title: Performance improvement CME for quality: challenges inherent to the process.
abstract: OBJECTIVE
  The purpose of this paper is to discuss the perspective debates upon the real-time challenges for a three-staged Performance Improvement Continuing Medical Education (PI-CME) model, an innovative and potential approach for future CME, to inform providers to think, prepare and to act proactively.
  
  
  METHODS
  In this discussion, the challenges associated for adopting the American Medical Association's three-staged PI-CME model are reported.
  
  
  RESULTS
  Not many institutions in USA are using a three-staged performance improvement model and then customizing it to their own healthcare context for the specific targeted audience. They integrate traditional CME methods with performance and quality initiatives, and linking with CME credits.
  
  
  CONCLUSIONS
  Overall the US health system is interested in a structured PI-CME model with the potential to improve physicians practicing behaviors.
  
  
  CONCLUSIONS
  Knowing the dearth of evidence for applying this structured performance improvement methodology into the design of CME activities, and the lack of clarity on challenges inherent to the process that learners and providers encounter. This paper establishes all-important first step to render the set of challenges for a three-staged PI-CME model.
authors.affiliation: Division of Continuing Medical Education, The University of Alabama at Birmingham, Birmingham, Alabama, USA and Continuing Professional Education, Aga Khan University, Karachi, Pakistan.
authors.forename: Farhan Saeed
authors.initials: FS
authors.lastname: Vakani
authors.forename: Ronan
authors.initials: R
authors.lastname: O'Beirne
mesh_terms: D004502:Education, Medical, Continuing / Q000592:standards*; D006801:Humans; D058996:Quality Improvement; D014481:United States
keywords: CME; Challenges; Continuing professional development; Learners; Performance improvement; Providers