Technology-Enhanced CPD in the Post-Knowledge Era
What taxi drivers, disappearing notebooks, and performance data might tell us about the future of continuing professional development
Author: Vjeko Hlede, Ph.D., DVM
At AMEE 2026 in Vienna, I noticed something I had not really seen at a conference before.
I was sitting in sessions with 60, 70, sometimes 80 people, listening to presentations about interesting topics, and almost nobody was taking notes. People were not writing in notebooks. They were not typing on laptops. Most were simply listening.
This caught my attention partly because I had come well prepared to take notes. My own conference habits have changed over the years. I started with handwritten notes in notebooks. Later, like many people, I moved to a laptop. I had brought my light laptop to Vienna specifically because I wanted something convenient for taking notes during sessions. Apparently, I did not need to worry so much about that.
But there was something else happening in those rooms. People were not disengaged. Questions and comments were coming through the conference app. Moderators would select a question and read it aloud, and the presenter would respond. Sometimes the presenter was effectively having a conversation with the audience through the app. The dynamics were surprisingly similar to a webinar, except that all of us were sitting in the same physical room. It was a very hyflex-like format. In-person and live online participants had an almost identical experience.
This may be a sign of the post-knowledge era.
I use post-knowledge similarly to how the term post-digital is used. Post-digital does not mean that digital technology is over. Almost the opposite. Digital technology has become so embedded in what we do that the distinction between digital and non-digital is becoming less useful. Perhaps something similar is beginning to happen with knowledge.
AMEE and the changing CPD conversation
AMEE was an interesting place to have these thoughts.
The acronym originally stood for the Association for Medical Education in Europe, but the organization is now much more global than its original name suggests. Today it identifies itself as The International Association for Health Professions Education. Participants from 122 countries at the AMEE 2026 confirm that identity.
AMEE has started paying increasing attention to continuing professional development. Its CPD Committee has identified establishing AMEE as a global venue for CPD as one of its goals. This is not limited to putting more CPD sessions into the annual conference. AMEE now offers a Continuing Professional Development in the Health Professions course. It is a substantial program, estimated at 60 to 80 hours, for people involved in designing, delivering, evaluating, accrediting, regulating, or funding CPD and CME.
So, although AMEE has traditionally been focused on undergraduate and postgraduate medical education, CPD has become part of its scope and one of the plenaries gave me a very different way of thinking about it.
What does a taxi driver need to know?
In his plenary, titled “Raising the Stakes: The Power and Potential of Examination for Learning” Brian Hodges talked about taxi drivers.
At first, taxi-driver education might seem quite distant from medical education. Hodges compared approaches to educating and assessing taxi drivers in London, Canada, Paris, and Sweden. London is probably the most familiar example. London black cab drivers undertake what is famously called “The Knowledge.”
Following an exam format established in 1865, they are expected to learn tens of thousands of streets and points of interest and demonstrate that they can navigate between them. There is a particular idea of competence embedded in that assessment. A competent taxi driver must have a detailed map of London in her head. That was a valid need in 1865 when the Knowledge exam was established. But which need are we addressing in 2026 when every driver has GPS available?
The other systems Hodges discussed have made different decisions about what a taxi driver needs to know and what can be provided by technology. If navigation can be supported by GPS, perhaps assessment time can be spent on something else. Drivers may need to demonstrate capabilities in interacting with passengers, complying with regulations, handling payments, ensuring safety, responding to emergencies, providing first aid, or using technology appropriately.
I don’t think the conclusion is that one system expects more, and another expects less. They have made different decisions about what competence means. And, for me, this was the important part of the example.
Assessment does not simply measure competence. Before we can assess someone, we have already decided what kind of professional we are trying to develop. Only after making that decision does it make sense to ask what should be assessed and how. That is very relevant to CPD.
We spend considerable time discussing assessment formats. Should we use multiple-choice questions? Should assessment be formative or summative? Can AI generate good questions? How many attempts should learners receive? What constitutes a passing score? Those are useful questions, but Hodges’s taxi drivers example suggests that there is a question that comes before all of them. What do we actually want the professional to know and be able to do in an environment where technology is already part of professional practice? Who owns the evidence of performance?
