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Current Initiatives

• National and international satellite symposia
• Research presentations at national events
• CME innovation through self-directed learning
• Competencies across the medical education continuum
• Performance Improvement CME

National and international satellite symposia
The Indiana University School of Medicine’s division of CME presents many accredited satellite programs in conjunction with national conference events through collaborations with medical education and communications companies such as Health Focus, Helix, Deborah Wood & Associates, Rogers Medical Intelligence Solutions, CME2 and Virtual Meeting Strategies (VMS). In addition, the division is frequently represented at various national meetings such as those of the American College of Emergency Physicians and the American Academy of Family Physicians.

The division is an approved provider of Professional Acknowledgement for Continuing Education (P.A.C.E.) credits by the American Society for Clinical Laboratory Science. This allows us to offer accredited education programs to laboratory technicians. Joint agreements with Wishard Hospital and Butler University enable nurses and pharmacists to obtain credit as well. This builds a foundation to bridge disciplines and encourage integrated approaches to patient care, a long-time recommendation of the Institute of Medicine.

Roche Diagnostics awarded the division an educational grant to develop a nationwide program on Inpatient Glycemic Control in coordination with an email-based clinical expert network. This network helps accelerate adoption and implementation of intensive inpatient glycemic control protocols through peer-to-peer connections. Physicians gain access to experts and thought leaders in the field of hyperglycemia and point-of-care testing to assist them with instituting, implementing, or managing glycemic management programs in their institutions. Twenty-seven presentations were made throughout the country in 2007. This program continues in 2008.

Joint programs with international professional associations are also important to the division and include such efforts as:

• The Mexican Diabetes Association’s 17th Annual Diabetes Education workshop in Mexico City.
• A joint primary care physician education program in Argentina is conducted as a clinical trial (PRODIACOR) to determine which educational efforts are most effective in improving primary care physicians’ treatment of people with diabetes and cardiovascular risk factors.
• Three programs, jointly sponsored by IUSM and ACINDES (Asociación Civil de Investigación y Desarrollo en Salud) for Mexican oncologists in Indianapolis, New York and Texas. State-of-the-art clinical data on recent advances in breast cancer diagnosis and treatment is presented.

In addition to these types of initiatives, in 2007 the division was designated a WHO/PAHO Collaborating Center for Continuing Health Professional Education in Diabetes.

Return to top Research presentations at national events
CME is active in the learning community, offering research results as well as benefiting by other research in the field. Past presentations at national events include:

• January, 2005 – San Francisco, CA – “Assessing Indiana’s CME Needs: Facts or Fallacies?”
• January, 2006 – San Francisco, CA – “Activating Self-directed Learning Among Physicians: Diabetes Quality Care Improvement”
• January, 2007 – Phoenix, AZ – “Assessing Indiana’s CME Needs”
• January, 2007 – Orlando, FL – “Pain and Depression: Long-term Challenges for the Primary Care Physician”

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CME innovation through self-directed learning
The cornerstone for CME has been live courses and enduring materials which have been most effective for the transmission of information and reinforcement of knowledge. However, CME also encompasses opportunities for clinical and professional development through personal education programs and self-assessment. One such approach is through reflective learning. Physicians engage in reflective learning because of an unanswered question or issue of concern that is triggered by an experience in his/her practice. This is followed by a search for relevant information. Their search strategy may utilize a variety of resources such as a literature search (PubMed, MEDLINE, MDConsult, etc.), journal articles, or Web based research. Database research may include DynaMed, InfoRetreiver, PEPID, Physicians’ Information and Education Resource (PIER), Cochrane Database of Systemic Reviews or Evidence-Based Medicine for Primary Care. After finding and reviewing information, physicians may discuss it with colleagues or at a presentation. They select the most relevant data, reflect on how to best put this information into practice, and later, assess what impact the process had on their clinical practice. If the practice change isn’t successful, they revise their learning plan and begin the process again.

Reflective learning is thus self-directed. It does not come from a CME program, and it occurs in response to very relevant issues or problems in medical practice. It draws from any appropriate source; both programmed educational resources and other information sources such as colleagues, a study of the literature, or practice self-assessment such as reviewing the charts formally or informally.

The Reflective Learning for Physicians Project provides a set of tools to assist physicians in the development and conduct of self-directed, reflective learning projects that emerge from problems and issues encountered in clinical practice. Physicians may use the tool kit to conduct as many Reflective Learning Projects as desired, and CME credit of up to 10.0 hours per year will be awarded upon completion of the project. The CME office offers tool kits to establish reflective learning projects and CME educators are available to help physicians complete the appropriate paperwork to receive CME credit.

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Competencies across the medical school continuum
Initial efforts to develop linkages among undergraduate, graduate and postgraduate medical education began with a comparison of the undergraduate, graduate and postgraduate competencies. The resulting mapping assisted IU faculty in their development of teaching and evaluation strategies for IUSM medical students and residents. In addition, the division of CME sponsors faculty retreats and courses directed at improving the faculty’s educational and evaluative skills. More recently, and In response to the American Board of Medical Specialties (ABMS) challenge to tie CME to professional competencies, the division has begun to explore how to implement Performance Improvement (PI) initiatives to improve clinical practice.

Return to top Performance Improvement CME
In 2005, the American Medical Association (AMA) recognized and implemented a new CME format. Performance Improvement CME (PI CME) redesigns traditional CME from an outcomes orientation, drawn from quality improvement methodology. PI CME implements the core CME best practices—needs assessment, instructional design and development, and evaluation of learner results—in the context of the core quality-improvement practice. This newer CME model strives for learning that results in changing physician practice behaviors in ways that translate into improved patient outcomes. PI CME learning activities involve structured, long-term processes by which a physician or groups of physicians can learn about specific performance measures that will allow them to quantify the quality of a selected aspect of care, assess their own practice using these measures, implement and measure a practice change intervention with their own patients, and evaluate the results of that change. A complete PI CME activity integrates three stages:

1. Assess current practice using identified performance measures;
2. Conduct an intervention in practice based on the performance measures;
3. Re-evaluate and reflect on the performance in practice.

The Division of CME at Indiana University School of Medicine is committed to developing learning activities for physicians that incorporate the performance improvement process. A maximum of 5.0 category 1 credits for each of the three stages that physician learners complete. An additional 5.0 credits may be awarded to physicians who complete all three stages, for a total of 20.0 category 1 credits.