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CE News: Articles, Updates and Resources

In this issue

CE News Staff

Robert Dantuono, MHA
Martin Tremblay, PhD

Column Authors
Helena Filipe, MD, MMEd
Vjekoslav Hlede, PhD
William Rayburn, MD

CE News is a quarterly publication of the Society for Continuing Medical Education.

You’re Invited to be a part of CE News in 2021!

Submit an article about your CME/CPD program---its innovations, strategic initiatives, restructuring, team-based learning and practice improvement, use of patients in CME activities, new competencies and curricula, how technology can support life-long-learning across the continuum, assessment, faculty development, learner outcomes, collaborations, public partnerships, MOC or scholarly research projects, an interesting data-shot, etc. for publication in the newsletter. If you wish to author an article for CE News, please contact either editor: Martin (mtremblay@fmsq.org) or Robert (grd1951@gmail.com).

Our next copy deadline is March 15, 2021.

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  • 05 Jan 2021 12:24 PM | Anonymous

    Vaccines Offer Hope and Renewed Energy.

    Happy New Year, to all! It is a new year of great anticipation. Multiple vaccines have arrived to keep us safe from the deadly virus of 2020. We predict that vaccination and risk mitigation will impact SACME members in a very direct way as they go about their essential missions of promoting the quality of patient care and the health of the public through scholarship in CME/CPD. It may mean that we are likely to see at least a limited return of live educational activities, in combination with e-learning formats (both synchronous and asynchronous), in order to continue to expand participant access, assure greater teacher-learner interaction, advance learner retention and hopefully change behaviors and improve care outcomes. CME/CPD providers, and their faculty who are equipped with a new competency in e-learning technology, are well positioned to plan multi-modal educational activities (heralded to be the most effective learning model by researchers and educators) as a preferred standard activity format for the future. David Price, MD and Craig Campbell, MD in their insightful article Rapid Retooling, Acquiring New Skills, and Competencies in the Pandemic Era: Implications and Expectations for Physician Continuing Professional Development (JCEHP Spring 2020, Volume 40, Number 2, 74-75) imagine the possibilities and challenges for all CME/CPD providers to consider in the near future, post-COVID.

    Another innovation likely to become more common practice is the longitudinal curriculum, whereby learners are engaged over a period of weeks, even months, using a virtual format, with intermittent lectures, workshops and discussion boards. The one-day, live curriculum will become a “kick-off” event to a much longer, intensive and useful educational experience. It will be exciting to see if and how both these innovations come into practice over the new year.

    In this issue, we continue to develop our new format and offer important updates from SACME committee chairs, a list of highly relevant and useful scholarly publications for clinician-educators and CME/CPD professionals from Dr. Rayburn, plus two insightful articles from Dr’s Fillipe and Hlede which we hope you enjoy. As always, we encourage your feedback.

    Wishing our readers the very best in 2021,

    Robert Dantuono, MHA and Martin Tremblay, PhD
    Editors, CE News

  • 01 Jan 2021 9:28 AM | Anonymous

    By Asha Maharaj, MBA, Chair, Program Planning Committee

    The Program Committee is excited to announce a finalized agenda for the 2021 Annual Meeting. The theme for this year’s event, “The Art and Science of CPD: New Technology, New Knowledge, New Learning”, serendipitously was chosen before the onset of the pandemic and the historic momentum of the social justice movement. Indeed, the theme is quite relevant in our new reality today, as SACME continues to integrate scholarship and best practices in CPD. The 2021 program agenda offers many “firsts” in learning experiences---virtually---along with a stellar line-up of plenary speakers, further distinguishing SACME’s reputation as the premier organization nationally for CME/CPD.

    A longitudinal curriculum to maximize your engagement and learning experience…

    As one of our meeting “firsts”, the Planning Committee has adopted a longitudinal curriculum to engage learners over a period of weeks, not just days. Last spring, the SACME Virtual Learning Task Force was convened by the Board to study three curriculum models for the 2021 Annual Meeting and determined that a longitudinal curriculum was not only possible in a virtual learning environment, but preferrable. (See Task Force full report on curriculum models here.)

    While the core of the Annual Meeting’s live presentations will occur between February 24 to 26, there will be learning activities leading up to the core presentations and then followed by post-Annual Meeting sessions. Instead of our traditional consolidated curriculum occurring over three days, participants may register for sessions that will be held as early as February 3rd. Pre-conference workshops are typically 2-3 hour sessions and offer a more intensive, in-depth review of their topic. Faculty for these sessions are experts in their field and we encourage you to participate in these unique learning opportunities. (See links to detailed pre-conference worshops below.)

    Core program sessions that will provoke and challenge your thinking about critical issues…

    For the ”core” sessions which occur February 24-26, a line-up of dynamic plenary speakers and panelists will discuss the issues impacting medical education today. Keynote speaker, Julio Frenk, MD, MPH, PhD, President, University of Miami and Professor of Public Health Sciences, Health Sector Management and Policy, and Sociology, will share his insights, wisdom, global perspective, and ideas on educational reform along with his upbeat and energetic view on the promises of tomorrow vis-a-vis medical education.

