CMEpalooza Ask Us Anything: January Edition

Fresh off another Alliance conference, we open up the old mailbox to see who needs some advice.

If you have an issue (professional or personal) you want us to help with, you can click here to submit your question(s).

Dear Derek and Scott,

What do you do if you find out that an individual was not accurate on their disclosure (after the activity)? How do you think an accreditor would view the situation if you did everything by the book based on what was provided to you?

Warmly,

DisclosureMismatch

SCOTT: This sort of paperwork minutiae is not my area of expertise, but I was fortunate enough to get the perspective of others in our community who have more knowledge in this area to help me out.

Basically, it comes down to this: We are not the Disclosure Police. When we send faculty/planner/reviewers disclosure paperwork to complete, we should assume they are being truthful and forthright in the information they send back to us. It is not our responsibility to dig into their online profile, financial statements, and bank records to try to catch them in a lie (fun as this may be).

Now, let’s say that faculty X is presenting at a live symposium on the latest innovations in the treatment of disease Y. On her disclosure form, she does not list any relationship that would disqualify her from participation in the activity. However, upon a social post-activity conversation, she lets it slip that, oops, she has a financial relationship with a specific pharma company (who oh-by-the-way is developing a product she just spoke about at length) that would indeed have disqualified her from presenting at the symposium. While there are no steps you need to take from an accreditation standpoint to retroactively highlight this information, if there was significant bias noted by learners in their activity evaluations, you could potentially notify those learners via a follow-up communication (perhaps with additional educational reinforcement material) that it came to light after the live activity that faculty X had a relevant financial relationship with company Y that may have tainted the assumed unbiased nature of this segment of the activity. Again, you are not required to take this step under accreditation standards, but it could be an ethically appropriate step.

It goes without saying that you would likely not want to utilize this faculty member in future education.

DEREK: 100% agree with Scott here, which is an odd feeling. I’m not sure I like it. Anyway, my first boss at my first CME job used to tell me all the time that we are not the CME police. She even had an old police hat in her office that she would point to when she said this. Her point being, and one that I’ve come to appreciate more and more over time, is that we are all overworked and understaffed and don’t have the time to conduct an investigation on every disclosure form that comes our way. As much as I love Jake Powers, CME Detective, he’s a fictional character and should stay that way.

To answer the second part of the question — how do you think an accreditor would view the situation — I really don’t think it would be an issue. As long as you document the situation, how you managed it, and your plan for managing similar situations in the future, it should be fine.

Dear Derek and Scott,

Despite the wealth of knowledge and experience in our industry, why do we keep creating the same old educational formats? Why is the majority of the education created still following the “sage on the stage” format? I’ve heard it takes 17 years for research to become practice, but I’m pretty sure we’ve known for a much longer time that this passive type of teaching is not ideal.

Best,

Frustrated CME Crusader

DEREK: I’m having a little trouble answering this question because I am getting bogged down in determining the definition of “same old educational formats.” If we just look at very general categories of educational formats — live meetings, enduring materials, online programs, etc. — then fine, yes, we are still mostly producing the same old formats. But if we get a little more granular and look at the educational design of these activities, then I would push back on the idea that we are continuing to do the same old, same old.

Let’s look at satellite symposia as an example. I’m not going to get into the educational value of a satellite symposium, as that is another argument for another time, but I disagree with the idea that the majority of these symposia follow the “sage on the stage” format. Most of the medical symposia I have been to or seen proposed (I review a lot of proposals) over the past few years have had a mixture of educational elements beyond just didactic lectures. These include simple things like panel sessions and group breakout sessions; fun things like Jeopardy and quiz show formats; and cool things like VR headsets with video and patient simulations with holograms. I’ve seen Choose-Your-Own-Adventure and Escape Room style symposia. I’ve seen symposia with hands-on workshops and peer-to-peer interview training. The point being, there are a lot of creative and interesting things going on in the world of satellite symposia (and other formats, too. Remember, I’m just using symposia as an example.).

