the white paper, the portrait of the physician learner has changed dramatically. Physicians who graduated from medical school within the last decade are accustomed to using technology in their personal lives and also in their work to, for instance, communicate with patients and colleagues, to prescribe medications and order tests.
Increasingly, physicians are expecting the same types of experiences to enhance the continual learning they must pursue during their post-graduate medical education years. As such, the white paper cites the need to determine how to best harness and utilize the latest technologies to enhance both certified and non-certified professional medical education while preserving the integrity and high quality of information.
However, the need to transform how physicians learn beyond their medical school, internship, residency and fellowship training, and into their 30+ years of active practice between graduation and retirement, receives far less attention.
The paper asserts that, “The practice of medicine, this clinical education gap and discrepancy for clinicians in practice needs to be addressed in order to maximize how patient care is truly managed in line with increasingly limited healthcare spending. Professional medical education is approaching an inflection point, and a dialogue regarding the future is urgently needed.”
To begin addressing these issues in continuing medical education (CME), the paper identified the need to explore multiple, varied questions around a central theme: “how will the open learning movement and other current healthcare trends transform professional medical education and development activities for the healthcare professional in the future.” Some of the plausible questions include:
- How will advances of the digital age impact professional medical education?
- Will clinical content become a commodity?
- How will interactive, social learning opportunities shape medical education consumption habits?
- How will pressures on physicians affect learning habits?
- Will industry funding of professional medical education be reduced or eliminated? Will education content become more personalized?
- Will physicians engage on a more frequent basis via social media avenues?
Setting the Stage: Understanding Physician Challenges
The paper first discusses how “professional medical education is intricately linked to the tide shift taking place in healthcare and how those changes are impacting primary care physicians (PCPs).”
PCPs are at the frontline of patient care and “must contend with increasing patient and disease complexity, rising healthcare costs; nascent public health crises such as diabetes, obesity and heart disease; and a new influx of consumers due to aging boomers and healthcare reform. The average PCP sees 2,300 patients in the course of a year—and that caseload is only expected to rise in the coming years.
At the same time, given that many PCPs have their own stand-alone medical practices, stringent fiscal and time constraints also confront them. PCPs are called upon to treat a vast range of diseases, disorders and therapeutic approaches and to regularly coordinate with specialists to provide patients with the most appropriate and comprehensive treatment options and approaches. Juxtaposed with an increasing demand for (and increasing demands on) these practitioners, our nation continues to face a serious shortage of PCPs, with no relief in sight.
Additional challenges for PCPs include the transition to digital healthcare through electronic health records; and a shift in the doctor-patient relationship due to a new generation of informed and empowered “super consumers” who have access to specialized information and detailed research findings through the internet. There is also an increasing focus on tracking clinical outcomes to specific medical interventions—along with other potential changes in health policy and value-based reimbursement strategies, such as pay-for-performance and the introduction of accountable care organizations (ACOs).
Certainly, to provide optimal care in this complex and fast-moving world, PCPs must have easy, nearly effortless, quick and specific frequent access to affordable, high quality, impactful information. They need to be able to retrieve the latest evidence-based and validated clinical research findings across a broad spectrum of disease and therapeutic approaches, along with guidance on evaluating and assimilating those findings into clinical practice and behavior change.
“Professional medical education, including accredited CME, has shown to be an effective stop-gap to ensure practicing physicians’ education stays current.”
After portraying the challenging environment PCPs currently face, the paper recognizes that, “today’s providers of professional medical education have a unique responsibility to lead the development of a new paradigm to meet the next generation of physician needs.” One option the paper discusses is “Open education”—sometimes referred to as “Education 3.0”2—a global movement that has spurred a departure from the traditional closed approach to education, characterized by intellectual supremacy of the educator, toward one that is distributive, collaborative and characterized by self-directed learning.
Open education involves an assortment—and choice—of learning models from live to online, independent to group and everything in between. Content and curriculum may be “crowd sourced” from multiple experts—or the learners themselves—rather than flowing from a single authority.
The paper also noted that, “The expansion of virtual learning environments is prompting a transformation of the physical classroom model as well, resulting in enhanced live learning experiences that are more dynamic and interactive, as demanded by today’s sophisticated learners.”
