title: Impact of a Performance Improvement CME activity on the care and treatment of patients with psoriasis.
abstract: BACKGROUND
  The Performance Improvement (PI) CME format improves physician performance in other specialties but data are lacking in dermatology.
  
  
  OBJECTIVE
  We sought to assess the impact of a PI CME activity on physician practice patterns for patients with psoriasis, which was developed, implemented, and evaluated by the American Academy of Dermatology (AAD), in part to assist dermatologists in fulfilling Part IV of their Maintenance of Certification requirements.
  
  
  METHODS
  In this PI CME activity, participants: (1) self-audited patient charts, which met inclusion criteria in stage A, and reflected on their results, benchmarked against peers; (2) reviewed educational materials in stage B and developed an improvement plan; and (3) self-audited a different set of patient charts following the plan's implementation. Aggregate stage A and C data were analyzed using χ(2) tests.
  
  
  RESULTS
  We found a statistically significant improvement in the advisement of patients with psoriasis regarding their increased risk for cardiovascular disease, to contact their primary care provider for cardiovascular risk assessment, and in shared decision making regarding the treatment plan. We also found an overall statistically significant improvement in history taking per the guidelines.
  
  
  CONCLUSIONS
  Learner chart selection bias, self-reporting of chart data, and lack of a control group are limitations.
  
  
  CONCLUSIONS
  The AAD psoriasis PI CME activity demonstrated significantly improved dermatologists' documentation of patient's history, counseling of patients for lifestyle behaviors, and shared decision making.
authors.affiliation: American Academy of Dermatology, Schaumburg, Illinois.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Gist
authors.affiliation: American Academy of Dermatology, Schaumburg, Illinois. Electronic address: rbhushan@aad.org.
authors.forename: Reva
authors.initials: R
authors.lastname: Bhushan
authors.affiliation: American Academy of Dermatology, Schaumburg, Illinois.
authors.forename: Elaine
authors.initials: E
authors.lastname: Hamarstrom
authors.affiliation: American Academy of Dermatology, Schaumburg, Illinois.
authors.forename: Patrick
authors.initials: P
authors.lastname: Sluka
authors.affiliation: American Academy of Dermatology, Schaumburg, Illinois.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Presta
authors.affiliation: American Academy of Dermatology, Schaumburg, Illinois.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Thompson
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Kirsner
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D003880:Dermatology / Q000193:education*; D004502:Education, Medical, Continuing / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D011565:Psoriasis / Q000628:therapy*; D058996:Quality Improvement; D011795:Surveys and Questionnaires
keywords: Maintenance of Certification; Performance Improvement CME; comorbidities; counseling patients; evidence-based medicine; part IV; patient outcome; physician performance; practice gaps; psoriasis; psoriasis guidelines; shared decision making