    Panels to be convened are focused on Equity, Diversity and Inclusion; Technology; Music & Wellness; Value Proposition of CME/CPD Innovation. See full panel descriptions.  

    A user-friendly, virtual meeting platform which will assure your satisfaction…

    After months of study and due-diligence by a dedicated group of members serving on the Virtual Learning Task Force, SACME engaged the Pathable Virtual Events Platform for the Annual Meeting. This platform was selected based on its outstanding features and characteristics that will serve to support and enhance the learning experience.  It offers many options for presenters and learners to interact directly with each other through Q&A, in-session polls, discussion forums, themed “conversation cafes”, networking activities, and live video networking opportunities.  The Committee’s goal is to maximize opportunities for attendees to engage with the content for the full duration of the program, pre-, intra-, and post-meeting sessions.  Brief presentations of selected research and best practice abstracts will be available for viewing and discussion with the authors.  There will be time set aside during the core program days to interact with the presenters and ask questions. Comprehensive research and best practices presentations will be available for viewing and authors will have scheduled time in the agenda for live question and answer discussions with our attendees.

    Lastly, the Committee has included opportunities for our attendees to find out about more about SACME and the work that happens through the Committees and the Academy, as well as dedicated time to visit vendor exhibits, for social networking and activities to fuel personal growth and wellness.

    We look forward to welcoming and interacting with our attendees beginning early next year, over the live programming days and post the Annual Meeting. Don’t delay and register today!

    Asha Maharaj, MBA, is Director, Community and Continuing Education, Centre for Addiction and Mental Health, University of Toronto.

    2021 SACME Pre-conference Workshops (Separate registration and fee required.)

    Strategic Leadership in CPD*

    Continuing Professional Development (CPD): A Framework for Embedding Equity, Diversity and Inclusion into Instructional Design

    Program Evaluation and Assessment

    The Basics of Journal Manuscript Review: Learning Research Through Critical Review

    Writing Up a Scholarly Project: Transforming Ideas into Words

    Funding CME/CPD Programs in Virtual Environments

    Creating a Faculty Development Program for CPD

    Exploring Diversity, Equity, and Inclusion with Interprofessional Continuing Education at the University of Wisconsin-Madison

    *This workshop has reached capacity.

    Register TODAY for the SACME Annual Meeting at sacme.org/Annual-Meeting.
  • 01 Jan 2021 9:23 AM | Anonymous

    Here are 12 compelling reasons...

    1. Network with your colleagues
    2. Receive updates on current scholarship and research in CME/CPD
    3. Learn how to create more scholarly programming
    4. Learn how to design an outcomes-based program evaluation
    5. Advance your leadership abilities
    6. Join an “incubator” group to discuss advancements in CME/CPD
    7. Pandemic-proof your program
    8. Help to build a culture of inclusivity and belonging
    9. Access global ideas to solve local problems
    10. Become a visionary---be inspired, renew your imagination, and get creative
    11. Engage in outreach---link your program to local community public health initiatives
    12. Get support and give support (achieve personal well-being and resiliency)

    Register TODAY for the SACME Annual Meeting! Go to sacme.org/Annual-Meeting.

  • 01 Jan 2021 9:17 AM | Anonymous

    By William Rayburn, MD

    This column provides a list of insightful publications on topics of interest to teaching faculty and professionals in CME/CPD.

    Current Listings | Winter 2021

    Health Care Professionals' Reflections on Their Learning as Spiritual Generalists and Integration Into Practice
    Meeting spiritual needs of patients is important for quality health care. This interdisciplinary, simulation-based workshop involved 211 participants.  Questionnaires before and after the workshop confirmed that the workshop offered clinically applicable value in meeting spiritual generalists, appreciating spirituality/religion and its role in health care, and interfacing with chaplaincy. A subsample who completed delayed post surveys at 3 to 9 months reported making clinical practice changes by improved spiritual screening, recognition of spiritual distress and referral to chaplaincy.

    (Thiel M, Luff D, Kerr E, Robinson M, Meyer E. J Contin Edu Health Prof. 2020; 28. Doi: 10.1098/CEH.0000000000000318) PMID: 33136759

    Can the recruitment of senior transitioning clinician educators enhance the number and quality of resident observations? Thinking outside the-box

    The Accreditation Council for Graduate Medical Education’s Next Accreditation System has mandated direct observation by faculty of trainee performance. Most faculty perceive that they have limited time to observe trainees’ achievement of competency in an efficient and effective manner. Hiring more faculty is not feasible or a priority, and faculty development programs have not been universally effective to enhance observations. The author proposes recruiting the enlarging pool of senior clinician educators who are either retired or transitioning retirement to play a much-needed role in teaching at an academic health center. 

