So Long, But Not Goodbye

Today is my last day at Penn State College of Medicine and my last day operating D. Warnick Consulting. I am moving on to a new endeavor in the continuing healthcare education community and with that change, feel that now is the right time to take a break from the Confessions of a Medical Educator blog. Right now, I don’t think that it means goodbye forever, as I do hope to resume the blog at some point in time, so I’m not going to go through a long retrospective where I reflect on my 3 years plus with the blog. Suffice it to say that I continue to be thankful for all of you who have read the blog over the years and I am honored that there are so many of you interested in what I have to say. Thank you.

For those interested in such things, Don Harting recently posted a profile he wrote up on me (I remain baffled by this). You can read it on his blog.

I’ll finish this off with a quote from my favorite philosopher, Winnie-the-Pooh (and Piglet, too).

Piglet: ‘Pooh?’
Pooh: ‘Yes, Piglet?’
Piglet: ‘I’ve been thinking…’
Pooh: ‘That’s a very good habit to get into to, Piglet.’

A good reminder for us all.

 

The Importance of Access in Education

Last fall, for the first time in 15 years, I started getting a newspaper delivered to my home. A guy drives past in his beat-up old Honda every morning, tosses the rolled up paper into my front yard (and every once in a blue moon it even makes it all the way up onto my front porch, bringing me endless joy and delight), and I, disheveled and bleary-eyed, walk out, pick it up, and carry it back in to read over breakfast.

When I told friends and family about this rather pedestrian development in my life, the responses I received ranged from, “Oh…neat.” to “Why would you do that? Might as well just dump it right into the recycling bin!” Most wanted to know why I would choose to pay for a paper version of the…paper…when I could just read it online for free (or mostly free)?

It’s a fair question and the answer is quite simple: I chose to get a home delivered newspaper in order to give my kids access to it. Not just access, but easy access. If the newspaper is available, spread out in front of them, it makes it pretty easy for them to just grab it and start reading. It’s right there and the only thing they can do with it is read it. And it comes everyday, so it’s always around. And if it’s always around, then, they’re bound to start reading it at some point, right? Let’s check in and see how that’s working out:

paper

Success! OK, yes — my daughter only reads the comics and my son only reads the sports section, but it’s a start. And lately, they have both begun to browse the front page, looking at the headlines, asking questions. Because I have given them easy, convenient access to a news source, they are taking advantage of that access and learning a little bit more about the world they live in.

Side note: I ordered the newspaper subscription shortly after reading this fascinating article from the The Chronicle of Higher Education on the correlation between “a child’s academic achievement and the number of books his or her parents own.” They did not look at how many of these books the children read, mind you, but strictly at the amount owned. Again, it’s about giving access.

Early in my career as a CME professional, I took the access I had to resources for my own continuing professional development for granted. It was a given that I would be able to go to events such as the Annual Alliance conference and AMA Task Force meeting every year. Then I moved to a job where funds for these activities were limited and needed to be divvied up amongst a pool of others. I had lost my access to my main source of professional education. It became much harder for me to keep up with current changes in the CME community and took much more effort and time to find alternative resources to supplement my CPD. This is one of the reasons I started CMEpalooza and the reason why I chose not to have a registration form or charge a fee. I wanted to level the playing field and give easy access to these educational resources to everyone, not just those who were able to pay. My goal is to keep it that way for as long as I am able.

Similarly, it is this issue of access that drives my continued support of industry-funded CME. If my job as a CME professional is to educate healthcare providers, then it is vital that I provide my target audience with easily accessible and convenient educational opportunities. If they are free, well, that certainly makes access to them much easier, not just for financial reasons, but logistical, too. For example: If you click on a link to read an article from the New York Times, are you more or less likely to read it if you first encounter a paywall? Less likely, of course. You could pay for it, sure — it’s not that expensive. But you need your credit card and it’s in your wallet and you left your wallet over on the counter and the cat is sleeping on your lap and you don’t want to stand up and disturb her so you just do something else. See what I mean? It’s not much different when folks are hunting for CME activities.

The following is a quote from the brilliant Neil Gaiman, delivered during his lecture on why our future depends on libraries, reading, and daydreaming:

The simplest way to make sure that we raise literate children is to teach them to read, and to show them that reading is a pleasurable activity. And that means, at its simplest, finding books that they enjoy, giving them access to those books, and letting them read them.

