The 4th annual Mayo Clinic Update in Hospital Medicine was completed today. It was my first time to attend this particular conference and the first hospital medicine course I’ve attended that was not affiliated with the Society of Hospital Medicine. I had high expectations for the course (after all it’s Mayo Clinic, right?) and was not disappointed. This course was comparable in quality to Bob Wachter’s excellent and very popular course in San Francisco and I would recommend it highly to hospitalists and other health care professionals interested in hospital medicine.
There is currently a groundswell of sentiment which seeks to ban this type of lecture based CME (a subject many of you probably think I’ve already beaten to death in the pages of this blog). The naysayers seem to occupy one of two camps. One maintains that lecture based CME is worthless, and wants all future CME to consist of case based interactive programs with built in mechanisms to measure how much the activity resulted in changed physician “behavior”. The other camp seeks to block the accreditation of all programs that receive support from the pharmaceutical industry. That would mean the end of the program I attended this week, the end of Bob Wachter’s program and the end of CME as we now know it.
To the agitators I say rubbish. What makes them think they know my learning style and educational needs better than I do? And I’m more than a bit rankled by the paternalistic arrogance of those who want to tell me what medical literature I should and should not read. I’m an adult. I graduated from medical school quite some time ago. The responsibility for life long learning lies with me and I take it very seriously.
Yes, I need occasional feedback about the strengths and weaknesses of my fund of knowledge. For that purpose there are plenty of self assessment tools (e.g. MKSAP) I can choose and on which I have spent hundreds of dollars through the years. For most physicians the external requirements for maintenance of licensure and certification are already onerous enough.
Trips to lecture based CME activities, although they constitute just one of several types of CME I participate in, have helped me to be a more effective physician though often in intangible ways which can’t be “measured”. Many important content areas such as basic clinical skills, pathophysiology and certain abstract concepts (one of today’s sessions dealt with heuristics and other cognitive traps in medical decision making) could never reasonably be expected to result in direct, measurable changes in physician behavior because they impact intangible attributes such as judgment and skill.
But those who want some form of verification of the educational impact of my activities this week can read my last few posts about some of the content areas. Moreover, rest assured that for the next several weeks while pouring over the course syllabus I’ll be looking up primary sources of information and background material. And I’ll be reflecting and thinking extensively on ways to put the information to the most appropriate use for the benefit of hospitalized patients.
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