Systems-based framework for continuing medical education and improvements in translating new knowledge into physicians' practices

Abstract

Concerns about health care costs and quality are focusing increasing attention on physicians and their continuing medical education (CME). These concerns have produced several calls for “a new definition,” “a new vision,” “repositioning,” “reinventing,” and “transforming” CME. However, differences in conceptualizations and vocabularies have introduced appreciable confusion in recommending changes. This article uses a systems-based approach to describe and analyze the processes involved in translating new information into physicians' practices. The article (1) introduces a conceptual framework that links physician learning and performance to systems for information, education, implementation, and regulation in the context of the larger health care system; (2) uses the framework to identify concerns and opportunities for the major types of systems immediately relevant to CME: and (3) uses the framework to suggest broader implications for CME, including the nature of process for changing physicians' practices, needed improvements, priorities in performing research, and implications for CME professionals.