CME Enterprise, Indianapolis, Indiana, USA.
Acad Med. 2010 Jan;85(1):16-8. doi: 10.1097/ACM.0b013e3181c41b6f.
Traditional continuing medical education (CME), necessary for keeping physicians current and competent, is insufficient in translating physician practice into better patient outcomes. CME, then, must be transformed from a system of episodic interventions to a more personalized, contextual, flexible, and targeted process within a continuing professional development framework. The core of this transformation must be a formal process of physician self-assessment. Unfortunately, health care providers tend toward inaccurate self-assessment, regardless of training, specialty, or manner of self-assessment. Therefore, the development of an external validation system conducted by credible, informal peer review in a safe environment is essential. Clinicians must be able to access practice and patient data without concerns about accuracy, timeliness, confidentiality, attribution, or unintended consequences. New analytical tools are also needed to illuminate the data compilations and present them in compelling, individualized, and comparative formats. However, such developmental work will not be possible without strong community leadership coordinating a collaboration of resources and a sharing of data. Ensuring physician competence has long been an issue for medical societies, state licensing boards, and others invested in improving patient care. Now it's time to get serious. Current efforts at massive health care reform provide the perfect opportunity to fully integrate physician self-assessment and performance improvement into the larger health care system through a continuing professional development model. Practitioners in CME have been far too complacent with the current practices. A shift to a focused and dedicated sense of urgency must occur to ensure physicians' continuous learning and change.
传统的继续医学教育（CME）对于保持医生的最新知识和能力是必要的，但在将医生的实践转化为更好的患者结果方面却不够充分。因此，CME 必须从一个偶尔干预的系统转变为一个更个性化、更具背景、更灵活和更有针对性的持续专业发展框架内的过程。这种转变的核心必须是医生自我评估的正式过程。不幸的是，无论培训、专业或自我评估的方式如何，医疗保健提供者往往倾向于不准确的自我评估。因此，必须在安全的环境中，通过可信的、非正式的同行评审来建立外部验证系统。临床医生必须能够访问实践和患者数据，而不必担心准确性、及时性、机密性、归因或意外后果。还需要新的分析工具来阐明数据汇编，并以引人注目的、个性化和比较的格式呈现。然而，如果没有强大的社区领导来协调资源的协作和数据的共享，这种发展工作是不可能的。确保医生的能力一直是医学协会、州许可委员会和其他致力于改善患者护理的机构关注的问题。现在是认真对待的时候了。当前的大规模医疗改革努力为通过持续专业发展模式将医生自我评估和绩效改进完全纳入更大的医疗体系提供了绝佳机会。CME 的从业者对当前的做法过于自满。必须转变为专注和坚定的紧迫感，以确保医生的持续学习和变革。