    (Greenberg L. Teach Learn Med 2020; 25: 1-6. Doi:10.1080/10401334.2020.1801442) PMID: 32841577

    Impact of Educational Format on Learner Commitment to Change and Satisfaction

    The value proposition of CME lies in its ability to elicit change in learners so new knowledge and skills are used to improve patient outcomes. The authors analyzed post activity learner evaluations of 9 educational formats produced by the American Academy of Family Physicians between 2015 and 2017. Education that was interactive and leveraged elements of social learning theory produced the greatest commitment to change the score. By contrast, satisfaction scores were not significantly different between formats.

    (Bird GC, Kozakowski SM, Mullins A, Campbell E. J Contin Educ Health Prof 2020; 40: 207-210. Doi: 10.1097/CEH.0000000000000301) PMID: 32898121

    Health Professions Educators’ System-oriented Roles as Educational Advocate, Quality Improver, and Broker

    This qualitative study was intended to ask health professionals about their educational roles besides teaching and student support. Results of surveys and interviews revealed three strategic dimensions: 1) educational advocacy, aimed at championing education at different levels and parts of the educational system and building educational capacity, 2) educational quality improvement, focused on shifting narratives about education and educational change in health service settings and leveraging educational evidence, and 3) educational brokerage, oriented at connecting clinical and educational communities to build trust and consensus.

    (Kumar K, School A. J Contin Educ Health Prof 2020; 40: 176-181. Doi: 10.1097/CEH.0000000000000309) PMID: 32898119

    Regional Education on Endoscopic Surgery Using a Teleconference System with High-quality Video via the Internet: Saga Surgical Videoconferences

    Effective education is needed for unskilled surgeons, especially at low-volume institutions. This report describes establishing local remote teleconferences by combining the use of a general web conferencing system and a synchronized remote video playback system about endoscopic surgery (ES). Fourteen teleconferences involved viewing an uncut video of ES that had been performed at one of the institutions. The procedure was discussed frankly, and expert surgeons advised improvements. This system was of low initial cost and offered easy participation and high-quality videos.

    (Manabe T, Takasaki M, Ide T, et al. BMC Med Educ 2020; 200: 329. Doi: 10.1186/s12909-020-02215-0) PMID: 32972399

    Twelve Tips for Being an Effective Clinical Skills Peer Teacher

    Most clinical skills teaching is delivered through peer teachers (other students) rather than over-qualified physicians.  Teaching benefits both the learner and teacher through an informal and improved learning atmosphere. Peer teaching by students is invaluable in cultivating teaching skills.  This article outlines 12 tips, with a paragraph about each tip, as to how students can be effective and successful in teaching clinical skills. Practical guidance was gathered from faculty reflecting on their roles and the wider literature on peer teaching in clinical skills.

    (Niaz H, Mistry J. Med Tech 2020; Nov 2; 1-6. Doi: 10.1080/0142159X.2020.1841130) PMID: 33136451

    What are We Really Talking About? An Organizing Framework for Types of Consultation and Their Implications for Physician Communication

    Consultations between providers on an outpatient or inpatient basis is one of the most frequent means of interdisciplinary communication and learning.  In this Perspective, the authors propose an organizing framework of 7 types of consultations, which apply broadly across disciplines: ideal consults, obligatory consults, procedural consults, S.O.S. consults, confirmatory consults, inappropriate consults, and curbside consults. Descriptions of this framework may help practitioners to be more productive, efficient, and collegial about patient care, which may facilitate improved work satisfaction and enhanced learning.

    (Hale AJ, Freed JA, Alston K, Ricotta D. Acad Med 2019; 94: 809-812. Doi: 10.10971ACM.000000000000002659) PMID: 30768469

    Incorporating Physician Input into a Maintenance of Certification (MOC) Examination: a Content Validity Tool

    Periodic MOC examinations are intended to evaluate whether physicians have maintained competence and are current in the knowledge and judgment requires for practice in their discipline. Each MOC exam comprises multiple-choice questions or case-based clinical vignettes. This study presents results from the cardiovascular disease MOC blueprint review. Responses from 441 review participants were analyzed to better address clinically relevant content.  The blueprint review garnered more detailed and valuable feedback from the physician community about the relevance of topics and their frequency seen in practice.

    (Poniatowski P, Dougosh J, Baranowski R, et al. Acad Med 2019; 94: 1369-1375. Doi: 10.1097/ACM.0000000000002727) PMID: 31460935

    Teaching Clinical Handover with ISBAR

    Clinical handover is a critical core skill that needs to be taught to health professionals of all stages of experience and disciplines. Use of a structured, standardized framework for handover improves patient outcomes The ISBAR (Introduction, Situation, Background, Assessment, Recommendation) framework provides a standardized approach to communication in any complex clinical environment. The purpose of this review is to highlight key elements of effective clinical handover, and to explore teaching techniques that aim to ensure the framework is embedded in practice.

    (Burgess A, van Diggele C, Roberts C, Mellis C. BMC Med Educ 2020; 20 (Suppl 2): 459 doi: 10.1186/s12909-020-02285-0) PMID: 33272274.

