Highlights

During the past several months, the Accreditation Council for Continuing Medical Education (ACCME^®) has focused on helping the continuing education (CE) community respond to the pandemic. To help plan for an uncertain future, we recently conducted a survey of our accredited providers as well as several interviews. 

Although accredited CE providers reported that they are facing many current and future challenges, some survey respondents did express optimism for the coming year, projecting increases in numbers of activities and learners in 2021. As expected, almost all respondents reported a shift from live to virtual or hybrid formats for CE activities, bringing both benefits and challenges. Accredited providers anticipate that online programming will be the dominant format for the foreseeable future, a shift that may become permanent. Respondents asked the ACCME to promote the value of CE to stakeholders, disseminate resources, and streamline processes.

Accredited CE providers shared the following observations about opportunities and challenges in the current environment:

Opportunities

• There has never been a better time to show the value of CE for training and retraining of clinicians to allow organizations to respond to the pandemic.
• This is an opportunity to innovate:
  
  • Experiment with new activity formats, including live-streamed online activities, activities that bring together small groups to problem solve and learn from each other online, activities using social media as a learning tool, or a podcast series.
  • Involve patients and community members—they are more likely to be available online.
  • Experiment with deploying activities for interprofessional teams.
  • Connect your activities with measurable quality targets.
• Take advantage of new learning needs:
  
  • Help clinicians deploy telehealth care, reflect on equity and diversity, and work effectively in teams.
  • Help faculty teach effectively online.
• Learn more about creating effective, interactive online activities, using tools such as video, simulations, and polls.
• The necessity to evolve may push investment in more efficient online services such as a learning management system.
• Leverage the increased attendance and positive response from participants to build the trust of your community of learners.
• Engage a broader diversity of expert faculty who can more readily participate in your programs from remote locations.
• Use the additional flexibility afforded by ACCME to offer easy and more efficient activity approvals and support.

Challenges

• Creating a new educational strategy is not easy, and requires adaptation, flexibility and nimbleness.
• Faculty may be less available.
• It can be challenging to convince some faculty and learners to embrace new learning models.
• Educational staff may be more stressed.
• Newer online educational approaches are generally more time-consuming for staff, due to time spent prepping speakers, conducting run-throughs, and providing tech support.
• Uncertainty about commercial support availability in the coming year.
• Difficult to determine viable pricing models for virtual events.
• New issues in hosting virtual exhibit halls and satellite events while meeting ACCME and industry requirements.
• Having to ship training models to learners so they can practice surgical skills at home, with telementoring from the faculty.
• Properly recording attendance and ensuring feedback from online activities.

Tables and charts that reflect the quantitative data from the survey are below.

Details of the Accedited Provider Survey

In addition to the face-to-face discussions with providers, we conducted an online survey, selecting a representative sample of 150 accredited providers, including ACCME-accredited, state-accredited, and jointly accredited providers from each provider type. We received 64 responses, resulting in a 43% response rate. There were no substantial differences between respondents based on their accreditor or provider type, with two exceptions: hospitals/health systems were more likely than other provider types to report that staff had been furloughed; and specialty societies were more likely than other provider types to report that they needed to refund fees and return commercial support.

Demographics of Respondents

Table 1. Numbers and Percentages of CE Provider Responses by Accreditor

*Percentages do not add up to 100% due to rounding.

Table 2. Numbers and Percentages of Responses by Accredited CE Provider Organization Type, with Total Provider Numbers and Percentages for Comparison

Changes Reported in Recent Months

Table 3. Changes in CE Departments

*Respondents were asked to check all that apply.

In their comments, respondents reported funds being reallocated to address COVID-19, salaries being withheld or reduced, and salary and hiring freezes, meaning they could not replace staff who left. As a result, staff are taking on CE responsibilities without prior experience; training staff is especially difficult because of remote working environments. Some CE staff are taking on additional responsibilities due to layoffs in other departments. Respondents reported being overworked and worried about upcoming cost-saving measures, including CE department restructuring and layoffs.

Table 4. Changes to Numbers of Educational Activities

*Respondents were asked to check all that apply.

The table shows that most respondents have had to cancel or repurpose live activities. In their comments, respondents described the challenges and benefits of the shift to virtual and hybrid formats.

Changes Anticipated in the Future

Table 5. Anticipated Changes: Operations and Educational Strategy

Operations: Some respondents expect significant budget shortfalls and staff downsizing; some worry their CME programs would be eliminated.

Educational strategy: Respondents expect that their organizations will continue to shift toward virtual learning and hybrid formats, as well as more enduring materials. They need to focus on creating virtual and enduring materials that are more engaging and educationally effective.

Figure 3. Anticipated Changes in 2021: Staffing

About half of respondents expect no change in their department staffing for 2021 compared to 2019, with a small number of respondents expecting an increase in staff, and about 40% expecting a decrease.

Figure 4. Anticipated Changes in 2021: Numbers of Activities

About 16% of respondents expect no change in numbers of activities in 2021, while almost 46% expect a decrease, and approximately 38% expect an increase in activities.

Figure 5: Anticipated Changes in 2021: Numbers of Learners

About 15% of respondents expect no change in learner numbers in 2021, while approximately 46%expect increases and 36% expect decreases.

Figure 6. Anticipated Changes in 2021: Revenue

 Nearly 60% of providers expect decreases in revenue in 2021, with 14% expecting an increase. Approximately 26% percent of providers expect no change.