Learning Theory and Social Media

I read this really interesting piece on learning theory for medical educators interested in the use of social media.  The authors hint that it is really important for educators to consider an understanding of learning theory when integrating social media into the learning process.  I agree wholeheartedly for many reasons.  

First, after having given a recent grand rounds (to two separate audiences) on the topic of learning theory in medical education and how technology can help, I feel that it is very important to reflect on these theories for a better understanding of why learners use (or don't use) social media and other emerging technology.  Communities of practice (CoPs) are a great way to bring groups of people together around a common theme, and virtual/electronic CoPs are catching on in medicine and medical education.

Second, it is important, as the authors mention, to consider connectivism and constructivism as key theories behind why some learn with social media (and may prefer to learn via such tools).  Using constructivism, learners should be reflective, and the teacher needs to adopt a facilitative approach (instead of being an "expert").

For the educators out there who are integrating social media into your learning methods, which theory or theories reflect why you use social media or how your learners use social media?

CME, Industry and Outcomes

Recent medical literature describes the challenges of demonstrating the impact of CME on physician learning (with a focus on the lack of impact), and the need to reform the current system.  Writers suggest that it really is not having the impact that it should, given the financial resources provided.  Others have questioned how it is funded, suggesting that it may be biased given the resources provided by industry, and that it should be changed. 

While I admit my own bias as an Associate Dean for CME for a major medical school, I feel that it is important to study the peer-reviewed literature to best understand this important topic.

First, is the industry influence really that significant?  A piece by Cervero discusses this, and found limited evidence of the impact of industry influence on CME.  In the recent ACCME 2014 report (Table 8), only 11% of accredited CME received commercial support from industry.  My interpretation of this is that the commercial support is certainly not an overwhelming part of CME programs (our own institutional data would definitely mirror this finding).

Second, what is the real impact of CME?  The same above author recently published a piece in JCEHP (full disclosure: I am the social media editor for this journal, but was not involved in any way in the creation, revision, or decision to publish this manuscript) that concluded that CME can indeed impact patient outcomes and physician behavior (the former more than the latter).

Third, improvements in how CME is disseminated should occur.  Within this realm, patients should be included, and interprofessional learning should occur in team environments; this is highlighted by the new President and CEO of the ACCME, Dr. Graham McMahon, in a Viewpoint piece in JAMA that came out online earlier this week.

So where should we go from here?  I think there are several things we can consider.  Most importantly, physicians and other healthcare providers should continue to learn in order to provide optimal care of their patients in a changing environment; CME is one way to aid this learning.  Those in the field have been thinking about how to restructure it for many years and have made major strides in focusing on quality improvement.  Second, we should also consider learning healthcare systems as a way to promote learning for those who provide care for patients.  Lastly, we should be diligent about using technology to make our learning more effective.  Examples include online journal clubs and virtual communities of practice.  Given the complexities that abound in medicine in the current environment, anything that can make the process of learning how to "keep up" and best care for our patients easier should be welcomed.