    How to Conduct Cost and Value Analyses inHealth Professions Education: AMEE Guide No. 139

    Despite much talk about the growing demand for accountability and transparency in health care costs, education is lacking about the use of cost and value analyses. This guide from the Association for Medical Education in Europe (AMEE) introduces key concepts, methods, and literature that will enable novices in economics to conduct simple cost and value analyses, hold informed discussions with economic specialists, and undertake further learning on more advanced economic topics. Key steps include defining the economic research question, identifying an appropriate economic study design, and carefully identifying, quantifying, and pricing the cost ingredients.

    (Foo J, Cook D, Tolsgaard, et al. Med Teacher  Doi: 10.1080/0142159X.2020.1838466)  PMID: 33280483

    William Rayburn, MD, MBA is an emeritus distinguished professor, chair of obstetrics and gynecology, and associate dean at the University of New Mexico School of Medicine, Albuquerque, NM and a clinical professor of obstetrics and gynecology and graduate studies at the Medical University of South Carolina, Charleston, SC.

  • 01 Jan 2021 9:16 AM | Anonymous

    This column aims to generate a conversation on how continuing education and practice development is currently viewed and developed around the world, especially through the lens of the educator. We will acknowledge a variety of experiences and systems of continuing professional development (CPD) to support healthcare professionals’ (HCP) lifelong learning. 

    To Be Continued… Supporting Physicians’ Lifelong Learning

    By Helena Filipe, MD, MMEd, with Carolin Sehlbach, PhD

    This issue, I am delighted to focus my column on the investigative work of Carolin Sehlbach, a young researcher at the School of Health Professions Education, Maastricht University.  Her doctoral thesis draws our attention to the Continuing Professional Development (CPD) world in Europe.  Entitled To Be Continued… Supporting Physicians’ Lifelong Learning, Sehlbach research has chosen to spotlight two enticing aspects of CPD today: the idea of continuity, of movement, iteration and improvement, as well as those magic two words lifelong learning, the authentic cornerstone of meaningful CPD with impact on patient outcomes and on the public well-being.

    Sehlbach’s research presents how recertification and CPD practices are organised across 10 European countries.  Not surprising, despite the increasing mobility of healthcare professionals and patients across Europe calling for some harmonization to ensure patient safety and high-quality healthcare services, there is still a wide variety in rules and regulations, performance assessment criteria and stakeholders.

    Current recertification systems and approaches in CPD are often misaligned with daily practice and may fall short on including feedback from relevant stakeholders, such as family and patient involvement, with little peer involvement and even less patient involvement (1).  Physicians learn from experiences in daily practice, from interactions with patients, and the exchange of experiences and knowledge with peers.  In her thesis, Sehlbach calls for integration of physicians’ learning into daily practice, as well as for regular performance evaluations from multiple stakeholders.

    The importance of the patients’ “voice” in physicians’ learning has been receiving growing attention from national media.  Of importance, the ACCME has recently included activities that are planned with patient representatives and include patients in the formal program delivery among the revised ACCME Accreditation with Commendation Criteria for CME/CPD providers in the U.S. It might be that some individual physicians would oppose the idea that patients should play a role in physicians’ learning, particularly their performance assessment component. However, research findings were more nuanced by distinguishing the competences upon which patients wished to give feedback. These were physicians’ communication, collaboration and professionalism (2).  The interview data further revealed three different patients’ perspectives: the proactive perspective, the restrained perspective and the outsider perspective. These perspectives could change over time and depended on a perceived power balance, previous experiences, and self-efficacy, and impact individuals’ willingness to provide performance feedback. With patient empowerment gaining momentum, Sehlbach’s work calls for active and meaningful patients’ involvement by inviting their feedback while respecting individual preferences on how such feedback is nuanced.

    Sehlbach describes a misalignment of current recertification systems and CPD approaches with physicians’ daily practice (3). Data across three different countries shows that despite differences in system requirements, most physicians indicate that they are actively engaged in lifelong learning and continue to learn from daily practice. Organisational and collegial support and an “authentic” system, with an alignment of certification requirements with daily work, would yield higher levels of acceptance of and trust in the recertification system.

    Findings on workplace-based learning and on cues that physicians use of their practice based learning, further revealed variations in how sensitive individuals are in recognizing learning opportunities in daily practice (4). Implementing practical tools and training physicians to raise awareness of potential learning opportunities in and from practice, particularly communication with patients, might be worthwhile.

    Sehlbach’s investigation has implications on lifelong learning and performance assessment, partly calling for a re-evaluation and redesign of current systems.  It advocates for more patient involvement, diversification of formal educational activities and integration of learning into the workplace, thereby creating a culture of collaborative and informal learning. Her research highlights the need to advance and translate scientific insight into practical approaches.  Research into lifelong learning is yet “To be continued…”.

