Alliance for CME 2009 Presentation, Wake me Up Before it’s Over:Bringing out the “LIVE” in...
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Transcript of Alliance for CME 2009 Presentation, Wake me Up Before it’s Over:Bringing out the “LIVE” in...
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Wake me Up Before it’s Over:Bringing out the “LIVE” in Large Live Meetings
Wendy Turell, DrPH, CCMEP, Director, Strategic Relations and Educational Development, Pri-Med
Marissa Seligman, PharmD, CCMEP, Senior Vice President, Pri-Med Institute
Alliance for Continuing Medical Education Annual Conference
San Francisco, CaliforniaJanuary 31, 2009
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Disclosures
Wendy Turell• does not have an interest in selling a technology, program,
product and/or service to CME professionals.
Marissa Seligman• does not have an interest in selling a technology, program,
product and/or service to CME professionals.
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Objectives for Session
• Identify challenges Facing Educators and faculty in delivery of “Living Live” meetings
• Discuss tools available to educators to use in their practice, increase education activity, productivity, and effectiveness, while not loosing the “best” of what live has to offer
• Demonstrate the application of at least one of these tools
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How Adults Learn: Team Assignment
You will be assigned in to one of two “learner teams”. Please chose the appropriate team for yourself below!
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1. My last name begins with A – M
2. My last name begins with N - Z
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How Adults Learn: Question 1
According to Adult Learning Theorist Malcolm Knowles, adults are:
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1. More Intelligent than children
2. Most responsive to didactic instruction
3. Autonomous and Self-Directed
4. All of the above
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How Adults Learn: Question 2
What is the most important factor that draws learners to specific CME activities?
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1. Innovative learning formats
2. Prominence of thought leader faculty
3. Relevancy to learner’s practice/life
4. Focus on a “hot” topic
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How Adults Learn: Question 3
851 PCP’s were surveyed in 2008 regarding channels used to receive CME hours. Which answer best reflects their responses?
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1. 60% Live, 5% Print, 17% Online
2. 51% Live, 19% Print, 12% Online
3. 30% Live, 10% Print, 42% Online
(18% = other channels; mixed answers)
Source: National PCP Insights & Behaviors Study, May, 2008 (N=851 Primary Care Physicians)
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Key Principles of Adult Learning- Malcolm Knowles
• Adult learners are autonomous and self-directed– Impact for educators: Faculty must move from “expertise by eminence” to
facilitators who actively involve adult participants in the learning process
• Adult learners are relevancy-oriented– Impact for educators: Appeal to the learners need for “what’s in it for me”
• Adult learners are practical– Impact for educators: Make the education EXPLICITLY relevant to clinical
practice and not just “knowledge for knowledge sake”.
• Adults learners seek respect– Impact for educators: Acknowledge and use the experiences that participants bring
to the so that they will feel empowered to engage and be instructive to other participants as well as the faculty
Refs: http://en.wikipedia.org/wiki/Malcolm_Knowles; www.infed.org/thinkers/et-knowl.htm.
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Four Critical Elements of Learning-Application to Live
• Motivation: Best motivators are “interest” and “selfish benefit”– Setting educational tone, appropriate level of concern (the clinical care gap), appropriate
level of difficulty
• Feedback: Critical to provide specific feedback so that participants leave the education with specific knowledge of their learning results. This is their “reward”
• Reinforcement: – Ensuring learners “get” the education
• Retention– Directly affected by learner baseline learning. If participant don’t learn the material well
initially, “they will not retain it well either”
• Transference:– Ability of learner to use information/skills outside the classroom setting
“Show that the course benefits the learner pragmatically, the learner WILL perform better and the benefits will be longer lasting.”
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Something to think about….
• It is paradoxical that many educators and [faculty] still differentiate between a time for learning and a time for play without seeing the vital connections between them.
– Leo Buscaglia
• One must learn by doing the thing; for though you think you know it, you have no certainty, until you try.
– Sophocles
• A physician buries his mistakes, a dentist pulls them out but a teacher has to live with them.
– Anonymous
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Question: We are interested in learning how you have received Continuing Medical Education (CME) over the past 12 months. For each CME source listed below, please indicate the approximate number of CME hours earned through this source.
Live Events Remain the Preferred Channel For CME Hours
51%
19%
12%
9%
8%1% Live
Online
Board Review
Interactive(CDRom/AV/Mobile)Other
PERCENT OF CME HOURS EARNED BY CHANNEL
Internal Medicine: 48%FMs/FPs/GPs: 55%Ped/OBGyn: 57%Base: 851 physicians
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Case Based-Lectures are Preferred Learning Format, Followed by Didactic Lectures and Diagnostic Challenges
Case-based lectures w/ Q&A
Didactic lectures w/ Q&A
Diagnostic challenges
w/ ARS
Interactive workshops
Point-counterpoint
debate
OtherPatient simulation
Which, if any, of the following learning formats would you be most interested in participating in?
