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Overview of Online CME

Overview of Online CME. The Seventh Annual Meeting of the Global Alliance for Medical Education June 23-25, 2002 The McGill Faculty Club. Online CME – An Update. Review of June 2002 Bernard M. Sklar, M.D., M.S. www.cmelist.com bersklar@netcantina.com. Plan of Talk. Results of Survey

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Overview of Online CME

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  1. Overview of Online CME The Seventh Annual Meeting of the Global Alliance for Medical Education June 23-25, 2002 The McGill Faculty Club

  2. Online CME – An Update • Review of June 2002 • Bernard M. Sklar, M.D., M.S. • www.cmelist.com • bersklar@netcantina.com

  3. Plan of Talk • Results of Survey • Types of Instruction • Physician Use of CME and Online CME • Obstacles to Physician Use

  4. Master’s Thesis • This review is based on a recent update of the database that I created for my master’s thesis, The Current Status of Online Continuing Medical Education (June 2000). Find the thesis online at http://www.cmelist.com/mastersthesis • The thesis was based on a review of the CME literature and a survey of online CME done in February 2000.

  5. How Was the Survey Done? • Internet search of multiple search engines using search string “online + continuing + medical +education” • Following up leads from those searches • Information from ACCME • Email from viewers and CME providers

  6. Description of the List Each entry shows the name and URL of the site, when I last visited, how many credit hours are available, who awards the credit, the cost per unit, when the educational material was last updated, a description of the site and its contents and links to individual courses found at the site.

  7. Extensive Updates • I have been maintaining the list for about 5 years • The list was updated for my master’s thesis in February 2000, again in August and December 2000, in December 2001 and in June 2002.

  8. List of Online CME

  9. Database Created from List Based on examining each site, I created an Access database of the 207 sites actively offering CME in June 2002. The DB contains the number of activities, number of hours of instruction, types of instruction, specialty audiences, cost to users, sources of financial support and other parameters.

  10. Results of Study I • The number of sites and activities is rapidly increasing • April 1997 – 13 sites • December 1997 – 18 sites • August 1998 – 61 sites • May 1999 – 69 sites • December 1999 – 87 sites

  11. Results of Study II • February 2000 • 96 sites, 1874 activities, 3064 credit hours • August 2000 • 135 sites, 3659 activities, 5659 credit hours • December 2000 • 150 sites, 3510 activities, 6553 credit hours • Because of overlap, duplication, and miscounting , the “true number” of hours should have been about 5500.

  12. Results of Study III • December 2001 • 197 sites • 12026 activities • 17523 hours

  13. Results of Study IV • June 2002 • 209 sites • 10952 activities • 18266 hours

  14. Size of Sites – December 2000

  15. Size of Sites – December 2001

  16. Size of Sites – June 2002

  17. The Largest Sites December 2000

  18. The Largest Sites December 2001

  19. The Largest Sites June 2002

  20. Fee Structure by Site Dec 2000

  21. Fee Structure by Site Dec 2001

  22. Fee Structure by Site June 2002

  23. Hourly Fee Structure Dec 2000

  24. Hourly Fee Structure Dec 2001

  25. Hourly Fee Structure June 2002

  26. Financial Support Dec 2000

  27. Financial Support Dec 2001

  28. Financial Support June 2002

  29. Sites by Specialty – Primary Care Dec 2000

  30. Sites by Specialty – Primary Care Dec 2001

  31. Sites by Specialty – Primary Care June 2002

  32. Sites by Specialty – Subspecialties Dec 2000

  33. Sites by Specialty – Subspecialties Dec 2001

  34. Sites by Specialty – Subspecialties June 2002

  35. Sites by Specialty-2001- Other • 26 sites (13%) offer subjects of interest to many different specialties; for example, ethics, legal, practice management, genetics, and basic science • Many other specialties were included at 5 or fewer sites

  36. Sites by Specialty-June 2002- Other • 33 sites (16%) offer subjects of interest to many different specialties: for example, ethics, legal, practice management, risk management, tobacco cessation, genetics, basic science • Many other specialties are included at 5 or fewer sites

  37. Five “Different” Sites I • CE Medicus has no CME of its own, but offers access without fee to about 600 activities at five sites (apparently by special arrangement) • Digiscriptcontains many hundreds of audio and video slide lectures recorded at medical meetings. The yearly charge is $400. Some activities offer CME and some do not. The site is searchable by medical topic and by sponsoring organization. You may have to pay an additional fee for CME credit by any given sponsor.  • Doctor’s Guide also has no CME of its own, but offers descriptions of over 600 activities (free and fee) with links to those courses

  38. Five “Different” Sites II • Stanford SKOLAR offers credit for performing Internet literature searches on topics of your own interest • University of Wisconsin Professional Courses offer credit for courses on non-medical subjects which could be expected to improve your practice or your life.