    For more detailed information, you may access the full text of Dr. Sehlbach’s thesis here. Readers are welcome to contact the author at carolin.sehlbach@maastrichtuniversity.nl

    Note: Carolin Sehlbach’s PhD trajectory was made possible by a collaboration between the European Respiratory Society and the School of Health Professions Education (SHE) at Maastricht University.  We hope this might serve as an inspiration for more young researchers to select CPD as their research interest field and find support from scientific, medical organisations.

    Helena Prior Filipe, MD, MMEd, is a consultant in the College of Ophthalmology of the Portuguese Medical Association International Council of Ophthalmology, University of Lisbon, Portugal.


    1. Sehlbach C, Govaerts MJ, Mitchell S, Rohde GGU, Smeenk FWJM, Driessen EW. Doctors on the move: a European case study on the key characteristics of national recertification systems. BMJ Open. 2018;8(4).
    2. Sehlbach C, Govaerts MJB, Mitchell S, Teunissen TGJ, Smeenk F, Driessen EW, et al. Perceptions of people with respiratory problems on physician performance evaluation-A qualitative study. Health expectations : an international journal of public participation in health care and health policy. 2019.
    3. Sehlbach C, Govaerts MJB, Mitchell S, Rohde GGU, Smeenk FWJM, Driessen EW. Box-ticking and Olympic high jumping – Physicians’ perceptions and acceptance of national physician validation systems. Medical teacher. 2018;40(9):886-91.
    4. Sehlbach C, Teunissen PW, Driessen EW, Mitchell S, Rohde GGU, Smeenk FWJM, et al. Learning in the workplace: Use of informal feedback cues in doctor-patient communication. Medical education. 2020;54(9):811-20.

  • 01 Jan 2021 9:13 AM | Anonymous

    The purpose of this column is to highlight innovative CME/CPD initiatives in Canada in order to establish a conversation within the SACME community.

    A New Online CPD Practice Community in Canada 

    The Physician Learning and Practice Improvement Community of Interest is an online community for CPD providers, leaders, administrators, accreditors and patient partners.

    Our Shared Vision. It is a place where the CPD community can connect with each other in a new way and advance the quality and impact of CPD across the country. The goal is to create the conversations and support the initiatives that help build a CPD system in Canada that support physician learning and practice improvement. Launched in October 2019, there are 116 members and we have offered six Coalition webinars on timely topics, with a theme on transforming CPD during a pandemic, and collaborated with the Royal College to promote their CPD: A New Virtual Reality series of webinars. All webinars are for members only and are archived in the Ask the Expert section of the site.

    Why join? To interact and learn from others who have a passion for CPD; to get your questions answered and to help others with theirs; to improve your and your colleagues’ practices in CPD development and leadership; to help build up the CPD community in Canada and beyond.

    Who can join? We invite physicians and non-physicians with a passion for CPD and practice improvement to join here. The community is hosted on the Canadian Medical Association (CMA) Community engagement platform. You do not have to be a CMA member to participate but you will need to create an account on cma.ca to access the community (see attached PDF for instructions).

    This online community, led by the College of Family Physicians of Canada, is an initiative of the Coalition for Physician Learning and Practice Improvement. The Coalition was established in 2019 and includes eight national medical organizations whose goal is to carry forward into action the recommendations of the Future of Medical Education in Canada (FMEC) CPD report.

    For more information please contact Fran Kirby, Community Manager, fkirby@cfpc.ca.

    Canada’s KeyLIME Podcast Makes MedEd Literature Easy, Short and Fun 

    How do you keep up-to-date with the medical education literature?  How do you find the important articles, let alone have time to read and critique them? 

    Physicians are crunched for time but do want to stay current when it comes to research. Resolving this tension was a big motivation for the creators of the Key Literature in Medical Education (KeyLIME) podcast.

    A weekly podcast produced by the Royal College of Physicians and Surgeons of Canada since 2012, KeyLIME does the leg work for listeners, focusing on valuable research that is published outside of top medical education journals or their own specialty.  In each episode, the hosts - Dr. Jason Frank, Dr. Jonathan Sherbino, Dr. Linda Snell and Dr. Lara Varpio – discuss the main points of an article in less than 30 mins.

    KeyLIME’s short format, the hosts’ enthusiasm (funny outtakes anyone?) and their engagement with their audience via Twitter has proved to be a successful mix, that keeps the podcast’s reach growing every year. Fun facts include:

    • Almost 300 episodes
    • Over 241,000 downloads in 2020
    • A fan base that spans across the globe, with top listeners hailing from countries such as the United States, Australia, the UK, the Netherlands, Singapore, New Zealand and Finland
    • Opportunities for audiences to participate live recordings at medical education conferences throughout the world
    • Listeners can earn Maintenance of Certification (MOC) credits under Section 2 for each podcast

    Want to check it out? Subscribe to KeyLIME via iTunes and look for weekly posts on Tuesday mornings on the Royal College’s Twitter and LinkedIn page.