I believe this translates well to my role as an educator of adults: Give them good content; give them easy access to that content; and then, get out of their way.

 

Leggo My Logo

The ACCME just released a Q&A about their recently announced policy prohibiting commercial interest logos in disclosure of commercial support. This policy change has been much buzzed about in CME circles and has the distinction of being one of the few things that both pharma-free CME and industry-supported CME advocates can agree on — they both hate it.

Maybe I’m just irritable about the unseasonably cool weather we’ve been having in the northeast or maybe I’m grumpy that the Phillies haven’t had a decent bullpen since 2008, but somehow, I disagree with everybody.

A major focal point for those against the logo-banning is the issue of transparency — or lack thereof — which I find kind of baffling. First, most CME providers I know have no interest in hiding the source of funding for their activities. Why would they? They eventually would like to get more funding to produce more activities, so why would they want to annoy the funder by burying their acknowledgement in the fine print? That makes no sense. Second, while a corporate logo is certainly more obvious than a plain text name, it’s not that hard to format the text so it stands out more. Use a bigger font or make it bold or use all caps or print it in purple. It’s not that hard. This seems like a weak argument to me.

On the other hand, I don’t really see the point of the logo prohibition in the first place. I don’t understand why it’s OK to list the name of the commercial supporter, but not their corporate logo. There’s not much difference.

Why is this OK: Pfizer small

 

But this isn’t? Pfizer logo

Take away the blue circle and change the font and they’re exactly the same.

To me, it looks like what’s really being banned is window dressing, which, I mean, if that’s what you’re going for, then, mission accomplished. Is it “continuing the separation of promotion from education”, the stated reason for the policy? I don’t know. I never really thought of having a commercial supporter’s logo in a syllabus as promotion. It’s just an acknowledgement of their financial contribution. It seems perfectly reasonable to me to use a logo to acknowledge financial support without assuming the company behind that logo is influencing the content within. Every summer I go watch the Phillies play at Citizen’s Bank Park, but I don’t assume that a representative from Citizen’s Bank is helping Ryne Sandberg fill out his line-up card (though maybe they should). I fail to see how swapping out a logo for text makes much of a difference. It’s just one more rule for me to keep track of.

A Quick Hit From #2014AIS: Learning From Those Who Care

I went to this week’s ACEhp Industry Summit and learned something. I learned something about perception. I learned something about judging people based on their occupations. I learned something about being a cynic.

I went to this week’s ACEhp Industry Summit meeting and heard people employed by pharmaceutical companies and device manufacturers talk passionately about improving the quality of healthcare in America. There was no talk about products or logos or marketing. There was talk about quality improvement, quality measures, and utilizing the continuing education of health care providers to improve the unacceptably low percentage of citizens receiving standard levels of care in this country. This talk despite the fact that we continue to put more and more regulations in place to further stigmatize the industry dollars vital to achieve this goal and potentially add to the increasing wariness with which the public views commercially supported CME.

I heard people talking who cared. They cared about health, they cared about education, and they cared about the people they were speaking to. The cynic in me would normally add “…and they cared about their bottom line.” That may be so, but even more than that, they cared about making a difference.

We have our fair share of opponents to the use of industry funds for continuing education of health care providers and they have their reasons for believing as they do. I wish there was some way I could have transported all the anti-commercial support advocates to this morning’s provider/industry panel session on supporting QI educational initiatives and had them hear what I heard. Maybe it wouldn’t have done any good, or maybe, like me, they would have learned something they weren’t expecting.

CMEpalooza Part Deux

It’s ba-ack!

Back by popular demand (or something like that), CMEpalooza returns October 15 with a new format (panel-only) and a new name (CMEpalooza Fall). Though we briefly considered calling it some variation of “CMEpalooza 2″ (CMEpalooza II: The Panels Strike Back; CMEpalooza 2: Judgement Day; CMEpalooza 2: Temple of Outcomes; CMEpalooza 2: Electric Boogaloo), we settled on the much more boring “CMEpalooza Fall” to set it apart from the original CMEpalooza and because, well, it’s in the fall (and yes, I realize that my title satirizing Star Wars should technically be “CMEpalooza II: Attack of the Panels”, but those “first” three movies are crap and I’m pretending they don’t exist.)

