VIEW on Medical Education August 2007 The True Value of Educational Outcomes Measurement Sherri Foster, Senior VP and General Manager Outcomes measurement has become the buzzword in continuing medical education (CME) over the past few years. It comes amid growing recognition among stakeholders in the CME enterprise — the ACCME, CME providers, commercial supporters, and physicians — of the importance of demonstrating that improvements in the quality and safety of healthcare are occurring as a result of the continuing professional development of physicians. Driving Forces With increasing public and governmental demand for healthcare effectiveness, appropriate use of resources is one of several forces driving educational outcomes measurement. In addition, new maintenance of certification (MOC) and maintenance of licensure (MOL) requirements from the American Board of Medical Specialties and the Federation of State Medical Boards have shifted the focus to the demonstration of improvements in quality of care rather than record keeping. As of 2006, the ACCME updated accreditation criteria to require CME providers to analyze the changes that result from their program’s educational interventions in terms of learner competence, learner performance, or patient outcomes. And commercial supporters view outcomes measurement data as a means of assessing the value of the activities they support. Increased Activity The push toward outcomes measurement has spawned a burgeoning new field of investigation and entrepreneurship. A new professional journal, CE Measure, was launched recently, and several new companies dedicated solely to the measurement of educational outcomes have hung out their shingles. In addition, outcomes measurement is a hot topic at every professional CME congress, and CME providers are working assiduously to develop and incorporate appropriate outcomes measurement methodologies into their CME activities. The fervent activity in this area will inevitably lead to improved and better-validated measures of outcome and to more frequent incorporation of outcomes data into needs assessments for future activities. An Integral Part of the Process Regardless of the particular methodology used to assess educational outcomes, outcomes measurement must be designed as an integral part of the planning process for an educational activity to be effective. In fact, determining the desired outcome and the metrics by which the outcome will be assessed should be one of the first steps in the planning process because these decisions will guide a host of other decisions in planning an activity. As CME providers become more experienced in framing activities from an outcomes perspective, they will also gain a more nuanced understanding of how physicians learn and how they incorporate new knowledge into practice over time. This more sophisticated understanding of adult learning and of the practical realities physicians face in incorporating new learning into a systems-based practice will ultimately lead not only to better outcomes measurement but also to better designed activities that truly address physician needs. Ongoing analysis of outcomes measurement data will likely also lead to the establishment of more realistic educational goals for single interventions and to the development of longer-range, multitiered initiatives that allow for incremental and serial learning. It will also expand the opportunities for assessment of changes in physician attitudes, skills, competence, and performance. Outcomes: Changing the Approach to CME Activities While the specific goal of outcomes measurement is to demonstrate improvements in the quality and safety of healthcare in America, the focus on outcomes is resulting in much more than a report card on the success of individual educational activities. Indeed, it is fundamentally changing the approach to the development of CME activities, which will lead to vast improvements in the quality of the education being provided and ultimately to the overall quality of healthcare. And that is where its true value lies. Outcomes measurement must be designed as an integral part of the planning process for an educational activity to be effective. Determining the desired outcome and the metrics by which the outcome will be assessed should be one of the first steps in the planning process. Scienta Healthcare Education, Durham, N.C., is dedicated to improving healthcare practice and delivery by providing high-quality, evidence-based continuing medical education activities that enhance the ability of physicians and allied personnel to provide optimal medical care that ultimately translates to improved patient health outcomes. For more information, visit scienta-edu.com.

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