Wednesday, February 21, 2007

What’s out there in the world of cyber CME?

On line CME is increasing in popularity because it’s easy to access and, in most cases, free. A review of on line CME in the November 17 2006 issue of Medical Economics features interviews with several experts including Dr. Bernard M. Sklar who maintains this huge repository of CME web sites (add it to your book marks—it’s the most comprehensive listing I’ve seen).

Although the first on line CME provider was Cyberounds, the current leader is Medscape. Part of Medscape’s appeal is that its CME, like that of about 70% of CME sites, is free. This is not without controversy since most free CME is underwritten by commercial sponsors. Out of concern about biased content some doctors, the same ones who refuse to see drug reps or attend CME meetings underwritten by drug companies, refuse commercially sponsored on line CME. Sklar estimates that these doctors are in the minority making up 10%-15% of CME users. However it’s a very vocal minority and one that is lobbying vigorously for an end to all forms of industry supported CME for the rest of us. If they have their way Medscape, CE Medicus, emedicine and many other free sites will be gone. Perhaps in an attempt to convince doctors that all would not be lost PharmedOut, a web site which appears to oppose drug company marketing, has compiled a list of non industry supported free CME offerings. Although the list looks impressive at first glance, the range of content is very limited. Most of the sites are government supported, including questionable offerings from the National Center for Complementary and Alternative Medicine. Let’s face it, if industry support went away tomorrow, CME would be much less accessible and prohibitively expensive for some. We’re all for open access, aren’t we?

A relatively new form of on line CME consists of so called “point of care” activities in which content is searched for based on a clinical question, often related to a patient encounter. In order to obtain credit the user must document the purpose of the search and how the information was applied. UpToDate has this format for its CME offering. I used it extensively last year and found the on line documentation process for obtaining credit very user friendly.

Despite the increasing popularity of on line CME Dr. Sklar predicts there will remain a large demand for traditional CME meetings with didactic lectures, despite the fact that the CME thought police would like to curtail most forms of didactic instruction.

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