Evolution of a remedial CME course in professionalism: addressing learner needs, developing content, and evaluating outcomes.
BACKGROUND
Scant information is available about the nature of the professional violations resulting in referral of physicians for remedial continuing medical education (CME). The CME program at Case Western Reserve University (CWRU) School of Medicine has developed the Intensive Course in Medical Ethics, Boundaries, and Professionalism (medical ethics course) for physician referrals due to ethical breaches. In this report, the authors present 7 years of data regarding the type of behavior that resulted in course referral as well as information regarding course and outcome evaluation development and participant demographics.


METHODS
The medical ethics course has been designed in consultation with licensure agencies to address the learning needs of physicians with problems in the areas of boundary maintenance and ethics. Teaching methods and outcome evaluations include lectures, case discussions, multiple-choice question tests, skill practice sessions, and writing a reflective essay based on the participants' ethical lapse. Information is also gathered regarding participant demographics, training, and practice characteristics.


RESULTS
Between September 2005 and February 2012, 358 learners participated in the course. The average age was 52 years and 73% were board certified. Of the 269 physicians who wrote a reflective essay, the reasons for referral included prescribing of controlled drugs, sexual boundary issues, providing services to family or friends, not maintaining proper medical records, and billing issues.


CONCLUSIONS
This report outlines the strategies used by CWRU to develop remedial CME courses using the medical ethics course as an example for course and outcome evaluation development. This is the first report characterizing the type and frequency of the medical ethics violations that result in mandatory participation in remedial CME.
Medical Director, Program in Continuing Medical Education, Isabel & Carter Wang Professor in Medical Education, Case Western Reserve University School of Medicine.
Theodore V
TV
Parran
Amy Ross
AR
Pisman
Stuart J
SJ
Youngner
Stephen B
SB
Levine
D004502:Education, Medical, Continuing / Q000379:methods*; D004992:Ethics, Medical / Q000193:education*; D005260:Female; D006801:Humans; D008297:Male; D009820:Ohio; D010817:Physician-Patient Relations / Q000941:ethics*; D011361:Professional Competence / Q000592:standards*; D016730:Program Development; D015397:Program Evaluation; D012073:Remedial Teaching / Q000379:methods* / Q000592:standards
boundary maintenance; doctor-patient boundaries; medical ethics violations; physician problematic behavior; professionalism; remedial CME