There was another part of the taxi example that particularly interested me. In some of the systems Hodges described, traditional taxi organizations, regulators, governments, and technology companies such as Uber have had to find ways to coexist and, in some cases, work together. That introduces a different problem.
Uber does not only help a driver find a passenger or navigate to a destination. The platform also accumulates data about the driver’s actual performance. That includes ratings and feedback received from taxi users, as well as ratings of taxi users by drivers. Suddenly, a significant amount of potentially useful evidence of professional performance exists, but it may be held by a technology company rather than by the professional organization or regulatory body responsible for standards. Who owns those data? Who can access them? Who can use them to provide feedback?
Sitting in the plenary, I immediately thought about healthcare. We already have a system that contains enormous amounts of information about what healthcare professionals actually do: the electronic health record. The EHR can contain information about clinical decisions, prescribing, ordering patterns, adherence to guidelines, quality measures, outcomes, and many other aspects of practice. In other words, it potentially contains precisely the kind of information that could help connect CPD with actual professional performance, but CPD providers usually do not own those data.
For an academic medical center connected to its own health system, bringing some of these data into education may be possible – after we address substantial technical, ethical, and governance questions. For organizations such as professional societies, the problem is considerably more difficult. A national society can provide CPD to tens of thousands of clinicians working across hundreds or thousands of different organizations.
The society may know a great deal about what those clinicians learn in its educational programs but very little about what happens when they return to practice. Our LMS may tell us that somebody completed a course, answered 80 percent of the questions correctly, downloaded a resource, or claimed CME credit. Meanwhile, somewhere else, the EHR may contain evidence much closer to the performance we actually hope the education will influence.
Connecting those two worlds is not just an interoperability problem. Sharing of clinicians’ performance data raises questions of ownership, patient privacy, clinician privacy, consent, governance, and trust. Finally, there is an uncomfortable question: when does useful performance feedback become surveillance? I don’t think CPD has resolved these questions yet.
CPD in a post-knowledge era
This brings me back to the people not taking notes in Vienna. I don’t know why they were not taking notes, and I would not claim that one conference audience demonstrates a fundamental change in learning behavior. But I think observation is worth paying attention to. Our relationship with recorded knowledge has changed. A presentation can be recorded. Slides can be photographed and converted to text. Speech can be transcribed. A transcript can be searched in a matter of seconds and then AI can summarize it, reorganize it, compare it with other materials, provide links to external resources, or answer questions about it. This doesn’t mean knowledge is less important, but it changes how we need to handle it. The focus is not on preserving a small amount of knowledge, but on managing a huge amount of knowledge.
If a learner knows that the information can be retrieved later, she may focus on the big picture rather than attempting to capture every important sentence. Perhaps I should be listening for connections, identifying disagreements, thinking about implications, or trying to formulate a useful question. The same issue appears in Hodges’s taxi example. The fact that GPS can reliably guide drivers through busy downtown streets, help them avoid traffic jams, and accurately estimate arrival times raises the question: what is the purpose of memorizing the streets? Is that the best use of professional learning and assessment time, or a solution to a problem that technology has eliminated?
Healthcare is obviously much more complex, and there will always be knowledge that a healthcare professional must possess without looking it up. The point is not that professionals no longer need knowledge. The question is how the knowledge is being redistributed and used. For CPD, there may actually be two knowledge problems emerging. The traditional problem is deciding what knowledge needs to reside in the professional. The newer problem is deciding what to do with knowledge about the professional that increasingly resides in technological systems.
The first takes us back to assessment of taxi drivers and the decision of whether a street map belongs in the driver’s head or in a GPS. The second takes us to Uber, the EHR, performance data, privacy, ownership, and access. Perhaps those are questions of the post-knowledge era.
Knowledge has become distributed and co-constructed across people, organizations, databases, platforms, and now AI systems. The primary challenge for us is not about new ways to deliver more knowledge. The primary challenge is deciding what humans need to know, what technology can support, and how professional practice data can be responsibly reintegrated into learning.
That challenge has become physically palpable when, in a big, crowded conference room in Vienna, while typing on my laptop, I looked around and found – I was the only one taking notes.
