Course Director Support

Here are some questions to ask when assessing the need for a specific education activity and identifying the specific outcomes level at which the subsequent education might be targeted..

Imagine that data shows an increase in the number of deaths among patients who have been admitted to the hospital with pneumonia. This increase is accompanied by an increase in length of stay for this patient group and uptick in overall costs. When examining prescription data, we notice that certain classes of antibiotics are being regularly prescribed but guidelines suggest they are not appropriate for treating pneumonia.

We start asking ourselves some questions:

• Is there a gap between current patient health status and the desired state (patient population health)?
• Yes, the mortality rate is outside the target range for this condition
• Why is this happening? Is there a gap in performance?
  
• Yes, there appears to be since physicians are not adhering to pneumonia guidelines
• Is there a gap in competence?
  
• It's hard to use that word because a gap in competence suggests incompetence, let's not look at this as a dichotomy but a normal distribution, we have "less than optimal levels" of competence because we're not always following the guideline.
  
• We then ask ourselves, is there a gap in procedural knowledge? Do we know what we're doing?
• When we take a look at performance on qualifying and maintenance exams, we see that we're performing at a high level on material related to the guidelines, so we say no, there is not a gap between current and desired procedural knowledge.
  
• So in this case, we target competence as the appropriate level at which we design and execute a CME activity. We set a target, e.g. increase prescription of appropriate antibiotics for pneumonia by 10% within 6 months; decrease mortality rate by 5% within 12 months; design and develop education to close those gaps, and communicate goals and objectives to our physicians.