CME Outcomes Increase with Local Participation in Content
Teams from Rockpointe and Potomac Center for Medical Education worked together to draft an article recently published in the Alliance Almanac, walking readers through the outcomes-based activity design. Throughout the article, readers learn how they structured their ground rounds courses and the modifications needed to address different audiences. They also illustrate how relying upon expert opinions during a needs assessment could create a disconnect between the content and learners’ true needs.
The article focused on “Type 2 Diabetes Management: A Team Approach to Managing Hypoglycemia, Comorbidities, and Patient Challenges,” a one-hour grand rounds activity series held in community hospitals. The activity was designed to educate clinicians on patient-engagement strategies and guideline-based management of T2DM (type 2 diabetes mellitus), specifically in patients with comorbidities or at a high risk for hypoglycemia. The CME activity was held in thirty hospitals in nineteen different states, over the course of seven months from 2014 to 2015.
According to the article, the most effective strategies for educational design contain a multidimensional approach. As such,
[t]he content for the series was entirely case-based and tailored to the needs of each hosting venue.
The curriculum included six patient case scenarios, with two cases per learning objective. Each host site selected one of the cases per learning objective (three cases total) at the recommendation of the institution’s department chair or clinicians.
The outcomes methodology relies on assessment of responses to a series of case-vignette questions from a sample of HCPs who participated in the CME activity (participants) as compared to responses from a comparable, demographically matched group of HCPs who did not receive the education (nonparticipants).
Comparing the differences in response patterns between the participant and nonparticipant groups allowed for assessment of the following:
whether the therapeutic choices of participants were consistent with the clinical evidence;
whether practice choices of participants were different from those of nonparticipants;
what barriers exist to the optimal management of T2DM; and
which educational needs remain.
According to the article, sixty-five percent of responding participants “indicated that they always or frequently evaluated the risk of hypoglycemia in their patients with T2DM and adjusted management as necessary to avoid hypoglycemic episodes. The education was perceived as very impactful to the participants, successfully addressing their practice needs.”
Additionally, compared to nonparticipants, the activity favorably impacted the clinical decision making of the participants. Participants were more likely to account for the cardiovascular impact of glucose-lowering agents, as well as their effects on weight, their hypoglycemia risk and their contraindications when recommending treatment in a variety of patient scenarios.
The article concluded with the following:
Participation in an interactive, case-based grand rounds activity was associated with increased HCP knowledge and competence in the management of T2DM. It was also associated with a 51 percent increased likelihood that patients would receive evidence-based care from participating physicians, specifically in the context of comorbidities, renal impairment, cardiovascular risk and the need to limit weight gain. Participation in the grand rounds series has the potential to improve T2DM patient care during 92,196 patient visits each month to participating clinicians.