Evolution of planning in CME

Continuing medical education (CME) planners are faced with new challenges in creating a learning climate to address the needs of five groups of stakeholders: learners, teachers, planners, the institution, and the public. One way to look at planning is through its evolution in four stages: traditional planning, planning for measurable behaviors, planning for individualized learning, and planning within a learning system. Traditional planners used an expert as teacher to screen content and determine the relative importance of information within the field. Information was transferred to learning and they were expected to determine its use in practice. Planners working toward measurable behaviors moved the balance among the stakeholders to provide a more explicit role for learners with behavioral objectives or goal statements so that learning could be measured. However, planners were still concerned with groups of people. The climate of health care reform has been the impetus to move to a system that better accounts for the needs and learning processes of individuals by planning for individualized learning. Currently, we are moving further forward to look at a system that places individuals within the context of their own institution. Individual needs are based on data from the system; fulfillment of those needs is demonstrated by changes in the data. Conflicts arise in shifting the institutional mission from CME as simple numbers—number of programs, number of participants, number of hours—to CME that places value on how individuals change within the institution in ways that further the institution's mission.