76%
63%
48%
28%
1%
56%53%
Question: Which, if any, of the following learning formats would you be most interested in participating? Please check all that apply.
Ped/Ob/Gyn: 61%* Ped/
Ob/Gyn: 57%*
IMs: 60%
FP/FM/GPs: 33%
Base: 851 physicians
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Tools for Planners and Faculty
Non-Tech Options
•Sequential/linked education•Activity Education Design
Group discussionGroup exercises Individual exercisesHandouts
Technological Options
• ARS• Laptops• Insert webcasts
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As CME Providers We Know Learning Erodes Over Time Without Further Intervention
56%
37%
49%
39%
Baseline 6 WEEKSPOST
3 MONTHSPOST
6 MONTHSPOST
+51% -30%
Source: Pri-Med Clinical Outcomes Study, 2006. Baseline N = 65, 6 wks post N = 74, 3 mths post N = 87, 6 mths post N = 91
Patient Case Vignette Presented: How Confident Would You Feel Treating This Patient?
Topic Area: Bipolar
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Continuum of Education:Extension of Learning Cycle Pre and Post LIVE event
• Participant surveys
• Internet based engagement
• Message Boards/Chat Rooms
• Q&A Submission
• Literature Downloads
• Laminated Guidelines
• Screening Tools
• Fill-In-The-Blank Algorithms
• Patient Diagnostic Questionnaires
Take-Home ToolsPre-MeetingOn-Site Hand Out
Materials
• Online education
• Print education
• Audio education (podcast, radio broadcasts)
• Online Discussion Forums
• Online Faculty Q&A Chat / Boards
Post-Meeting- Enduring or Other Education
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Multi Channel Curriculums Help Reinforce Messaging to Facilitate Enhanced Outcomes (As Compared to Live Meeting Alone)
77%86%
93%
74%
Baseline Live Only Online Only Both Live and Online
Post Educational Intervention
(N = 1,816)
(N = 1,340)
Is Adherent in Treating Presented Patient (6 or 7 on the 7 pt. scale [ 7 is “ALWAYS incorporate this behavior”])
To measure performance, clinicians are asked: “How often do you incorporate the following into your practice when seeing patients with dyslipidemia?” [Scale: 1 (NEVER incorporate this behavior) to 7 (ALWAYS incorporate this behavior)]
Relativechange:
+4%
“Assess and manage dyslipidemia according to ATP III guidelines”
LIPIDS MANAGEMENTBase = clinicians seeing patients with dyslipidemia
Relativechange:+16 %
Relativechange:+26 %
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On-Site Hand Out Materials
Hand Out Materials Can Include:
Diagnostic tools/Algorithms
Laminated guidelines
Practice “Pearls” in summary form
List of Resources, Online Links
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On-Site Handout Example: Treatment Algorithms
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Post-Meeting Reinforcement Example: Newsletter
Program Details
• Follow-up Q&A based newsletter provides an opportunity to offer reinforcement and reference materials explicitly linked to the live experience to clinicians
• 4 page reiteration of the Q&A dialogue (per session) at a live program
• Targeted distributed of pre-registration and onsite attendees
• Distributed 6 weeks after the live session
• Not certified for credit
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Summary
Learning Continuum Includes a focus on:
At the Live Meeting, innovative ideas can also be integrated with varying focuses:
Structure of event, technology
Focus on learner behavior at activity
Focus of faculty behavior at activity
Pre, on-site, and post meeting strategies
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Live Meeting: Strategies to Increase Learner Engagement
• Live or Recorded Role Plays
• Integration of Multimedia
• Breakout Groups
• Working sessions
• Self-Reflection with group discussion
Take-Home ToolsMore Engaging
PresentationsLearner - Learner
Interaction
• “Town Hall” discussions
• FAQs from Prior Meetings
• ARS Techniques
• Workshops
Faculty – Learner Interaction
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Learning Framework
Introduction Intermediary Deep-dive
Epidemiology/MOA
Diagnosis & Risks Assessment
Guidelines
Treatment management
Patient management
LEARNINGOBJECTIVES:
Raise awareness & Build knowledge in P.C.
Apply “real-life” cases in specialty
GOAL: Self-evaluate gaps inclinical practice in P.C.
