European CME provider group raises concerns about policy statement from European Society of Cardiology

Dear Sir,

‘Relationship between professional medical societies and the healthcare industry, concerning scientific communication and continuing medical education: A policy statement from the European Society of Cardiology’ 1st March 2012.¹

We have read with interest the above document and agree with the objectives and aspirations of continuing medical education (CME). However, some key issues have been raised regarding the provision of CME that we believe are inaccurate and do not reflect the status and integrity of CME providers in Europe.

The document bases its recommendations on the US model for CME and the Macy Report. Anecdotal evidence has shown that the implementation of the Macy Report has not led to improved programme quality or indeed improved outcomes. There are differences in the way CME is implemented in Europe compared to the US—most significantly that commercial providers are not approved to accredit CME activities themselves. For an educational programme to receive CME accreditation in Europe, it must be reviewed by an appropriate independent accreditation body, that is, either by a professional society, government body or centralised accreditation body (e.g. the European Accreditation Council for Continuing Medical Education). Many of these bodies have guidelines/codes of practice at least as stringent as those promulgated in the document.

The US model for CME should not be adopted in Europe, but instead should be used as a lesson to help improve quality and standards.

The Good CME Practice group was founded 2 years ago by CME providers that are neither medical societies nor academic institutions. Our common purpose is the strengthening and maintenance of the quality of industry funded CME programmes. The group has drafted a set of guiding principles for all members and has been in consultation with approaching 100 medical societies and accreditation boards across Europe. The results of this consultation will be published shortly.

Guiding principles

Appropriate education

CME providers should ensure that educational activities have clear learning objectives that are derived from a coherent and objective process that has identified performance gaps and unmet educational needs. The education must be designed to positively reinforce existing good practice and effect a sustained change in daily clinical practice as appropriate.

Balance

Balance needs to be evident in content, faculty and review. Content has to be developed independently of the sponsor and reflect the full clinical picture within the framework of the learning objectives.

Transparency

All relevant information should be disclosed to the learner so that they understand fully how the content has been developed and presented. This includes the terms of the financial support, relevant disclosures of faculty and organisations involved in the development of the scientific content and the presentation of the programme.

Effectiveness

Post-activity evaluation should measure satisfaction, knowledge uptake and intent to maintain or change behaviour in line with learning objectives.

These guiding principles are contrary to the impression given in the policy document. However, it is apparent that there is a good deal of common ground between the European Society of Cardiology and the Good CME Practice Group in maintaining quality of CME in Europe. We think dialogue between us could produce policy and principles that would ensure that European CME is viewed globally as the paragon of quality and impartiality.