Consequently, the paper recognized that “The open education movement has made its way into the world of professional medical education. In fact, PCPs are on the leading edge of adopting this new paradigm, perhaps because postgraduate professional medical education is flexible by design and, thus, predisposed to accommodate the busy schedule of today’s practicing clinician.”
For example, physicians have found smartphones and online resources and applications to be an ideal solution to obtain data and easily consult with experts to support their work. This, in turn, has changed the way education providers consider curriculum, and design and develop content. This more “open” approach is also particularly well-suited to physicians who actively pursue insights and information on the latest clinical findings and guidelines in order to enhance their delivery of care and to yield optimal patient outcomes. The ability to obtain data from a broader range of contributors is enabling clinical content development that is becoming less siloed and more integrated, even at the point of patient care.
In addition, in this new model, content is easily shared and repurposed. This, in turn, allows education providers to create well-rounded curricula on a wide array of topics, providing up-to-date information not only on disease and therapeutic areas but also on practice management, healthcare reform, electronic health records and other relevant trends and technologies.
In addition to “Open Education,” the paper also recognizes the term Pharma 3.0, a collection of trends including health reform, health IT, comparative effectiveness, and the rising confidence in consumer power, that are signaling a new direction for the pharmaceutical industry and for the healthcare industry as a whole.
Coined by Ernst & Young in its Progressions 2010 report, Pharma 3.0 recognizes the transformation at hand whereby all participants in the healthcare ecosystem—patients, physicians, payers and pharmaceutical companies—are revisiting and realigning their practice and behaviors to improve health outcomes. As a result, the PriMed report asserts that, “Open education can be a catalyst for change in this new environment … by creating ways for physicians to share key learnings based on their clinical experience in near real-time, through online communities and exchanges that can complement more formal classroom experiences.”
The report also discussed how “funding for education is also becoming more open, shifting from a single stream originating from industry and associations to a multisource model. This new paradigm allows for all stakeholders—including payers, government and others—to contribute to the ongoing education of the medical profession. This migration is also reshaping disclosures and transparency practices across the
industry for the better, helping to mitigate perceived and actual conflicts of interest.”
However, as the report recognized, new funding sources for education “are no without risks.” Specifically, the report maintained that, “Content creation and sourcing become more important and more complex as a greater number of contributors enter the space. Not all content is created equally. When patient outcomes are at stake, systems and processes must be in place to ensure that physicians have access to quality information and possess a framework by which to provide tools to critically evaluate the source.”
The associated regulatory scrutiny under which the professional medical education world falls—with respect to both accredited and non-accredited medical education activities—adds an additional layer of complexity and potential future risk-mitigation. Additionally, while immeasurably valuable as an affordable and accessible source of information, digital learning experiences may lack some of the power that comes from face-to-face interactions with inspiring and energetic expert instructors, as well as face-toface communications with peers.
Consequently, the report noted that, “Incorporating open, web-based resources into the model for professional medical education has ancillary benefits, including greater interaction and networking for physicians in smaller practices. Frequent interactions and community development between and among physicians can take place virtually, in between live events. Mobile access also means physicians can obtain information at the point of care, regardless of their location.”
In addition, “Live meetings have also evolved to keep pace with the changing education landscape, adopting enhancements that add to the value of this educational format.” For example, the report noted how “the availability of more regional and local meetings translates to less time away from clinical practice as well as reduced travel costs” for PCPs. Moreover, “the integration of digital technologies into live meetings has spurred greater learner involvement and interaction (such as portable handsets for audience response systems and SMS texting for faculty question & answer sessions), as well as more independent learning opportunities (such as iPods for self navigated poster sessions). Many medical meetings now offer “edutainment” formats, such as clinical gaming, to deepen audience engagement and foster better retention of information.”
Ultimately, the report asserted that it is crucial that there be industry-and enterprise-wide collaboration to understand and prepare for the impact of macro trends on professional education. Ensuring forward momentum and “modernization” in professional medical education will require the heightened engagement of firms and partners from outside of the CME industry. This external insight and investment will complement and propel innovation originating from within the professional medical education industry.
All stakeholders in professional medical education must have a role in guiding the future of professional medical education. As CME providers and health stakeholders begin to work together, “all contributors can better prepare to continue meeting physicians’ post-graduate education needs,” which will lead to improved health outcomes for patients.