Surf to Learn Online CME Credits Offer Flexible Learning By Susanna Donato
According to Bernard Sklar, M.D., a Berkeley-based consultant in online continuing medical education (CME), about 5 percent of CME is earned online, as of early 2003. The field is growing, however. In February 2000, Sklar found 96 sites offering 3,000 credit hours of CME. In December 2002, Sklar found 230 sites offering 19,000 credit hours. Over the last few years, online CME and CE for nonphysician professionals have become more widely available to all types of health care professionals. “About 25 percent of the learners at ACCME-accredited organizations are nonphysicians,” said Murray Kopelow, M.D., chief executive of the Accreditation Council for Continuing Medical Education (ACCME). “The health care industry is learning together, just as it works together.” Online CME offers affordable, convenient options to keep up to date with your specialty or the latest management techniques. Various levels of continuing education from different accrediting organizations are available online, such as Category 1 and 2 for CME credit, Category A and B for CE credit, and required or elective courses. Quick, cheap, convenient Almost anyone can earn CME credits online. All you need is a computer, an Internet connection (“The faster, the better,” Sklar said.), speakers or headphones to listen to audio portions of lessons, and a printer to print a hard copy of your lessons or your final certificate. One of the advantages of online CME or CE courses is that they can be fit into the busiest schedule. Even chronic procrastinators should be able to take advantage of their convenient availability. “What happens to many technologists is that they wait until the last minute and need additional continuing education credits in the month prior to renewing their registry certification,” said Kristeen Schroeter, manager of compliance education products for GE Medical Systems, a provider of CE credits for a variety of health care professionals. “The great thing about online CE is that technologists can learn at their own pace, when they have the time to do so and be in control of their own destiny.” Online learning is affordable, too. Sklar said that approximately 16,000 hours of CME credits were priced between $5 and $15 per credit, with more than 2,000 hours available without charge. Currently about 53 percent of online providers offer free CME credits. There are a few disadvantages to online courses. “You do miss out on some of the human interaction and collegiality that some doctors like when they go to meetings,” Sklar warned. “And you have to be CME Credits Offer Flexible Learning By Susanna Donato Susanna Donato is a writer for Physicians Practice Article provided by Surf to Learn Online reasonably comfortable with how to use a computer.” Schroeter added that some professionals can’t complete the courses in the workplace and don’t have the appropriate computer or Internet access at home. 31 flavors Online CME courses come in a variety of formats, including question and answer, text, case studies that simulate actual patient diagnosis and treatment, games and even correspondence courses with other physicians. Users need only decide which format most appeals to them. According to Kopelow, the ACCME categorizes several types of CME, including live activities, enduring materials and journal CME. Live CME usually consists of lectures or small group discussions involving teachers, learners and facilitators in real time. Enduring materials can be Internetbased, CD-based or paper-based, “as long as the materials can be put on the shelf and returned to at any time, without changing the value or worth of the content,” Kopelow said. Journal CME is a hybrid, sometimes with a discussion group or journal club followed by a content-based challenge, such as a self-test, a real test or a hands-on activity. However, live CME seems to be the exception to the rule in online courses. “There’s not been much growth in the use of the Internet as a live media,” Kopelow said, referring to ACCME Annual Report data available at www.accme.org. He agreed that while live options are possible over the Internet, they sacrifice the convenience of self-scheduling that prerecorded materials make possible. Choose your method Accreditation should be one of the main criteria for selecting an online CME or CE provider. The accreditor’s seal of approval should appear prominently on the CME Web site. Also look for an ACCME accreditation statement to appear on each activity. “Most important to me and to most people is that it’s accurate, up-to-date information,” said Schroeter. And while each individual ultimately is responsible for tracking his or her own continuing education credits, “You want to know that the vendor awarding the CE credits tracks them for you, keeping records in case you are audited during your recertification process.” You also should consider who produced the course. Most sites have multiple, overlapping sources of support — sometimes both a medical school and a commercial company, according to Sklar. In general, companies (pharmaceutical or surgicalinstrument makers) support 52 percent of the sites offering CME credits. Universities and medical schools support another 38 percent of the sites, while medical specialty associations support 31 percent. Depending on the source, the focus of the CME course could change. “Everybody has an ax to grind. There’s almost nothing out there that’s purely without [a corporation’s] opinion,” said Sklar. “Once an organization supports a CME, it has to follow very strict rules about what it is allowed to say. It’s a question of the site’s emphasis: if five drugs treat a condition, the company that makes a drug will emphasize its drug more [in its CME materials], but it won’t say anything untrue about its drug.” Kopelow expressed confidence in the system. “All of our accredited providers have to follow the same rules. When there is commercial support, a set of ACCME Standards for Commercial Support helps manage the interface between commercial interest and the accredited provider. It’s very important that commerce be separated from education. That’s an added value of identifying accredited providers and of finding the ACCME accreditation statement on activities.” The online future Something to look for in the future of online CME is the ability to customize a course of learning for each individual physician. Kopelow said, “[Knowledge management] systems would let physicians complete self-diagnostics of their strengths and weaknesses, and then make informed choices about what they should look for in CME.” “My hope is that eventually a physician can do a knowledge assessment in January that tells which areas to look for new knowledge. Then if he does the same thing in May, and it says, ‘nice job,’ that gap closure lets physicians know they’ve been effective in their energies. That data is good for everyone,” added Kopelow. These kinds of knowledge assessments are now available through some specialty societies, Kopelow said, and soon will appear more widely. “It’s a part of the maintenance-of-certification process that is just unfolding.”
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