    Have a publication to recommend? Write to us at keylime@royalcollege.ca
  • 01 Jan 2021 9:11 AM | Anonymous

    By Vjekoslav Hlede, PhD

    This column aims to highlight the rapid changes occurring in E-learning methods, approaches and challenges, as well as its supportive technology, and how these will impact medical education.

    Book review: Justin Reich, Failure to Disrupt: Why Technology Alone Can’t Transform Education

    We have all heard those big promises about technology that will improve education and CME/CPD for good. Most of us were thinking, “Hmm, that will be an excellent addition to our CME/CPD services.” And we waited. And we waited patiently. And we sometimes asked ourselves why many of those big believable promises did not happen. This book provides a convincing explanation of why they did not happen and what we can do better.

    Justin Reich is a professor at MIT and Director of the MIT Teaching Systems Lab. In his latest book, Failure to Disrupt: Why Technology Alone Can’t Transform Education, (Reich, 2020), Justin delivers healthy skepticism about learning technology. This skepticism will curb our attempts to romantically dream big and hope that technology alone will address many of our complex problems. Simultaneously, the book’s insight will empower us to find areas where we can make noticeable improvements. It helps us avoid errors we made in the past and better plan CPD in our increasingly digital future.

    The book provides an easy-to-understand, high-level overview of the biggest challenges affecting online education. Jal Mehta, Professor of Education, Harvard Graduate School of Education, explains: “If you had to pick one book to learn about all things online learning, this would be the one.” Since all the issues discussed in the book affect online CME/CPD learning delivery, this recommendation is especially valid in the context of CME/CPD.

    Technology-enhanced CPD is an immensely multifaceted endeavor. The learning/educational technology industry, learning theorists, accreditors, licensing organizations, evolving medical, academic, and digital cultures, and above all, the massive transformation of the healthcare system create a cacophony of often conflicting needs and directions. The high-level “bird's-eye" overview Reich provides helps us map how technology interacts in this complex socio-technical system. 

    A map of the system is the key. Many unkept promises, false starts, and unfinished edu-tech projects are caused by a lack of understanding of the socio-technical system. Reich helps us map the system, better navigate through challenges, and make sustainable improvements. 

    I found interesting and often actionable insights on each page. Therefore, I recommend reading the whole book. However, busy professionals may decide to read just the introduction and conclusion. And they will not be sorry. In 16 pages, Reich presents the history and present of the three primary modalities for online learning at scale:  (1) instructor-guided, (2) adaptive, algorithm-guided, and (3) peer-guided networked learning. He explains why innovations, massive hype, and huge investments are not delivering on their big promises. Instead of significant transformative changes, we see only small, incremental improvements.

    Technology has failed to disrupt. And that is where the opportunity lays, Reich explains. There is no good reason to believe the situation will change. Technology alone cannot disrupt. Be skeptical of charismatic technologists who predict sweeping changes, Reich warns. Tinkering is the way to go. Tinkerers understand that education is a highly complex system. We have a tremendous opportunity to improve it. However, the improvement comes as a result of repeated incremental changes in the socio-technical system, rather than the simple sweeping implementation of new technology. Tinkerers are optimists, but they use critical thinking and research to find what is possible and how to achieve it.

    Reich (semi-jokingly) proposed the Reich Law: People who do stuff do more stuff, and people who do stuff do better than people who don't do stuff" (Reich, 2020, p. 24).

    That is the magic sauce. Instead of looking for the silver-bullet technology that may (in the indefinite future) address all our needs, we should tinker with the available technologies—to improve our performance. And do it again, and do it better and better.

    Reich provides multiple tools that can help us while we are tinkering with how to do it better. The book is the most important tool in the toolbox. Other tools are (1) the website, which includes a discussion board where you can chat with other readers and the author, (2) a series of (recorded) webinars that are available to registered users, and (3) a YouTube video presenting the highlights from the book.

    What are the key messages?

    There are three types of established technology-enhanced learning (TEL) formats that support learning at scale. The learning formats and associated technology stacks are built around the question: "Who defines the learning process for learners?" The answer can be faculty (and a learning design team), an algorithm, or a network of peers (networked learning communities). Each TEL format has a 60+ years long, well-documented history.

    TEL innovations are often built around new technologies and established pedagogies; they are rarely associated with pedagogical innovation. Therefore, the history of the technology-enhance learning formats in use can (1) help us predict outcomes and challenges we can expect, and (2) realize what is actual innovation and what is a new iteration of an established practice.

    Each of these three TEL formats come with benefits and noticeable limitations. The challenge is that it is hard to combine those learning formats in a manner that neutralizes limitations.