While CMEpalooza Fall will be a departure from the original, never fear, we will return to the original format for the spring version of the palooza. You can read all about CMEpalooza Fall over on the CMEpalooza blog and please, please, please, feel free to send me your suggestions for topics and/or speakers. I’m probably nuts for trying this again – and ramping up the difficulty level – but I like a challenge and I think the panel-only format could be really great with the right topics and speakers. I guess we’ll see…

10 Signs That You Might Work In CME

If you know what ACCME, ACEHP, CCMEP, PhRMA, OIG, AMA CEJA, FACEHP, SACME, PARS, NCCME, PICME, POC CME, MOC, MOL, IACE, GAME, PPSA, and CMS stand for…you might work in CME.

If you know the occupations of the spouses for everyone on your planning committee…you might work in CME.

If you ask for a $150,000 grant and get a reply email from the grantor saying they are pleased to inform you that your grant request has been approved for $2500…you might work in CME.

If the most common feedback you get on your program evaluations is “The room was too cold” or “The iceberg lettuce was wilted”…you might work in CME.

If you know the difference between “accredited” and “certified”…you might work in CME.

If you understand how to define and measure “competence”…you might work in CME.

If you have nightmare visions of plates of fettuccine alfredo with lemon-pepper chicken…you might work in CME.

If you have ever had to explain to the company you are asking for a six-figure grant from that, no, they can’t give any input, advice or suggestions about the program you would like them to fund…you might work in CME.

If you still get faxed registrations…you might work in CME.

If you know who “Murray” is…you might work in CME.

 

Google+ Hangout Moderator Training

For any of you who may be interested in learning a little more about how to use Google Hangouts, I am offering a Google+ Hangout Moderator Training session on May 21. In addition to going over the basics of a Google Hangout, I’ll also be sharing some of the tips and best practices I learned through the process of developing and moderating CMEpalooza. You can read the specific details over on the Hangout Training page on The CME Guy website. As always, feel free to let me know any questions you may have.

Comfort Books

Tax season is always a stressful time around the Warnick house. With a professional musician in the family (my wife is a violist), tax time has always been, well…taxing, but now that I have also joined the ranks of the self-employed, it has become that much more overwhelming. For 2013 we had twenty W2’s and 1099’s. Twenty! Yes, we do have an accountant. A few years ago we spent an entire Sunday doing our taxes on our own with Turbo Tax. At the end, after we submitted them, we looked at each other and realized we had no clue if we had done them correctly. We’ve had an accountant ever since. Even so, it’s always a guessing game as to how much we’re going to owe this year.

In times of stress, while many people turn to “comfort food” to ease their troubled minds, I frequently find myself turning to “comfort books” to help relax (OK, yes, I turn to comfort food, too…). For me, a comfort book is something for which the reading of it is a purely pleasurable experience. I want to be able to sit down, take a moment to read a chapter or two, and come out of it feeling more relaxed then when I started. This rules out much of my usual reading material. Whereas Connie Willis’s books on time-traveling historians in WWII era London or Henning Mankell’s Wallander series are really excellent reads, they are not the sort of books I turn to to soothe my soul. For that, I turn to baseball.

My go-to comfort books for the past few years have been memoirs and essays on America’s pastime. I love books about the history of the game and tend to gravitate towards authors who focus on the subtle nuances and pace of the game – writers not afraid to spend an entire chapter talking about sitting in the bleachers of a late July battle between two non-contenders on a hot and humid Texas night in 1982. They are masters at adapting their writing style to embrace the sights, sounds, and tastes of the game – less about telling a story; more about the slow rhythms and atmosphere that surrounds a night at the ballpark. David Halberstam’s Summer of ’49 and October 1964, Buzz Bissinger’s 3 Nights in August, and Dan Barry’s Bottom of the 33rd are all brilliant examples of this style of writing and my own personal comfort books. Summer of ’49 got me through my wife’s surgery to remove a meningioma. October 1964 was there when I came home late every night during my ACCME reaccreditation. 3 Nights in August traveled with me while going solo to a weekend conference in Spain.

