…that they may not be disclosing fully. According to an article in today’s Boston Globe, some researchers cross-referenced physician payment databases with journal article disclosures and found fewer than half of docs receiving $1 million or more from industry disclosed that fact. Though it does say that it’s not clear if the docs didn’t disclose or if the journals just didn’t publish their disclosures, and the study was limited to 40 orthopedic surgeon researchers who made at least a million from one company, and two who got a million from just two companies.

Here’s a link to the full article in the Archives of Internal Medicine. I’m not sure what you could, or should, do to ensure that faculty is disclosing fully. I suppose an organization could hire someone to do background checks similar to what these researchers did, but what a hassle.

There’s been lots of talk lately on the CME LinkedIn group about the need for someone, anyone, to take the lead in advocating the value of continuing medical education.

I think the ACCME is listening. In its June/July e-newsletter, ACCME also announced a survey it’s conducting to find out what accredited CME providers and other CME stakeholders are doing to “promote accredited CME’s value as a strategic priority,” from what you’re doing to what is and isn’t working to get the word out in your own organization, and the world at large. They’re also asking for ideas on how ACCME can “support you in these efforts.” ACCME plans to publish the survey results in an upcoming newsletter.

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From Anne Taylor-Vaisey: On this page I have updated a couple of journals (Medical Education, Academic Medicine) and added another journal (Medical Education Online).

From BMC Central: A hierarchy of effective teaching and learning to acquire competence in evidenced-based medicine:

Background

A variety of methods exists for teaching and learning evidence-based medicine (EBM). However, there is much debate about the effectiveness of various EBM teaching and learning activities, resulting in a lack of consensus as to what methods constitute the best educational practice. There is a need for a clear hierarchy of educational activities to effectively impart and acquire competence in EBM skills. This paper develops such a hierarchy based on current empirical and theoretical evidence.



Discussion

EBM requires that health care decisions be based on the best available valid and relevant evidence. To achieve this, teachers delivering EBM curricula need to inculcate amongst learners the skills to gain, assess, apply, integrate and communicate new knowledge in clinical decision-making. Empirical and theoretical evidence suggests that there is a hierarchy of teaching and learning activities in terms of their educational effectiveness: Level 1, interactive and clinically integrated activities; Level 2(a), interactive but classroom based activities; Level 2(b), didactic but clinically integrated activities; and Level 3, didactic, classroom or standalone teaching.




Summary

All health care professionals need to understand and implement the principles of EBM to improve care of their patients. Interactive and clinically integrated teaching and learning activities provide the basis for the best educational practice in this field.

From Anne Taylor-Vaisey: A new issue of JCEHP has just been published and indexed in MEDLINE. Link to this issue and to the latest issues of five other medical education journals here

 

From Anne Taylor-Vaisey: Last week I wrote about the series of 16 articles published in Health Research Policy and Systems on improving the use of evidence in guideline development.  The last articles in the series have been published and you can read about them here.

 

Around this time of year I always look forward to the publication of the BMJ Christmas issue. The 2006 issue isn‘t out yet, but, for your viewing pleasure, here are some links to issues of Christmases past.

From Anne Taylor-Vaisey: The reaction the recent BMJ study about physicians using Google as a diagnostic tool has been lively, to say the least. You can read about some of the reaction here.

From Anne Taylor-Vaisey:

Here is an article from the American Journal of Pharmaceutical Education [free full text]:

 

All Adult/Continuing/Health Education postings are here.

From Anne Taylor-Vaisey:

N Engl J Med. 2006 Nov 30;355(22):2330-7.

Patients’ views on financial conflicts of interest in cancer research trials. Hampson LA, Agrawal M, Joffe S, Gross CP, Verter J, Emanuel EJ. Department of Clinical Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.

BACKGROUND: Financial ties between researchers or medical centers and companies whose drugs are being tested have come under increasing scrutiny.

METHODS: We conducted in-person interviews with 253 patients in cancer-research trials (a 93% response rate) at five U.S. medical centers to determine their attitudes regarding potential financial conflicts of interest among researchers and medical centers.

RESULTS: More than 90% of patients expressed little or no worry about financial ties that researchers or institutions might have with drug companies. Most patients said they would have enrolled in the trial even if the drug company had paid the researcher for speaking (82% of those interviewed) or consulting (75%) or if the researcher had received royalty payments (70%) or owned stock in the company (76%). Similarly, most patients would have enrolled in the trial if their cancer center had owned stock in the drug company (77%) or received royalty payments from the company (79%). Most patients believed it was ethical for researchers to receive speaking fees (81%) or consulting fees (82%) from the company. However, a substantial minority of patients wanted disclosure of the oversight system for researchers (40%) and of researchers’ financial interests (31%); 17% thought no disclosure to patients was necessary. CONCLUSIONS: Most patients in cancer-research trials were not worried about financial ties between researchers or medical centers and drug companies and would still have enrolled in the trial if they had known about such financial ties. A substantial minority wanted to be informed about the oversight system to protect against financial conflicts of interest and about researchers’ financial interests. Copyright 2006 Massachusetts Medical Society.

From Anne Taylor-Vaisey: This book by Richard Gunderman was just reviewed in the November 30 issue of the New England Journal of Medicine. I looked around and found some more reviews of the book:

Gunderman, Richard B. Achieving Excellence in Medical Education, New York: Springer, 2006.

Read more here

All book reviews here.