The Nooks and Crannies of CME: Who Makes the Final Call on Content?

As the agenda for CMEpalooza Spring continues to take shape (we’ve made some recent additions you can check out if you feel the urge), you’ll notice that the big picture concepts of CME are fairly well covered by our panels. These are some of the broader debates we all have when we are developing education: our educational design, our technology platforms, our outcomes plan…things like that. And don’t get me wrong — these are all critical to discuss and debate at length, which we’ll absolutely do on Wednesday, April 16.

But in this periodic feature that I rolled out earlier this year, we’ll look at some of the nooks and crannies of CME that don’t get discussed often enough but are nonetheless critical for the community to pick over and understand.

Today’s Topic: Who Makes the Final Call on Content?

One of the basic principles of CME activities is that there is going to be a clinician (or group of clinicians) who will be the “face” of our education. The level of their involvement in the content development process will, of course, vary depending upon the educational design. In some cases, they’ll serve more as planners and reviewers while our content team (typically, full-time or freelancer medical writers) takes on the brunt of the work; in other instances, the faculty will take a more hands on role (for instance, when creating a slide deck for a live presentation). In either scenario, things can get tricky when we disagree with the advice of our faculty experts either on a clinical matter in which they undoubtedly have more overall knowledge than we do or are something more nuanced like wording or slide design.

Let’s look at a couple of real-world scenarios with some Monday morning quarterbacking from me to give you an idea of what I’m talking about. And yes, these all really happened.

SCENARIO #1: This one happened about 18 years ago, when I was notably younger, had considerably more hair, and felt the need to assert myself a little more to carve out my space within my employer. We were in the slide review room prior to a satellite symposium (do people still do formal slide reviews onsite? I haven’t been part of one for many years) and going through the content of one faculty member in particular who had sent us his deck 2 days prior. I had been the one doing the content validation (ie, fact checking) for this specific activity, and I noted that he had made an error in his analysis of the trial data on one of his slides.

Since we were so close to the day of the symposium (and slide review), I didn’t mention anything until we were onsite and I had a chance to discuss things with this faculty member face to face. Perhaps not appreciating being told, “You are wrong,” by a relative newbie to the CME space, this faculty member pushed back and refused to change the wording on his slide. Eventually, we got the faculty chair to weigh in, and he agreed with my perspective. However, he was a bit more diplomatic than I was, and helped to broker a compromise solution.

MONDAY MORNING QUARTERBACK: While I was in the right from a factual perspective, I probably should have let this go once the presenting faculty member disagreed with my assessment. I don’t remember the precise substance of the issue, but I am fairly sure it was relative minor and not essential to the educational messages of his presentation. Now, if it was more substantive, I have no problem with someone on our end holding their ground and fighting hard for their position. Of course, it helps to have someone (ie, medical director, faculty chair) backing you up.

SCENARIO #2: I was working more recently on a case-based online activity where we had held an initial planning call with our two faculty members to hammer out the general direction of two patient scenarios. Our medical writer on the project took this direction, and I worked with her to craft sensible details for each case. During the initial review of the complete content, one of our faculty members inserted a comment that read as follows: “Why don’t we change this from an IgG case to an IgM case? It might be less common, but could be a more interesting case.”

A few important things to note here:

1. She had agreed on the planning call (or at least had not audibly disagreed) that we’d create an IgG case. It doesn’t matter if you know what IgG is by the way, just know that it’s a different subtype of one disease state.
2. She wasn’t saying that anything was factually incorrect in the case that had been created, just that we could have gone in a different direction
3. Making her suggested change would have had a lot of downstream effects on the details and progression of the case
4. We were already several weeks behind in our launch timeline and this would have pushed us back even further

So in my response to her, while we accepted the majority of her suggested edits, I politely explained that, while her suggestion was certainly valid, we did not have the time to make all of the changes that would have been necessary if we followed down this new path. I encouraged her to let us know if there was anything factually incorrect with the case we had created. Fortunately, our faculty member was fine with this explanation and agreed to leave the case’s direction alone.

MONDAY MORNING QUARTERBACK: One of the points I did not mention was that I initially approached our freelance writer to find out, “How much of a pain would it be to make this change?”

Her response, in a nutshell? “A big, big pain. I’ll do it if I have to, but this really would take a lot of time.”

That gave me all the information I needed. Faculty certainly may change their mind on specific items from time to time, and we often need to just “go with the flow.” But when they make a suggestion that significantly alters a decision they had already previously make on what seems like a whim, we can be confident in steering them gently back in the original direction.

SCENARIO #3: A few weeks ago, I got a slide deck from a faculty member that would be part of a live symposium happening later this year. It was generally well done — sensibly organized and thorough. But, as happens quite often, there was far too much information packed on some of the slides. The font size for some of the text was 18 pts. or less, which may be readable on the computer screen when you are sitting 5 feet away from the monitor, but is impossible for someone sitting in the back of the conference room to see on the monitors at the front of the room (the dreaded, “I know you probably can’t read this, but let me tell you what it says” moment from the podium that we’ve heard over and over).

When I went through the deck our faculty member submitted, I did the best I could to simplify some of the information on the busier slides so that they would be more likely to be viewable onsite.

My efforts were not well received.

“Can you put slides 6, 8, and 13 back the way they were?” our faculty member wrote. “I’m afraid they’ve lost the message I am trying to tell with your edits.”

Again, there was nothing factually wrong with the information on the initial (or revised) slides. Our faculty member simply wanting things the way she wanted them. Could I have pushed back again and said, “These are not going to be readable onsite”? I suppose so. But this was one of those situations where it doesn’t always help to unnecessarily cause friction. Yes, I’ll be cringing onsite when these “original” slides come up and everyone in the back of the room has to squint to read the small text, but I’ll trust our faculty to “tell her story” the way she wants.

MONDAY MORNING QUARTERBACK: This one is pretty fresh in my mind, so I don’t know if I would have done anything differently. We’ll see how things go onsite and if this comes up in our faculty postmortem.

But the takeaway for this one is to choose your battles. It’s always OK to make your best recommendation, but if you find points of disagreement, it’s also OK to give a little to avoid unnecessary confrontation.

Agree or disagree with anything/everything I’ve said here? I sure hope so. Feel free to share your thoughts in our comments here or through our LinkedIn posts.