  39. Sites I Could Not View • There may be a number of proprietary sites, e.g., staff model HMOs, like Kaiser-Permanente, where access to instruction is limited to staff members of that organization. Those sites are not reviewed in this report.

  40. Email Reminders June 2002 About 25 sites send out regular email reminders about additions to their lists of activities on request by users: American College of Cardiology, Boston University, Cancer Education, CME Reviews, Cyberounds, Doctor's Guide Webcasts, Ecornell, EMedHome, EMedicine, cmecourses (HealthStream), Journal of Clinical Psychiatry, Medscape, Medinfosource, Medsite, MMWR, mypatient.com, Natal U, PDR.net, Pedsref.org, psychLINK, Psychiatrist.com (NetSociety), Serono, University of Wisconsin, Virtual Lecture Hall, and World Medical Leaders.

  41. Types of Instruction-Definitions • Text-Only • Text-and-Graphics • Slides-Only (or Slides and Text) • Slide-Audio • Slide-Video • Question-and-Answer • Case-Based Interactive • Guideline or Consensus (usually text only) • Correspondence • Games

  42. Types of Instruction – Dec 2000 • Text only -- 37 sites; 25% • Text-and-graphics – 45 sites; 30 % • Slide-audio – 45 sites; 30 % • Slide-video – 21 sites; 14 % • Guidelines – 5 sites; 3 % • Question-and-answer – 6 sites; 4 % • Case-based Interactive – 27 sites; 18 % • Many sites have more than one type of instruction

  43. Types of Instruction – Dec 2001 • Text only -- 47 sites; 24% • Text-and-graphics – 59 sites; 30 % • Slide-audio – 57 sites; 29 % • Slide-video – 21 sites; 11% • Guidelines – 5 sites; 3 % • Question-and-answer – 9 sites; 5 % • Case-Based-Interactive – 26 sites; 13 % • Correspondence – 3 sites; 2 % • Games – 2 sites; 1 % • Slides-Only – 4 sites; 2 % Many sites have more than one type of instruction

  44. Types of Instruction – June 2002 • Text only -- 57 sites; 27% • Text-and-graphics – 71 sites; 34 % • Slide-audio – 60 sites; 29 % • Slide-video – 23 sites; 11% • Guidelines – 8 sites; 3 % • Question-and-answer – 6 sites; 3 % • Case-Based-Interactive – 31 sites; 15 % • Correspondence – 2 sites; 2 % • Games – 2 sites; 1 % • Slides-Only – 4 sites; 2 % • Slides-and-Text – 4 sites; 2 % Many sites have more than one type of instruction

  45. More about Q&A Instruction • Only 6 sites (2%) feature Q&A, BUT the number of hours is relatively large • Challenger - 964 hours • TheAnswerPage – 300 hours • E-core – 27 hours • Familypractice.com - 25 hours Total about 1316 hours (7 %)

  46. CME Participation by Location Based on ACCME Figures for 2001 • Live meetings and conferences account for 76 % of “physician-registrants” • Home study CME (“enduring materials”) and journals account for 19.6 % of physician-registrants • Online CME accounts for only 4.4 % of physician-registrants

  47. Physician Usage of Online CME • Physician usage of online CME is increasing, but still accounts for less than 5% of all CME • According to ACCME: • 1997: 13,115 physician-registrants (0.34%) • 1998: 37,879 physician-registrants (1.03%) • 1999: 79,536 physician-registrants (1.79%) • 2000: 181,922 physician-registrants (3.57%) • 2001: 230,055 physician-registrants (4.44%)

  48. Why is Online CME Use So Low? I • Many physicians still uneasy with computers and Internet* • Many physicians unaware of online CME or don’t know how to find it • Much live CME, especially at the hospital, is convenient, free and offers collegial interaction

  49. Why is Online CME Use So Low? II • A series of “gates” for the user to pass through • Navigation; Download and install plug-ins • Registration hassle • Fear of giving out license, DEA, credit card • Paying in advance for content you can’t view • Get content free, leave without paying • Each site has a different procedure and password

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