THE WAY I SEE IT

CMEzzzzzzzz

Here's what's wrong with most continuing medical education courses—and what can be done to spice them up.

By William T. Sheahan, MD

The brochure for the conference looked good, the topics seemed interesting, and the event was local. I'd be able to meet CME requirements, yet save hundreds of dollars by not having to pay for airfare, a rental car, a hotel room, or other travel-related expenses.

That was the good news. The bad news, I soon discovered, was that this conference was no different from the ones I'd attended previously: short on useful information and long on snooze time.

I go to medical conferences in the hope of gathering clinical pearls that can help me improve patient care. Usually, however, these pearls—if there are any—are dispensed in the last five minutes of a 45-minute talk. During the first 40 minutes, the speaker focuses on epidemiology, pathology, and the economic impact of a particular disease process. New treatment recommendations are then glossed over because the speaker is "running out of time."

I always fill out the evaluation forms after a conference, and one of my principal suggestions is that the 40-minute introductions to the five-minute treatment discussions be excluded. When being given an update on, for example, bacterial conjunctivitis, I'd prefer to hear about why one antibiotic eyedrop is preferable to another.

Instead, the lecturer will begin with a lengthy review of material that most primary care physicians either know or don't care about—such as how much money was spent on the treatment of bacterial conjunctivitis in 1995—before briefly recommending an "antibiotic eyedrop."

I wish that conference coordinators were given night-vision goggles so they could see how many in the audience are sleeping during a lecture. I usually look around the room when I'm feeling drowsy, and the sight of health care professionals snoozing, drooling, and head-bobbing is usually funny enough to refresh me.

Still, when a large percentage of the audience is asleep, perhaps that's an indication that a lecturer shouldn't be asked back, or should be encouraged to change the course's content or presentation.

How can we get this message across? By being as specific as possible on the evaluation forms we get at all CME meetings. Here's some of what I usually point out:

CME conference rooms are typically dark, and that's conducive to sleep. But movies are shown in the dark, too, and few people fall asleep during a movie that has an interesting plot and vivid characters. So why can't a 45-minute lecture feature stories that capture the listener's imagination?

A skilled lecturer generally starts the presentation with a case history, then incorporates a brief review of epidemiology and pathology—and concludes with a discussion of an actual treatment plan and the rationale for choosing that therapy—without losing the audience. I think this is because most primary care physicians like stories. Our patients' lives are stories. We never fall asleep listening to a patient's story, even if the exam room is dark.

When a lecture incorporates interesting anecdotes and a minimum of "filler" material, we're left with clinical pearls to utilize when a patient presents with a similar story.

Although it's great when conference organizers bring in authorities from the "meccas" of health care, they should be skilled in delivering a lecture. If a world-renowned rheumatologist never lifts his eyes from his notes, he'll lose his audience.

A few other suggestions:

• Invite lecturers who see patients in addition to doing research.
• If the lecture is more than an hour, allow listeners to stand up and stretch periodically.
• Ask everyone in attendance to silence their beepers and cell phones.
• Be more selective about the snacks offered on breaks. After listening to a series of talks on heart disease, lipids, and obesity, I'd rather not munch on giant cookies and brownies.
• Make sure there are plenty of bathrooms nearby.

Maybe some day conference organizers will put as much effort into enhancing the quality of the presentation as they put into picking the conference's location. Until then, I'll stick to self-study courses—and I'll take my family on vacation when I want to visit an exotic location.

To all medical conference attendees: Sleep well, and happy dreams.

The author is a family physician in Winter Park, FL.

 

William Sheahan. The Way I See It: CMEzzzzzzzzzz. Medical Economics 2002;8:50.