Speaker: Graham McMahon, MD, PhD
Reported by: Ginny Jacobs, PhD, CE News Editorial Team
President and Chief Executive Officer of the Accreditation Council for Continuing Medical Education (ACCME®
SACME was pleased to welcome Graham McMahon, MD from the ACCME as a presenter at the annual meeting. Those who are familiar with the messages conveyed by the CEO of the ACCME (the U.S.-based accreditation system) will recognize that Dr. McMahon consistently promotes the need for CME/CPD professionals to develop new thinking and apply more engaging approaches to their educational programming.
To his credit, as part of the evolution of the field CME/CPD, Dr. McMahon routinely highlights our collective need to practice what we preach. He underscores our goal as a field to strategically plan activities in a manner that effectively identifies and addresses learners’ needs. His comfortable style of presentation, which on this day consisted of a mix of informational slides, video clips, and roundtable reflective activities, called attention to the core principles necessary to effectively design and deliver instruction. He touched upon the importance of adopting well-planned learning design strategies. The core tenets of design should include: learner engagement, active learner involvement, consistent feedback and reinforcement of key content.
One of the exercises that was briefly introduced during this session (as time did not allow for it to be fully developed) was a reminder of the notion that learners should be encouraged to track what they observe, feel, do, and think as they participate in an educational activity. This reminds activity planners to look for ways to actively engage learners and not allow them to merely be passive bystanders in their education. To achieve this goal, one must be mindful of what motivates learners and also be attentive to the competence-confidence gap, since information dissemination alone is insufficient. It is not enough to disseminate information with hopes that it is applied in practice. Additionally, learner feedback is an important component in one’s learning journey. Unfortunately, as Dr. McMahon pointed out, those clinicians who get little or no feedback will default to what is new, rather than what is needed to fill a gap and build confidence in their decision-making skills.
McMahon called attention to the fact that “information is not our currency anymore”. Information can be distributed through a wealth of available resources and tools. Development of the skills required to apply information and insights gained and then build that knowledge base to improve decision-making skills is key. At the base of the evolving field of CME, rests the concept that CME/CPD providers partner with individuals who have expertise in medicine. While CME/CPD professionals may or may not be experts in terms of clinical content, we should be confident in our ability to bring forward our expertise in teaching and evaluation.
McMahon provided a brief review of the State of CME, as reflected by a comparison of 2021 versus 2022 ACCME annual report data. The data, which summarized the CME activity reports produced by just over 1,600 accredited providers, pointed out the sheer scale of educational activities being certified within the United States (a 13% increase in 2022 to a reported 230,184 activities). While the number of physician interactions remained stable from 2021 to 2022, there was a notable increase (15%) in the number of other healthcare professional learner interactions during that reporting period .
The fact that the number of medical school providers (152) and the number of publishing/medical education company providers (151) were so closely matched made for an interesting analysis in terms of the total income reported by each group. The most striking contrast appears specifically related to the amount of commercial support received across the provider types. Publishing/medical education companies received 7.5 times as much commercial support as compared to medical schools.
It was evident from the data shared that there is a significant disparity with respect to the income reported by each of the organization types. For example, the average total reported income for the 151 publishing/medical education companies was $10,657,645. The non- profit physician membership organizations, which account for 320 providers, received an average total reported income of $3,831,363, while the average for medical schools was $1,880,455.
When McMahon outlined his agenda at the beginning of his presentation, it was admittedly my hope (naïvely so, I know) that he would disclose some new and creative funding sources to the audience. Wouldn’t that have been ideal? A big reveal of a new pool of money strategically being offered to credible educational planners. That was not the case, however, McMahon’s data review did serve as a reminder that significant amounts of commercial funds are unevenly being directed to some provider types as a means to offset the costs associated with healthcare education. He invited all parties (especially medical schools and medical specialty societies) to re-evaluate their funding strategies and to, potentially, consider pursuing additional industry grant support.
In my view, I suspect many organizations who elect not to aggressively pursue industry funds do so to avoid the risk management burden that can often accompany those arrangements. The chosen path of funding may likely result from their lack of institutional support, infrastructure and resources (e.g., dedicated faculty time).
In terms of the level of CME outcomes demonstrated in the 2022 aggregated data, it was interesting to see the breakdown of activities that measured learner competence, learner performance, and patient health.
| Level | % of activities | Types of measures |
| Learner Competence | 95% | 29% objective; 58% subjective |
| Learner Performance | 40% | 20% objective; 72% subjective |
| Patient Health | 16% | 16% objective; 63% subjective |
Following his high-level review of the data, McMahon posed a question to the meeting attendees. “Are you ready to grow?”, he asked. As part of his follow-up to that somewhat rhetorical question, he described opportunities to meet the changing expectations of learners and to step up our efforts to support faculty to deliver effective learning experiences. His added commentary further encouraged planning groups to pursue innovative programming, recognize the power of reflection, consider grant support, and embrace data integration as means to promote healthcare professional growth and development.
McMahon reminded us of the ACCME’s Strategic Goals which were communicated in 2022.
- Act with integrity
- Advance excellence in accredited CE
- Provide exemplary service
- Promote diversity and inclusion
- Demonstrate the power of collaboration
As an organization, the ACCME firmly believes:
- Health professionals’ education is among the most powerful currencies for change in the healthcare ecosystem
- CME providers are mission-driven to create lasting change in the wellbeing of individuals, organizations, and societies around the world.
- Educators are central in harnessing the power of learning for better health.
McMahon wrapped up his one-hour long session by discussing the multitude of initiatives that ACCME has in place to help educational providers achieve their goals related to the expanded scope and improvements in the quality of their program portfolio. Many materials and tools have been developed through ACCME’s collaborative projects and McMahon encouraged participants to utilize the available resources which include:
- CE Educator’s Toolkit (developed by SACME)
- How to Evaluate – pages 168, 171-172
- Example of a logic model – page 163
- Companion courses on ACCME Academy
- Clinician Educator Milestones (developed by AAMC, ACGME, AAMC, and AACOM)
- MATE Act (SAMHSA and DEA)
- Learner Data Reporting and CME Passport (8 medical specialty boards & 16 state/territory licensing boards)
- Improving Care of Patients with Disabilities, DEI Resources (AMA, SAMHSA)
- Joint Accreditation (ACPE, ANCC, plus 7 health professions accreditors)
McMahon noted that SACME members should consider accredited CME programs as the following:
- A performance management engine for professionals
- A partner for quality goals of your organization
- Where team-based learning transforms team-based practice
- Longitudinal curricula that provide opportunities for rehearsal, repetition, reinforcement
- Active learning and feedback for every activity
- A partner to simplify and centralize learner data management
Overall, Dr. McMahon’s presentation was designed to call attention to the power of CME/CPD. As mentioned in his title, if we can continue to find ways to incorporate more creative practices in our instructional design, delivery, and evaluation, perhaps we can unleash that power and utilize CME/CPD to find ways to change the world one CME activity at a time.