Last week I attended the ACCME’s “CME as a Bridge to Quality” Accreditationangell Workshop and spent an evening wandering around After-Words New & Used Books — a must-stop for me whenever I’m lucky enough to have a little free time in Chicago. While browsing through the used books, I was thrilled to find a pristine hardback copy of Season Ticket by Roger Angell, one of my absolute favorite baseball writers (and one of my favorite writers, period, as exemplified by his recent New Yorker article on aging). What better way to get through the stress of another tax day than a series of essays on baseball in the 80’s — the decade that shaped and molded my childhood fandom — by our greatest living baseball writer? Just read these few sentences on escaping a crowded parking lot during a July 4th Mets game:

Actually, by the time we turned up at Shea the lot was full, with the gates and pay booths closed, and we had to make do with a narrow, muddy little junkyard off some street out beyond the center-field parking sectors, where a local entrepreneur took our seven bucks and then absolutely buried us in a welter of other late-comers. No hope, but when we found our way back there, hours later, beyond the motionless thousands of overheating cars and captive fans and patriots self-blocked in the main lot, someone in our group spotted a little alley at the back of our yard, and we took a chance and swung that way, against the flow of cars inching out, and found a miracle there: an empty street. I zipped through a couple of blocks, hung a right away from the honking tangle, extemporized a dazzling U-turn under the Whitestone Expressway, guessed and grabbed another right, spotted the good old boat basin off to my right, and laid a little left onto the Grand Central Parkway: home free, homeward bound, with the cheers of my fans in the car and cascades of Queens-side Roman candles on either hand celebrating our brilliant departure.

Sounds about perfect to me. If anyone needs me, I’ll be reading.

CMEpalooza Recap

It’s now one week post-palooza — seems like a good time for a recap. Let’s get right to it…

So, what was the point?
The point of CMEpalooza was three-fold:

  1. Provide a forum for individuals to present on any topic related to CE/CME. More specifically, I was particularly interested in folks who were uncomfortable presenting in traditional formats or who had something they wanted to share but had been unable to do so at the Alliance conference and elsewhere. I think CMEpalooza was successful in meeting this goal, judging from the variety of presenters and topics we had. I know for certain that several of the speakers did presentations for which they had abstracts turned down by the Alliance. I don’t know if any of the presenters chose to talk at CMEpalooza because they don’t like speaking at “normal” live meetings/conferences, but at least there were people presenting whom I’d never heard speak before.
  2. Show that doing an event of this scale was possible with freely available tools. In other words, if I was going to talk-the-talk, I wanted to walk-the-walk. I’ve done a number of blog posts and presentations on DIY CME and I’ve done some small scale projects, but I really wanted to show that the same tools I used for my smaller projects could be used just as easily for larger scale projects. Mission accomplished. We had a two day, 21 session event that over 200 people visited each day (more details below) and I spent absolutely no money on. Zero dollars. That includes software, hardware, marketing, AV, etc. All the tools I used were free for me and they’re free for you.
  3. Demonstrate that content is still king. From my perspective, the beauty of CMEpalooza was not that Google+ Hangouts is this incredibly unique learning format that keeps participants engaged purely through its own inherent awesomeness. Really, it’s just streaming video with slides and talking heads. Nothing so special about that. No, the beauty of CMEpalooza was the diversity of topics and excellent speakers — there was something for everyone. Participants visited CMEpalooza for the content, not the format. The tools are what enabled me to put it on, but if we had had lousy presenters or topics no one was interested in, no one would have watched regardless of how it was presented.

Was it a success?
Well, I had pretty low standards going in to it — as I stated many times, my goal for CMEpalooza was a consistent standard of “good enough” — so based on that, I’d say yes. We had a few technical glitches and delays, but nothing that stopped any sessions from happening and we never got too far off-schedule. All of the presenters and participants I heard from seemed to be happy and/or impressed with how it went (side note: I heard from a couple of folks afterwards who told me  they had their doubts about whether I could pull off an event of this scale with the tools I was using). I was happy with how it went. But, let’s look at the actual data.

Live sessions: most sessions averaged between 30 and 40 viewers, with a high of 50 and low of 10. The exact number of viewers per session is difficult to determine since I heard from multiple individuals who said they were watching sessions in a group setting, so the actual number of viewers is likely a bit higher than the number of views.

