Longitudinal Analysis of Continuing Medical Education Learning Outcomes in Relation to Stated Objectives
thesisposted on 01.12.2020, 00:00 authored by Randy Lynn Jensen
Continuing medical education (CME) activities are required for physician board certification, licensure, and hospital privileges. CME activities are designed to specifically address professional knowledge or practice gaps. Many CME organizers use statements taken from participants of their “intent-to-change” as data to determine whether the CME activity content achieved a stated learning objective. No prior studies have examined the longitudinal relationship of learning objectives and intent-to-change data over time. We hypothesize that an assessment could prove useful in understanding the efficacy of CME for closing identified knowledge gaps and for determining unmet needs for future CME planning. We performed a retrospective mixed-method thematic content analysis of written and electronic records from specific CME activities. Specifically, the data were first analyzed using a quantitative, deductive content analysis approach to examine whether meeting objectives result in specific intent-to-change statements in learners’ evaluation of the CME activity on a direct basis for one year as well as longitudinally over 6 consecutive years. Intent-to-change data that did not align with meeting objectives were further analyzed inductively using a qualitative content analysis approach to explore potential unintended learning themes. Data for this study came from a total of 85 CME activities, averaging 12–16 meetings per year over 6 years. This yielded a total of 424 meeting objectives averaging 58–83 meeting objectives each year. The objectives were compared with a total of 1950 intent-to-change statements (146–588 intent-to-change statements in a given year). Thematic patterns of recurrent intent-to-change statements that matched with meeting objectives included topics of resident education, complication avoidance, and clinical best practices and evidence. New innovations and novel surgical techniques were also common themes of both objectives and intent-to-change statements. Intent-to-change statements were not related to any meeting objective an average of 37.3% of the time. Approximately a quarter of these unmatched statements led to subsequent CME activity new learning objectives. However, the majority of intent-to-change statements were repeated over a number of years without an obvious change in subsequent meeting learning objectives. An examination of CME learning objectives found that 15% of objectives had no intent-to-change statements associated with those objectives. When these learning objectives were analyzed for common themes, we observed that objectives focused on specific (procedural, clinical and medical practice) topics failed to correspond with intent-to-change statements for just one year, while broader (declarative knowledge, academic, scholarly) learning objectives were more likely to lack a corresponding intent-to-change statement for multiple years. On the other hand, CME learning objectives on general topics were more commonly found to be unmatched to intent-to-change statement for multiple years. A number of CME learning objectives are repeated for the same meeting for a number of subsequent years without change. We did not find that repeating a given objective related to unmatched status to intent-to-change statements. An examination of CME learning objectives and participant intent-to-change statements provides a rich source of information for examination of both meeting planner and learner attitudes and motivation for progression of medical knowledge.