    In more detail:

    • Faculty-guided self-paced learning at scale (like xMOOCs) works well for experienced learners, but it is not the best solution for many learners (especially the struggling ones).
    • Peer-guided learning at scale works well for informal and non-formal learning. It is usually an essential part of successful quality improvement projects. However, it does not work well with the standard school or CME/CPD curriculum (with predefined learning objectives).
    • Adaptive learning systems work well for many learners, but they work well only with well-defined topics. Justin Reich uses examples of mathematics and early reading, where results can be easily standardized. Adaptive learning relies on quiz questions and applications that grade learners' assignments (autograders) – methods that cannot evaluate the quality of reasoning well.  Hence, adaptive learning used to train practicing professionals in complex topics as healthcare assumes some compromises in the quality and depth of learning. However, adaptive learning programs are good preparation for standardized tests (like board exams).

    Consequently, 1) TEL learning at scale was able to deliver many context-specific improvements – but not a sweeping system-wide improvement, and 2) for successful TEL at scale, we should combine technological innovations with well-planned improvements of the complex context/system.

    Vjekoslav Hlede, PhD is a Senior Learning Management Specialist with the American Society of Anesthesiologists, Chicago. 


    Reich, J. (2020). Failure to Disrupt: Why Technology Alone Can't Transform Education: Harvard University Press.

  • 01 Jan 2021 9:10 AM | Anonymous

    By Joyce M. Fried and Mary G. Turco, EdD

    SACME’s Strategic Affairs Committee provides support and guidance to the SACME Board of Directors regarding strategic direction, planning, and management of the Society.  The committee, chaired by Mary Turco and vice-chaired by Joyce Fried, consists of 13 additional members, eight who serve vis-à-vis their leadership position in SACME and five who are at-large members proposed by the committee chair and approved by the Board of Directors.  The committee meets monthly.  Meetings are by invitation only.

    The purpose of the committee is to guide and inform the Board of Directors by: (1) developing effective process and performance approaches for advancing the strategic plans of the Society; (2) preparing recommendations to the Board of Directors on current and future strategic initiatives, as appropriate; (3) overseeing organizational and committee work plans designed to advance strategic priorities; and (4) establishing processes to guide the solicitation and management of grant funding to support the scholarship of CME/CPD in the future.

    The Strategic Affairs Committee is a relatively new SACME committee having evolved over the last eight years from what had been called SACME’s Research Endowment Council. The Council had been created many years prior to enhance the work of the Research Committee by seeking large grants to create an endowment fund to promote the Society’s scholarship. 

    In 2012, the Council determined that it was difficult to raise funds for an organization that does not have a strategic plan.   As a result, the Council morphed into the Strategic Affairs Work Group which carried out a strategic planning process that was built on four strategic initiatives--Scholarship, Strategic Collaborations, Leadership Development, and House-in-Order. 

    In 2014 Society Bylaws changes made possible the creation of the current Strategic Affairs Committee as an official standing committee of SACME.   The chair of this committee is appointed by the president.  The committee’s first chair was Leanne Andreasen (2013-2015), followed by Moss Blachman (2015-2017), Barbara Barnes (2017-2019), and Mary Turco (2019-2021). 

    The Strategic Affairs Work Group and its successor Committee have held an annual retreat to address its charge by reviewing and updating its recommendations to the Board based on the evolving status of the Society.   The 2019 Strategic Affairs Committee retreat was held in Chicago.   Attendees developed a set of recommendations to the Board of Directors categorized by issues related to mission, members, and management.  They also reviewed and made recommendations about budgetary requests and strategic collaborations.   

    In March 2020, the Board of Directors asked the Strategic Affairs Committee to review and suggest updates to the Society’s strategic planning documents.   To that end, Mary Turco, with the assistance of former Board Secretary Edeline Mitton, who was advisory to the Strategic Affairs Committee, gathered and shared eight archival strategic planning documents dating back to the era of the Strategic Affairs Work Group.   The committee reviewed these documents and then met twice in May and once in June to draft suggestions to the Board for updating the four original strategic initiatives:  Scholarship, Strategic Collaborations, Leadership Development, and House-in-Order. The committee shared its suggestions and proposed recommendations in June 2020.  During its meetings in Fall 2020, the Board endorsed those recommendations. 

    The Committee It is also developing an executive summary report that will contain the current SACME Strategic Plan and major strategic planning documents that have informed that plan.  The Strategic Plan will be shared with the membership once completed.  Look for more updates in future issues of CE News and other SACME publications in the new year.  

    Joyce Fried is Emeritus Assistant Dean, CME, UCLA School of Medicine. 

    Mary G. Turco, EdD, FSACME is Clinical Associate Professor of Medicine, Geisel School of Medicine at Dartmouth, Principal for Scholarship Enhancement and Academic Professional Development, Department of Medicine, Dartmouth-Hitchcock.