Archived sessions: The CMEpalooza archive was posted a week ago and since then, each session video has been viewed at least 33 times. Most of the March 20 videos (which were posted 3 days earlier than the March 21 videos) have at least 70 views with a high of over 100.

Website: On the first day of CMEpalooza, March 20, the CMEpalooza website had 243 unique visitors and 1932 views. On the second day of CMEpalooza, March 21, the website had 204 unique visitors and 2055 views. Since then, the website has averaged about 140 views per day.

Considering that when I first decided to do CMEpalooza, I didn’t know if anyone would watch, I can’t help but think that these numbers show that it was a rousing success.

If you had to do it over again, what lessons were learned for the next go-’round? (Question courtesy of Jacob Coverstone)
In all honesty, there’s not a lot that I would change. A few things that come to mind:

  • If I do it solo again, I’d design the schedule differently to give a little more time in between sessions. I’d like to have a little more time in the “green room” with the presenters before going live, to work out any last second glitches and not feel quite so rushed.
  • A second moderator would be ideal. As one session is going on, the other moderator could get the next one set-up and be ready to go as soon as the current session was over. They would also be able to help with questions. I was literally running slides with my left hand and responding to email, texts, etc with my right.
  • I wasn’t totally satisfied with the options for Q&A. The Google+ app worked exceedingly well, but too few people watching had a G+ account to use it. I’m not sure if the lack of questions was due to people not being able to ask them or just not having any.
  • It’s not a high priority, but having a nice set of headphones/microphones for all presenters would have been helpful. It’s something to consider if I do this again.

Are you going to do it again?
Many people have asked me this and…I don’t know. People seemed to enjoy and appreciate it, so I think I’d like to. I was in a unique position that allowed me to have the time to dedicate to a project like this (i.e. one that i made no money from) and I don’t know if that will be the case in the future. So for now I’m going to leave it that I’d like to, but we’ll see…

Overall, I was really pleased with how CMEpalooza went. If anyone has any questions or feedback, please feel free to comment below or shoot me an email. Thank you.

CMEpalooza: One Week To Go!

[a tumbleweed slowly rolls by, nearly taking out a semicolon on its way past...]

Things have been a might bit quiet around these parts, lately. A little too quiet, if you know what I mean…

Yes, the old Confessions of a Medical Educator blog has been gathering a bit of dust while I’ve been focusing my energies on CMEpalooza. Sad. But while we’re on the subject — Hey! CMEpalooza is only one week away! Wow!

If you haven’t been following the palooza blog (spellcheck tells me “palooza” isn’t a word. YOU’RE NOT THE BOSS OF ME SPELLCHECK!!!) here are a few quick updates on how the prep is going.

  • We’ve extended the palooza to a second day (I say “we” to make you think I have a staff of 20 working behind the scenes on stuff. There’s no staff. It’s just me. We’re very streamlined and efficient.). Here are the links for the March 20 and March 21 agendas.
  • For the past two weeks I have been holding quick Google+ Hangout training sessions with each CMEpalooza presenter and they have proven to be well worth the time and effort involved. If you’re ever [nuts] enough to try something like this on your own, I highly recommend doing something similar. It’s helped iron out a few glitches, both self-induced (sending my first two “trainees” the wrong link to access the Hangout) and presenter-induced (usually simple things like accidentally muting the laptop or forgetting to turn on headphones).
  • As I stated over on the CMEpalooza blog, I’m now 99% sure I can pull this off. Using Google+ Hangouts On Air is a good system, but not a perfect system. The audio and video quality fluctuates and isn’t always 100% in-synch. The picture can be a little jerky depending on the speed of the presenter’s internet service (I learned the hard way not to let my kids stream Netflix while I’m trying to do a Hangout. Good Luck, Charlie, indeed!). But overall, it’s pretty good and that’s my basic goal for this. I’ll be happy with “pretty good” and satisfied with “not bad”.
  • Lastly — and maybe most importantly — I created a page on the CMEpalooza website (http://cmepalooza.wordpress.com/live) where you can go to watch all the presentations as they stream live. You can read more specific instructions about watching the presentations here.