That said, I don’t completely disagree with your point, Frustrated CME Crusader. I’ve certainly sat through my share of 2-hour lectures during this same time. The fact is that these more traditional education formats are generally easier and cheaper to produce, and there is still an audience for them. Plenty of people prefer this type of passive learning, though you are right to question whether we should still be giving it to them. But as long as “butts in seats” remains a primary metric for determining “success,” we will continue to have these types of programs around.

SCOTT: As Derek notes, there are a lot of providers who develop more innovative formats, but I won’t go so far as to say the majority of CME activities I see in our universe stray from the “sage on the stage model.” I don’t think the reasons for this are terribly complex – leaning on the tried-and-true slide deck and talking head model is both relatively inexpensive and easy, both for providers and faculty. More innovative models that involve newer technology can be costly and complex to develop. In some cases, faculty have a hard time “getting it” – basically, you are asking them to participate in a way that is unfamiliar to them. Some will love this sort of opportunity, some won’t. And in a world where supporter budgets are often squeezed, it shouldn’t be surprising that many providers continue to trot out traditional, cost-effective (and profitable) models.

Now, a personal perspective. I hate “sage on the stage” lectures. I hate keynote addresses where a supposed expert in whatever topic talks at me for 60 minutes without even trying to incorporate interactive or unique components. This is a big reason why you rarely see traditional lectures in CMEpalooza sessions, even though we don’t have a technology budget. We can all use our creativity to design education that puts a unique twist on our most traditional models. We are all definitely doing better than we were a decade ago (almost every program used your “sage on the stage” model back then), but there is still undoubtedly progress to be made.

Dear Derek and Scott,

I believe that patient advocacy organizations are significantly underutilized by the CE/CME/CPD industry. How can we better collaborate with these dedicated organizations to develop educational initiatives that truly encourage patient-centered care, moving beyond supplementary patient-education resources and testimonials that are often relegated to the end of the agenda?

Fondly,

Advocate Ally

SCOTT: I don’t know that you will find anyone in our community who will claim that patient advocacy organizations don’t add value to our education, and I have heard many people in our community echo your sentiments. So then why indeed are patient advocacy organizations still an afterthought for many of us?

Here is my two cents: It takes time to build relationships with any potential educational partner, and many of us already have to develop and cultivate partnerships with academic institutions, professional/state associations, joint accreditors, and/or other groups who, in many cases, are essential to the development of the education for a variety of reasons. Adding on patient advocacy organizations is simply deemed less of a priority, not because they aren’t seen as valuable partners but because they are seen as less valuable partners.

I’ll share a personal example to perhaps illustrate this point: I worked on a grant proposal last year where our team was planning both professional and patient-facing education (the potential funder had asked for both modalities in an RFP). We reached out to a patient advocacy group who we felt best fit our proposed education. After much back and forth, along with multiple conference calls, they agreed to be part of our proposal. We did the usual dance, talking about the potential role their organization would play in the education and finally hashed out the framework of an agreement. Great!

Grant was submitted. And denied.

So that time we spent building the relationship for that single relatively niche-oriented proposal was likely wasted. We parted on good terms, of course (“Hope we can work together in the future!” although the true likelihood of this happening is relatively slim), but this experience doesn’t exactly have us running to more new patient advocacy organizations for everything we are planning. You choose selectively and invest the time where you deem it to be appropriate.

DEREK: I’ll chime in just to add that if you do decide to work with a patient advocacy organization, loop them in from the very beginning. Don’t design the entire program and then reach out to them at the end. It makes the patient advocacy organization feel unimportant and tells them that you are only including them because it will look good in the proposal. From the supporter side, it’s fairly obvious when a patient advocacy organization (or any partner, really) has been included from the early stages or when their contribution has been relegated to a patient education handout tacked on at the end.

Remember, if you have an issue (professional or personal) you want us to help with in a future iteration of Ask Us Anything, you can click here to submit your question(s).