Stanford Adopts New Approach to Continuing Medical Education to Prevent Industry Influence

Jan. 11, 2010 -- STANFORD, Calif.--(BUSINESS WIRE)--Stanford University School of Medicine has developed a new, industry-funded model for the continuing education of physicians that aims to improve patient care while ensuring that corporate donors do not exert influence over the curriculum.

In September 2008, Stanford became the first medical school in the country to limit industry influence on continuing medical education programs by accepting industry support only for a broad range of activities, not for specific, designated programs. The school then began looking at alternative educational models that could involve industry but would be guided by the needs of physician/learners, rather than by commercial interests, said Robert Jackler, MD, the school's associate dean for CME.

"We believe that the education of practicing physicians should be based solely on the best scientific evidence presented in a fair and balanced way," said Jackler, professor and chair of otolaryngology. "Unfortunately what's happened is that the partnership with industry has led CME astray, to the point where the curricula are too often biased toward business interests.

"So we set out to see if industry would be willing to partner with us to create a high-quality curriculum, under the condition that Stanford faculty would choose the topics and design the curriculum independent of the relationship with industry," he added. "We sought not to prevent partnerships with industry, but rather to redefine it."

Under the new model, Stanford will use a new, $3 million, three-year grant from the pharmaceutical company Pfizer to design and implement a novel curriculum that uses a variety of advanced technologies and teaching methods, including simulated and immersive learning tools. The Pfizer grant comes with no conditions, and the company will not be involved in developing the curriculum.

The overall goal of the program is to improve patient care and outcomes, with a focus on specific patient-care issues identified by Stanford physicians, Jackler said.

"We continue to believe that robust relations between academia and industry are essential to translating knowledge from research to patients. And we believe that academia and industry have much to learn and teach each other," said Philip Pizzo, MD, dean of the medical school. "But the learning and teaching has to be free of marketing or influence and focused on truly improving the lives of the patients we serve and the students and physicians we educate. We are now entering a new relationship and I am encouraged that this can be a new beginning-and a novel rebooting."

Freda Lewis-Hall, MD, Pfizer's chief medical officer, noted that the company has a long tradition of funding continuing medical education.

"We've pioneered approaches that ensure the independence of the academic institutions designing and delivering CME curricula," Lewis-Hall said. "Our multi-year support of Stanford's efforts demonstrates our willingness to help redefine how CME is funded so that practicing physicians can get access to the latest science, presented in ways that unquestionably put the interests of the patient first and foremost."

In recent years, a number of national organizations, including the Institute of Medicine, the Association of American Medical Colleges and the Josiah Macy, Jr. Foundation, have concluded that the way in which CME is currently financed and conducted is fundamentally flawed. In a December 2009 report, the IOM noted the growing support of CME by pharmaceutical and device makers, "which are using continuing education inappropriately to influence health professionals so as to increase market share." The report also noted that current CME programs make use of outmoded, lecture-based teaching methods that are ineffective and fail to result in better outcomes for patients.

The new curriculum is being designed by a group of physicians at Stanford who have a special interest in new educational approaches. It will focus on interactive methods, rather than the traditional CME method of passive, lecture-based courses, as studies have shown interactive learning is a far more effective way for improving physician practice, Jackler said.

The teaching program will capitalize on Stanford's wide-ranging technologies in immersive and simulated learning. These include new facilities at the Li Ka Shing Center for Learning and Knowledge, set to open in 2010, where physicians can test different patient scenarios in a fully simulated hospital, among other activities.

Curriculum topics will be chosen based on areas of practice determined by Stanford as having room for improvement, Jackler said. For instance, it may target efforts to reduce surgical infections, improve diabetes management, help prevent patient readmissions for heart failure and increase patient use of smoking-cessation programs. The goal of the teaching program is to produce measurable improvements in patient care.

"It will be used for what CME is actually meant for-to improve the ability of learners to provide better and more efficient health care for their patients," said Harry Greenberg, MD, the school's senior associate dean for research.

"If we really help physicians do best practices, that improvement in health care will be good for industry as well as for patients," he added. "It seems to me that Pfizer is saying, ‘Maybe there is something to this. Let's put some money behind it and try it.' At some point, industry officials will have to decide if the money they put in serves their purpose."

Unlike past CME programs, which typically are held at resorts or hotels, the new CME curriculum will seek to attract physician/learners from around the world to the Stanford campus, taking advantage not only of Stanford's teaching facilities but of the other cultural attractions on campus as well, Jackler said.

The Stanford University School of Medicine consistently ranks among the nation's top 10 medical schools, integrating research, medical education, patient care and community service. For more news about the school, please visit http://mednews.stanford.edu. The medical school is part of Stanford Medicine, which includes Stanford Hospital & Clinics and Lucile Packard Children's Hospital. For information about all three, please visit http://stanfordmedicine.org/about/news.html.

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