  • 01 Jan 2021 9:10 AM | Anonymous

    Association of American Medical Colleges (AAMC). The AAMC released a new strategic plan to respond to rapidly changing health care landscape, A Healthier Future for All, October, 2020, Washington, DC.  Learn more

    AAMC MedEd PORTAL Recent Publications

    • Resident Workshop to Improve Inpatient Documentation Using the Progress Note Assessment and Plan Evaluation (PNAPE) Tool
      Physicians enter residency with varied knowledge regarding progress notes and proficiency writing them. An educational workshop and note assessment tool was constructed based on a review of literature and best practices. Kirstin A. M. Nackers, MD, Kristin A. Shadman, MD, Michelle M. Kelly, MD, MS, Helen G. Waterman, DO, Nicole L. Bentley, MD, Daniel P. Gorski, MD, Collette Chorney, MD, Jens C. Eickhoff, PhD, Carrie L. Nacht, MPH, Daniel J. Sklansky, MD Publicaiton Date: 11/20  Read it here
    • Clinical Coaching Cards: A Game of Active Learning Theory and Teaching Techniques
      This resource is a faculty development card game that applies active learning theory within a framework of peer coaching to teach bedside and clinical teaching techniques. Bjorn Watsjold, MD, MPH, Diana Zhong, MD, Publication Date: 11/20  Read it here
    • Opioid Use Disorder and Assessment of Patient Interactions Among Family Medicine Residents, Medical Students, and Physician Assistant Students
      In light of the US opioid epidemic and the need for training to conduct difficult conversations about opioid dependence, this module was created to show motivational interviewing with patients who have opioid use disorder. John G. Spangler, MD, MPH, Catherine N. Shull, PA-C, Carol A. Hildebrandt, Keli Beck Jones, MD, Andrew L. Brewer, MS, Mark P. Knudson, MS, MD, Gail S. Marion, PA-C, PhD, Julienne K. Kirk, PharmD, Publication Date: 11/20  Read it here
    • Empowering Medical Providers and Trainees to Care for Patients and Families with Limited English Proficiency: A Training Workshop
      The use of professional medical interpretation has been linked to improved access to care and better outcomes, but it remains underutilized. This workshop aims to teach the skills needed to use medical interpretation. Jessica Jones, MD, Kerrilynn Rice, MD, MPH, Victor Cueto, MD, MS, Coralee Del Valle Mojica, MD, MPH, Meghan Stawitcke, Sara Salem, EdM, Elizabeth Talley, MD, Rebecca Blankenburg, MD, MPH, Publication Date: 11/20. Read it here

    American Board of Medical Specialties (ABMS). Draft Standards for Continuing Certification – Call for Comments Delayed Until April 2021 due to COVID-19

    The American Board of Medical Specialties (ABMS) had been prepared to release the Draft Standards for Continuing Certification – Call for Comments in early December, in accordance with the timeframes established in the Continuing Board Certification: Vision for the Future Commission’s (Commission) final report. However, the recent surge in new Coronavirus (COVID-19) cases, which has placed additional burden on the already stressed health care system, has prompted ABMS to postpone the opening of the public comment period. ABMS has decided to move the opening of the Call for Comments to April 2021, pending the status of the COVID-19 surge and the hospital caseload at that time.

    Accreditation Council for Continuing Medical Education (ACCME).

    New Accreditation with Commendation Criteria resources have been published including detailed examples of compliance and non-compliance to assist providers in their further understanding of the criteria. Explore the ACCME Compliance Library

    New Standards for Integrity and Independence in Accredited Continuing Education.  The ACCME has recently announced new Standards for Integrity and Independence in Accredited Continuing Education. The Standards are designed to ensure that accredited continuing education provides healthcare professionals with accurate, balanced, evidence-based information that supports safe and effective patient care.

    The ACCME has produced resources to support the continuing education community’s successful transition to the new Standards. Providers in the ACCME System (ACCME-accredited, state-accredited, and jointly accredited providers) will be expected to implement the new Standards by January 1, 2022.

    • New Standards Webinar: The ACCME will hold a free webinar, open to all, on January 11, 2021, at 1 pm Central. Register here
    • New Standards Info Package: This PDF includes an overview and full text of the new Standards, transition timeline, and links to resources.

    American Medical Association (AMA). The AMA Ed Hub offers CME and professional education from the AMA and other trusted sources—all in one place. AMA Ed Hub supports professional development and makes it easy for physicians to discover education that meets their practice needs and in formats they like to learn. Formats include articles, audio podcasts, video, and interactive modules.

    Federation of State Medical Boards (FSMB). The FSMB works to identify, develop, and implement CME activities that address content areas that include medical regulation, licensure, discipline, Step 3 examination, and advocacy and policy to promote public health, safety and welfare. Educational information on these topics and more, at www.fsmb.org/education.

  • 01 Jan 2021 9:08 AM | Anonymous

    Society for Continuing Medical Education (SACME). Phil R. Manning Research Award in Continuing Professional Development. Call for Proposals - The Manning Grant has up to $50,000 (USD) over two years available to support scientific research. For detailed information and to submit your letter of intent by midnight (CST) on Friday, January 15, 2021 go to the submission portal.

    Patient-centered Outcomes Research Institute (PCORI). Upcoming Funding Opportunities. Check for research areas and upcoming application deadlines.

    Royal College of Physicians and Surgeons of Canada (RCPSC). offers a variety of grants to support medical educators, clinicians and researchers. Find more information here.

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