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.

It seems as if this is the week that we’re all writing about our “CME origin” stories — Derek led us off last week and Intern Katie followed him a few days ago — so I guess I’d better share mine. It’s equally riveting.

As a 16-year-old high school junior, I remember completing an assignment where we had to write a letter to ourselves 25 years in the future. You probably had to do it too – seems like one of those things every high school English teacher in the country would have conspired to assign to their students.

The assignment was given right about this time of year, so I wrote something like, “I assume you are at the Super Bowl getting ready to cover the game for Sports Illustrated.” (Keep in mind that Sports Illustrated was a big deal back then. Now? Not so much.) The details of my essay are a bit hazy, but I definitely remember writing, “I’ll be very disappointed if you aren’t doing something related to sports.”

Sigh.

Yes, 16-year-old Scott would not be particularly impressed with my career path, but as with many of us in our little CME niche, it’s actually turned out quite nicely, thank you.

Unlike Derek, I did actually find full-time work in my initial chosen field — sportswriting — spending 5 years toiling away in the glamorous “not-Phoenix” part of Arizona and the equally-glamorous “not-Chicago” part of Illinois before becoming frustrated enough with my lack of professional progress and walking away.

My first healthcare job was at a medical publication company, where they apparently churned through people like me who didn’t know the difference between a myomectomy and a myeloma every couple weeks. I was told that one recent hire started on Monday morning, went to lunch, and didn’t come back. Great. That was reassuring.

What came next was even worse. As a “Welcome to our new employee!” gesture, the team I was working with said they’d take me to lunch.

Great, I love a free meal!

I sat quietly in my corner cubicle waiting for someone to come get me “around noon.” Noon came and went. 12:05. 12:10. I didn’t want to be the annoying newbie interrupting busy people, so I waited until 12:15 to stand up and see what was going on.

The department was empty. Everyone else had gone to lunch but no one had thought to take the new guy along. Was it a hint? (Yes Derek, you can insert your snarky comment now) (Note from Derek: Too easy. I’ll let it slide.)

Anyway, I survived the day after profuse apologies (“Oh, we all thought someone else was taking you.” Sure, sure) and kept plugging away. I could talk about the intricacies of Temple basketball’s 1-2-2 zone press for hours, but now I had learn about the ABCs and XYZs of bulk allograft transplantation for osteochondral lesions of the talus. It was not easy. There were many days when I felt way, way over my head. Katie wrote about how she was overwhelmed by all of the jargon and abbreviations at her first CME department meeting. We’ve all been there.

Within a year or so, I transferred over to the medical education group and found my home. This was back in the “Wild Wild West” days of CME where supporters were typically very much involved in the development of content. I remember numerous lavish dinners the night before a live program where the “supporters” (these were all marketing folks back then) would drop lots of money on food and drink and then sit side-by-side with you the next morning at the actual program offering their thoughts or commentary to be shared “during a break.” It was certainly different.

I was likely a bit of an arrogant, self-absorbed 30-year-old know-it-all (things haven’t changed very much) as I meandered about professionally over the next decade, wondering why no one realized how brilliant I was (Note from Derek: Again, too easy.) I finally started making some real progress about a decade ago, making enough friends that striking out on my own as a freelancer back in 2014 wasn’t quite as risky as it might have otherwise been.

I’ve been extremely fortunate to be able to partner with some really talented and kind people over the last several years. I am not naturally a particularly nice person (I was quite proud of my last professional nameplate where we all were assigned a cartoon doppelgänger. I was Oscar the Grouch), but I like to think the CME world has made me a bit more well rounded. I make fun of Derek a lot – you know you love it!! – but it’s OK because he is truly one of nice guys. I think that people like me more just because I’m tied with him through CMEpalooza. I tell my son all the time, “Surround yourself with good people. That way, everyone else will think you are a good person too, even if you aren’t.” It’s good advice for you too.

(Note from Derek: Well, crap, I wasn’t expecting that. Does this mean I need to go back and delete the jokes I made about Scott?

[thinks]

Nope. Nice try, Kober.)

We’re joined again today by our CMEpalooza Spring intern, Katie, who brings her cheery, sunny personality back to the blog. Needless to say, you don’t get that from either of us, so enjoy the respite!

Hello CMEpalooza groupies — hope you are having a great day! I wanted to share with you what happened on my first day in CME and how I’ve learned the ins and outs of our little nook.

So one day while I was in a different sort of role at Memorial Sloan Kettering, I had just gotten back from going out to lunch (which I rarely do) and got a message that the vice president of human resources was looking for me.

Oh no! Did I do something wrong? Was I about to get fired for taking a 1-hour lunch? Stupid, stupid, stupid!!

So I enter her office and see that my manager is also sitting there… and now I’m really scared! Fortunately, they weren’t there to fire me, but rather to tell me that there was a department that needed some help and they both thought I would be the perfect person to assist them with a current project. I forget whether I said anything, but I guess I must have said, “OK,” because 30 minutes later, we were walking over for a 2 p.m. meeting.

I arrived and sat down with a room full of people I didn’t know throwing around a bunch of cancer terms I had never heard of, with one dizzying acronym after another. I wrote as many down as I could, planning to look things up later. At the end of the meeting, the woman sitting next to me asked nicely, “Please let me know if there is anything I can help with.” It’s one of those throwaway lines that you are supposed to say to people to be polite, right? I mean, I probably mean it, but Scott and Derek? Eh. (Note from Scott and Derek: She’s right. We don’t mean it.)

Anyway, instead of pretending I captured everything perfectly, I looked at her and asked, “WHAT DO ALL THESE LETTERS MEAN?” She kindly talked me through a few, but I was still left with a lot of research to do. The most important abbreviations that stood out for me, the ones I heard over and over, were  “ACCME” and “AMA PRA Category 1 Credits.” So I took to the ACCME and AMA websites and read through them multiple times.

That’s how I’ve primarily learned about CME – it’s been self-taught, on-the-fly education through reading, asking my peers (they should know by now not to say to me, “Please let me know if there is anything I can help with,” right?), and engaging with the CME community. I’ve also learned a lot from attending live meetings. My first was the annual ACCME meeting where I took the pre-conference session that discussed the basics of CME. I learned about the Alliance for Continuing Education in the Health Professions, became a member, and have gone to their annual meeting for the last two years. I attend the local CME meeting for providers in the northeastern United States. I learn so much from attending these meetings, not just at the sessions, but also at the networking opportunities where I have the chance to discuss my day-to-day struggles and learn best practices.

I participated in my first CMEpalooza during the Spring of 2019. I love going to the Archive page and being able to view any one of the 100+ previous CMEpalooza sessions if I’m curious about a topic or need a fresh perspective on something. Where was Jake Powers when I started in CME?!

I’ve learned when I feel puzzled about something, I’m never alone, and that no one should be afraid to ask questions. So if you’re new in the CME community, don’t be afraid to speak up when you don’t understand something — we’ve all been there!