Continuing medical education. The next step.

Traditional continuing medical education (CME) keeps physicians aware of the state of the art. It has limitations, however, as a quality-assurance tool: it is memory based, involves a group endeavor with diffuse goals, often unrelated to practice, is an inappropriate remedy for many problems in patient care, is hampered by poor-quality evaluation, and is governed more by market factors than educational outcomes. The self-study of practice and practice-linked CME offer rich potential for development. The physician's monitoring of his work, with appropriate improvements in performance, is valuable CME. Computers provide facts and guidance at the time and place the physician is developing diagnostic plans, diminishing reliance on memory. The next step in CME is for hospitals, societies, and medical schools to perfect methods of self-study of practice and practice-linked CME.