LEVELS:
• Lecture
• Plenary sessions
• Webcast
• Panel of experts
• Point/counter-points
• Clinical debates
• Small workshop
• Very interactive
• Lot of cases
FORMAT:
Epidemiology/MOA
Diagnosis & Risks Assessment
Guidelines
Treatment management
Patient management
Epidemiology/MOA
Diagnosis & Risks Assessment
Guidelines
Treatment management
Patient management
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Faculty and Learner Interaction Examples
Faculty interaction
Learner interaction
HIGH
LOW
didactic
Case studies
ARS
Point-counterpoint
simulations
workshops
Expert panel
Role plays
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Live Meeting Innovation StrategiesPrinciples of Adult Learning: Education should be interactive, problem-based, active and creative.
FORMAT DESCRIPTION
Diagnostic Challenge
Use ARS to engage attendees in solving clinical problems. This formats works especially well for topics where diagnostic decision-making employs visual elements (dermatology, imaging studies) but has worked well for those that do not (kidney disease).
Best of . . . Focus in one therapeutic area, but allowing faculty to frame real-life practice applications through discussion of recently published medical data or literature.
Choose Your Own Path
Using ARS, audience chooses the case they want to hear about
Competition/Game Divide the audience into groups and use ARS to pit sides against each other
Point-Counterpoint Two or more faculty members present different viewpoints on a clinical topic in a debate format, which can allow for Q&A throughout.
Patient Simulation Actor “patient” attends session and engages with faculty to demonstrate symptom presentation, physical examination and/or interview techniques
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Innovative Format Example: Live Patient Cases at Pri-Med Meetings Demonstrate Real Practice Situations and Enhance Attendee Experience
Conducted in Collaboration With
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Learner – Learner Interaction
Breakout
Groups
Working
sessions
Self-
Reflection
with group
discussionAllow participants
to exchange
solutions to
common practice
barriers – get stock
photo of docs in
small groups
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Faculty-Learner Interaction
“Town Hall” discussions
Roving Moderator with Microphone
FAQs from Prior Meetings
Bring in past program evaluation results and comments
ARS Techniques• Audience “teams” to foster
involvement and/or debate discussion• Extended ARS response time to
encourage table discussions prior to faculty comment
• ARS “gaming” to enhance audience participation
Workshops
Getting faculty to change their education styles and interaction with participants in the LIVE format is MISSION ONE in achieving success. So
•Engage with faculty
•Train faculty not just on COI but on “best practices” in education
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Activity: Breakout Groups – Case 1
• A hospital-based CME office arranges for the chief of the rheumatology department to deliver a 40 minute rheumatoid arthritis lecture to the (generalist and specialist) physician attendees of the weekly grand rounds meeting.
• In order to ‘liven things up’, she shows a 5 minute video on the disease in the middle of her talk. At the end of the lecture period, the chief is joined at the podium by two other rheumatologists who engage the audience in a very lively and well-received 20 minute question and answer period.
• What was a strength of this strategy?
• How could this have been better undertaken?
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Activity: Breakout Groups – Case 2
• A medical education company organizes a 2.5 hour live CME satellite symposium activity on the topic of overactive bladder at a national association meeting for primary care physicians. In attempts to increase the interactivity of the event, they arrange for ARS keypads to be placed at every seat.
• The 120 Learners, who are sitting in “rounds” of 8, are encouraged to chat as a group prior to keying in their ARS answers. As a follow-up, learners are sent a link to an online case-based activity on the same topic 3 weeks following the live event.
• What was a strength of this strategy?
• How could this have been better undertaken?
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Activity: Breakout Groups – Case 3
• The Arkansas chapter of a national primary care medical association plans to host a CME lunch meeting during their annual chapter gathering on the topic of GERD. The 50 learners are served boxed lunches, and seated at long tables to listen to a 25 minute lecture.
• Following the lecture period, participants separate into “breakout rooms” in groups of 7-8, where they discuss their own experiences treating patients with GERD. The learners become so caught up in their chats that the moderator is unable to reconvene the group to share key insights of group members.
• What was a strength of this strategy?
• How could this have been better undertaken?
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Examples/thoughts From Breakout Groups
Shared as a Group
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How Adults Learn: Question 1
According to Adult Learning Theorist Malcolm Knowles, adults are:
1. More Intelligent than children
2. Most responsive to didactic instruction
3. Autonomous and Self-Directed
4. All of the above
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How Adults Learn: Question 2
What is the most important factor that draws learners to specific CME activities?
1. Innovative learning formats
2. Prominence of thought leader faculty
3. Relevancy to learner’s practice/life
4. Focus on a “hot” topic
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How Adults Learn: Question 3
851 PCP’s were surveyed in 2008 regarding channels used to receive CME hours. Which answer best reflects their responses?
1. 60% Live, 5% Print, 17% Online
2. 51% Live, 19% Print, 12% Online
3. 30% Live, 10% Print, 42% Online
(18% = other channels; mixed answers)
Source: National PCP Insights & Behaviors Study, May, 2008 (N=851 Primary Care Physicians)
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Presenter Contact
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