Surgical continuing medical education: format and impact

Area of Science:

• Medical Education
• Surgical Training
• Healthcare Quality Improvement

Background:

• A 1975-1976 survey of 140 surgical continuing medical education (CME) offerings revealed a lack of post-experience evaluation of learning or behavioral changes.
• The estimated cost for 83 surveyed CME courses was approximately two million dollars.
• Current CME lacks evidence of achieving its objective: improved patient care.

Purpose of the Study:

• To propose a shift from an education-based system to a competency-based evaluation system for surgical CME.
• To introduce a multicomponent system incorporating objective cognitive skills and behavior measurement.
• To advocate for methods ensuring improved patient care through enhanced surgical education.

Main Methods:

• Survey of 140 surgical CME offerings from 1975-1976.
• Proposal of a competency-based evaluation system.
• Recommendation of computer simulation-modeling for deficit identification and active learning.
• Emphasis on developing practice profiles and patient outcome databases (morbidity, mortality).

Main Results:

• No evidence of learning or behavior change evaluation was found in any surveyed CME offering.
• The current CME modality does not demonstrate effectiveness in improving patient care.
• Significant financial investment in CME was noted without measurable impact on patient outcomes.

Conclusions:

• A transition to a competency-based evaluation system is essential for effective surgical education.
• The proposed system includes objective cognitive skills assessment and behavioral measurement.
• Implementation requires collaboration with academic and professional societies to establish practice profiles, outcome databases, and measures for innovation adoption and obsolescence.