When Words Matter (Maybe)

One day last week, Derek and I were exchanging emails about some nonsense topic (it’s amazing how much time we spend on this every week), when I responded to something he wrote with, “We just need to figure out how to do it differently than those other moolyaks.”

Moolyak? What’s a moolyak? Frankly, I couldn’t even remember where I pulled it from, but I knew it wasn’t a phrase I created myself. So off to the trusty Interwebs I went, and tada! — it was from one of my all-time favorite Cheers skits where Cliff offers a story about ritual circumcision. Watch till the end – it kills me every time.

Anyway, “moolyak” is not a term I use often. Frankly, I can’t remember using it recently at all outside of this email. Perhaps it was because I had just come from a bris a few days before and my subconscious pulled up the phrase. Have at that, psychotherapists of the world!

What’s important, though, isn’t to think too deeply about these topics but rather to focus on Derek’s response. He didn’t say, “What’s a moolyak?” He was able to use those fancy things called “context clues” to figure it out. I could have wrote “ding-dongs” or “beetlebrains” or “ninnies” or any one of a number of colorful adjectives instead of moolyak and it wouldn’t have made a difference.

Let’s now tie things back to CME by taking a look at something that’s been in the our industry’s news a bit in the last week – the Outcomes Standardization Project (OSP). We had a session in the Fall of 2018 as this group was ramping up their efforts, and they have done impressive work. There is a comprehensive website that is now available with a variety of resources, and just last week, an article was published in the Journal of European CME that looked at the progress of this consortium of experts over the last 3 years. We are even acknowledged at the end of the article among those who have “provided meaningful contributions.” Why Derek’s name appears before mine, I am not certain, but let’s overlook that insulting error for now (note from Derek: [exchanges a knowing nod with the reader]).

Every few years, there is a call to “standardize” something in CME. For instance, a few years ago, there was some brief momentum to standardize grant submission portals. We all know how that went. The OSP team has certainly done much better, and produced something that might, might be valuable to our community. After years of hearing people throw around outcomes terms that some in our industry simply assumed meant the same thing to everyone, they realized that, no, there are a lot of different interpretations of some really basic vocabulary and well, goshdarnit, we should do something about it.

Now that the brunt of the OSP’s initial work is complete, they have offered to us how they believe specific common outcomes terms such as “participant” and “learner” and “completer” should be defined. They have even have included terms which I would have though were somewhat obvious such as “pre-test” and “follow-up assessment.” This group has done a lot of hard work with undoubtedly hours of conference calls and emails behind them, but really, the hardest work is still to come. It basically comes down to the question, “Will anyone care?”

We have likely all heard about how it takes approximately 17 years for medical research evidence to be adopted into clinical practice. It’s a number that is startling. We all often educate the medical community about the latest and greatest, yet the truth is that it’s going to take many years and many repetitions before a large part of our audience even considers changing their practice how we and our faculty might suggest.

So is the CME community going to be any different? Do we want to be any different? Are there those among us who will decide, “You know what, I am going to change how I determine when a learner has actually completed an activity now?” or will we simply fall back upon the definition we have always set within our organization?

To their credit, the folks who make up the OSP seem to understand the challenge before them. In their recent article, they highlighted the importance of consensus-building and outreach throughout the CME community to get all-important buy-in. It won’t be easy, for example, to convince company XYZ that their “1000 learners and 500 completers” based upon their internal definitions must now be revised to “500 learners and 250 completers” with the OSP’s new proposed definition. When funding dollars are potentially at stake, there is undoubtedly going to be pushback. “If company XYZ isn’t revising their internal definitions, why should I?” That sort of thing. We’ll see if some of the major players in the world decide to become trendsetters or naysayers.

In the meantime, go have a beer with your favorite moolyak. You can send Derek the bill.