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).

“This could either be one of the best things or one of the dumbest things we’ve ever done.” — Derek Warnick, December 2024

Back in the late 1800s, it was very popular for famous authors to publish their latest novels as newspaper serials, releasing a new chapter every week in whatever broadsheet paid them the most money. Classics such as The Count of Monte Cristo, A Tale of Two Cities, and Around the World in Eighty Days were all originally published in this manner before being released as full novels. It was a way for authors to make extra money as well as build interest in their literature. I am guessing it was somewhat akin to the way that we used to have to wait until every Wednesday at 10 pm to find out the latest twist in the Dynasty feud between the Carringtons and the Colbys.

Of course, seeing as Derek and I are on the cutting edge of technology, we figured we’ll roll back the clock (wayyy back) and revisit the glory of the serial story era this winter with our special form of improv literature. Starting today and continuing over the next 6 Fridays, we’ll publish one part of The CMEslinger. We’ve alternated the writing of each part, basically forcing each other to continue the story where the last person has left off. We didn’t discuss our plans for the story as it progressed (hence the “improv” component). I think we’ve done fairly well not trapping each other into a corner with each part, but you can be the judge of that.

So without further ado, part one of The CMEslinger.

Part 1 (Derek)
The man in black fled across the desert, and the CMEslinger followed.

The omnipresent sun, nearing its unmerciful daily zenith, had scorched the sky free from all but the barest traces of blue. Slouching down slightly in his saddle to better settle into the rhythms of the palomino pony he rode, the CMEslinger reached for the canteen strapped across his body and lifted it to his dried, cracked lips.

Of all the disappointments the CMEslinger had experienced in a life full of many, none brought his faded grey eyes closer to tears than the hollow sound of the desert wind howling across his empty canteen. Flinging it away in disgust, he spurred the pony on, muttering to himself, “I really should have filled up the dang canteen at the office before I left. And why did I decide to ride a horse instead of calling an Uber?”

Crusty old Phinneas – part mentor, part tormentor, part department head – would be disappointed in him. “Never be not prepared!” he constantly drilled into his team, his indirect phrasing baffling them all into a fresh awareness of old ideas. Old Phinneas would be disappointed in him, but not surprised, the CMEslinger never being a favorite. That honor was reserved for the darkly dressed man he now pursued.

With a head shake of annoyance, the CMEslinger glanced at the dented pewter pocket watch with the Philadelphia 76ers logo in the middle that he always kept tied to his saddle horn. He’d been chasing the man in black for several hours now and had made no progress. Peering through narrowed eyes battling the sun’s unrelenting rays, the only remaining sign of the man in black was the powdery dust kicked up by his rental car settling on the desert highway.

The conference was in two days and the man in black was slipping from his grasp. He had to get moving.

Hey there 2025 – nice to meet you. Be kind to everyone, please.

In the vein of comradery and community, we’re rolling out the 2025 CMEpalooza blog with one of our new features that we announced last month called “Ask Us Anything.” If you recall, this is your chance to get “expert” advice from Derek and I about whatever is on your mind. I know that people were initially reticent to write about their current issues until they saw the quality of advice that we were going to give, but we did get a few interesting submissions that we’ll address here and now.

If you have an issue you want us to help with, you can go here to submit your question(s)

Dear Derek and Scott,

I am in academia and nursing, and I need to understand other academic settings (outside of medicine) and how programming is supported. Are provider units self-sustaining or part of the school’s business functionality? I need to understand different business models on how academic centers are producing lovely programming, and I am sitting here struggling without a budget to develop enduring programs, obtaining instructional designers, paying speakers, etc. Any help or references to other members would be great!

Warmly,

It’s Not So Academic

DEREK: Given that 2025 will be my [checks notes] 25th(!) year working in CME/CE, I’ve had the opportunity to work for a number of different provider types, including twice in academia. Of those two academic CME providers, one was almost entirely self-funded and the other was a mix of institutionally and self-funded. In talking with a number of other academic providers, it appears of them fall into one of those two categories, with very few being 100% institutionally funded.

I won’t sit here and tell you that I am an expert on business models for academic centers. It’s a tough business, and I definitely remember muttering some words that would make my mother blush every time the “Dean’s tax” would cut out a portion of the already meager funds we were able to bring in. From my experience during this time, there were two tactics that helped us balance the budget:

1. Utilizing internal resources. One of the advantages of working at an academic center is that there may already be staff members in other departments that you can tap into for help. An academic center is no different than any other large organization in that so often the left hand has no idea what the right hand is doing. Did you know the Health Policy department has a full-time instructional designer on staff? Did you know the Office of Information Technology has a couple interns available to help with digital content? You might be surprised what is already available within your own organization.
2. Some academic providers bring in additional income by partnering with outside organizations (MEC’s, medical societies, etc.) to develop programs. This can be a convenient way to help fund internal programs without the workload of taking on all aspects of program development.

