To investigate how urologists currently make use of different types of continuing medical education (CME) to stay up to date with the latest clinical findings, and how they perceive this use will change in the future with the advent of new innovative CME platforms.

An email invitation to participate in an internet-based survey was sent out via different networks of healthcare professionals with focus of urological care. The survey was organized by ISSECAM, an independent provider of CME activities. The respondents were asked to value 14 different types of CME activities, ranging from reading scientific literature, attending conferences, to e-learning courses, and discussions with different stakeholders such as key opinion leaders or industry representatives. They also estimated the time they spend on reading literature, attending live events such as conferences and on online CME activities and how they perceive this might change in the future and to value different aspects of CME.

The survey was completed by 86 medical doctors from 33 different countries. 74% of the respondents were male, and 55% reported more than 15 years of experience. The majority (54%) of the respondents were specialized in urology, followed by general practitioners (14%) and radiotherapists (9%). 
Current use of CME
85% of the respondents indicated that scientific guidelines were an extremely or very valuable source of information for them. Attending international conferences and discussion with key opinion leaders received a similar score by 80% of the respondents. The top-5 was completed with scientific journals (77% of respondents) and discussions with colleagues (70%).
The high value scores assigned to scientific literature and international conferences is also reflected in the time the doctors indicated they spend on these activities. Over 60% of the participants indicated they attend at least 4 conferences a year (Figure 1). However, there were remarkable differences between the two age groups (< 15 years’ experience vs. ≥15 years’ experience): 90% of the younger physicians attended between 1-7 conferences a year, while more than 70% of the more experienced doctors attended ≥4 conferences a year. Almost 80% of the doctors spent at least 2h/week reading scientific literature. And while online CME is being adopted by most physicians as part of their CME curriculum, almost 13% indicated they spend no time on this type of activity.
When asked to value 11 different aspects of CME, 84% of the respondents gave the highest or second highest score to the applicability of the activity to their own patients. Also, the reputation of the provider was considered very important (77% of respondents) as well as time-efficiency (73%). Interestingly, there was no statistical difference between the respondents with <15 year or ≥15 year of experience on any of these aspects, except for “fun to do”, which was more important to the younger respondents.
Future use of CME
Given the time the respondents currently spent on certain CME activities, 56% of the respondents believe the time spent on reading scientific literature will not change, but almost 1/3 participants think they’ll spend more time on this activity (Figure 2). At least for the near future, scientific literature will remain an important source of information.
Also, conferences will continue to be attractive, with almost 40% of the respondents indicating that they will spend more time on these events. However, the new conference attendees will mostly be younger doctors, as 39% of them stated they will attend more conferences in the future, versus 26% of the more experienced doctors. However, 26% of the younger physicians will attend less conferences, which is twice as much as the “older” doctors.
For online CME there is quite a growing margin in this category, according to 65% of the respondents.

Due to the small sample size, data should be interpreted as being explorative, and the findings should be corroborated by larger studies.
The survey respondents assigned a high value to classic CME activities such as conferences and scientific literature, but at the same time, they indicated the importance of content that is applicable to their own patients, and of activities that are time-efficient. This seems to be contradictory, because congresses can hardly be termed “time-efficient” and information from scientific literature cannot easily be applied to a particular patient’s situation. Perhaps these aspects apply more to how CME “should be”, rather than how CME currently “is”. Online activities, which will gain importance in the doctor’s CME curriculum, have the flexibility to incorporate these aspects. Micro-CME activities focusing on short interactive patient cases, such as the accredited Mirrors of Medicine’s PinPoint Case platform, are very well received by the scientific community (1) and shown to be effective in improving the physician’s knowledge and (virtual) patient’s outcome (2). In addition, as the majority of the survey respondents indicated that they don’t expect to spend less time on literature and live events, but do expect an increase in online CME, the burden of participating in CME is likely to increase. Flexible formats such as the Pinpoint Case platform can be accessed whenever, wherever. Thanks to this flexibility, these types of learning do not add to the daily professional burden, but rather allow for a more efficient use of (limited) time available.

Old habits die hard, so despite the advent of innovative online learning activities, physicians tend to stick to more classical CME methods such as literature and conferences. However, change is on the way, with an increasing role assigned to online CME activities that should be time-efficient and focused on content applicable to the physician’s daily practice. Such platforms are currently being tested and implemented and may contribute to an improved knowledge base and more importantly to improved patient outcomes.