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Domains‐based Outcomes Assessment of Continuing Medical Education: The VA's Model

Gilman, Stuart C. MD, MPH; Cullen, Robert J. PhD; Leist, James C. EdD; Craft, Carol A. RN, PhD


Demonstrating outcomes of continuing medical education (CME) efforts has become increasingly important to CME providers, accrediting organizations, and licensing bodies. Many CME providers have difficulty defining the nature of the outcomes, much less documenting the outcomes for which they are responsible. The vague nature of the terms “outcome,” “impact,” or “result” in the complexity of health care and medical education environments is a particular obstacle to many education providers. To overcome these barriers, the VA's Employee Education System (EES), a large CME provider, created a model identifying five major domains of possible outcomes for CME interventions; these are the domains of individual participants, employee teams, the larger organization, patients, and the community. These domains are useful in either assessing a single CME activity's outcomes or comprehensively assessing a CME provider's outcomes-assessment strategy. The use of such a domains-based outcomes-management strategy links organizational mission, needs assessment, specific activity assessment, and assessment of the overall education program. This approach may be useful to CME providers, accrediting and licensing bodies, or others interested in the relationship of CME outcomes to the activities of CME providers.

Dr. Gilman is director, Health Professions Accreditation, Department of Veterans Affairs Employee Education System, and associate clinical professor of medicine, University of California, Irvine, College of Medicine; Dr. Cullen is director, Organization Performance and Improvement, Department of Veterans Affairs Employee Education System (EES), Brecksville, Ohio; Dr. Leist is co-director, faculty development, Department of Community and Family Medicine, Duke University Medical School, Durham, North Carolina; and Dr. Craft is evaluation coordinator, Department of Veterans Affairs EES, St. Louis Employee Education Resource Center, St. Louis, Missouri.

Correspondence and requests for reprints should be sent to Dr. Gilman, Long Beach Employee Education Resource Center (00E), 5901 East 7th Street, Long Beach, CA 90822. Phone: (562) 826-5505 x3974; fax (562) 826-5986; e-mail: 〈〉.

The laparoscopic cholecystectomy activity used as an example in this article was supported in part by the William Campbell Felch/Wyeth-Ayerst Award from the Alliance for Continuing Medical Education.

This article was in part a result of a pilot demonstration project between the Department of Veterans Affairs Employee Education System (EES) and the Accreditation Council for Continuing Medical Education. Some of the contents were presented at the 2000 Congress for CME, Los Angeles, California, June 2000.

© 2002 Association of American Medical Colleges