Lastly, if anyone reading this has any additional suggestions or recommendations, please feel free to add them in the comments section below.

SCOTT: Since I have no personal experience working in an academic center (although I have partnered with academic centers on numerous occasions), I’ll only add that you will find our CME community to be extraordinarily friendly and willing to offer advice. If you are a member of the Alliance for Continuing Education in the Health Professions, you could search their member directory for other providers in your geographic area and perhaps reach out to connect with someone whose professional demographic seems similar to yours. Another option is to connect with someone in the Alliance’s Hospital and Health System member section (one of their current co-chairs is a former CMEpalooza intern) to see if they might have someone they could suggest you chat with.

Being creative in finding low (or no) cost solutions is a skill at a premium in our industry. There are ways to create quality education on a shoestring budget — it just isn’t necessarily as easy as when you have lots of dollars to throw around.

Dear Derek and Scott,

CE professionals are increasingly examining practice habits via claims data. This presents a new window through which CE planners can evaluate how well educational interventions are potentially addressing healthcare/practice gaps. However, access to this data in my limited experience is either sparce or very expensive. Can you identify or recommend avenues for collecting and analyzing claims data (ideally before and) following education delivery?

Fondly,

ClaimQuesting Coder

SCOTT: Ah, claims data. The holy grail of outcomes analysis. Look, we all understand the rationale – we want a more definitive way to objectively demonstrate that our education is (or isn’t) impacting how healthcare professionals operate on a day-to-day basis. Relying on self-reported intent to change is fine, but we all know that our learners aren’t exactly spending hours thinking about this and may or may not follow through on their intent. Logically, an analysis of claims data from our learners would be a great, nonintrusive way of measuring the impact of our education.

However, you are right to note that this is neither easy nor cheap. Healthcare systems don’t exactly willingly allow anyone to access their data willy nilly. While there are certain metrics they are required to report to broad databases, this really doesn’t help us much. What we need is to dive into specific points of information from our learners (and perhaps a control group of non-learners) that are directly tied to the education that we delivered. Not easy and not cheap.

Whenever an organization approaches me and says, “We have access to a claims database that will give you great data on your programs, and it’s only $25,000 extra per activity,” my first question to them is always, “What claims database are you talking about?” Usually, the answer I get is, “It’s proprietary,” which means that they won’t (or can’t) tell me, which means that my Spidey sense goes on full alert and I run away. Quickly.

The limited success I have had with claims databases recently involved working directly with regional Health Information Exchanges that have access to provider data across multiple healthcare systems in their area. But again, neither easy nor cheap, and you really need to think carefully about what you want to measure and assess to determine whether you have realistic expectations.

DEREK: I am going to take the easy way out here and state that I don’t have much to add beyond what Scott has already shared. The one comment I’ll make is that my experience over the past few years with using claims data for both targeted distribution and outcomes analysis has been positive. I agree with Scott that you should give careful consideration to the type and goal of your program, but overall, I think the value derived from claims data is worth the cost. My dad always told me that you get what you pay for, and I would argue that is the case with claims data.

Dear Derek and Scott,

Hi! There is a, well, I’m not sure what to call it but let’s just say it’s a sort of blog that rolls up into an event and back out again. The content is no longer core to my professional role, so I could/should just unsubscribe and move on, making space for something more directly relevant, but the people who run it are entertaining and clever, bordering on funny, which makes me hesitant to pull the plug. What should I do?

Hugs and Kisses,

Entertained but Unsure

DEREK: This is an easy one. All you need to do is quit your current role and find a new job that is more relevant to the content of your favorite blog. Problem solved!

In return, perhaps the people who run the blog can work on moving it from “bordering on funny” to “actually, kind of funny.” I recommend they include more jokes about their favorite sports teams, 80’s trivia, and Top 5 lists. Also, more cat videos. You can never go wrong with more cat videos.

SCOTT: I am fairly sure that cat videos stopped being trendy about the same time as Despacito disappeared from your radio dial. Please try to keep up with the rest of the world, Derek. Our friend here seems to be in dire straits, and I get it.

On the one hand, we only have so many hours in our working day to devote to nonessential content, and there are so many time sucks waiting to, well, suck our time away. On the other hand, if the two people who run this supposed blog are so entertaining and clever, I would be hesitant about pulling the plug on them. Qualities like this are in short supply these days.

The solution is rather simple — substitute those 10 minutes you usually devote to making your morning cup of coffee and instead devote them to mental caffeine by ingesting your favorite, wittiest, most debonair blog. That way, you aren’t sacrificing any of that crucial time you need on your job, but you also are living a more enjoyable life.

Remember, if you have an issue you want us to help with next time (any issue), you can go here to submit your question(s)