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Why eCME?

If you are investing time, money and effort into Continuing Medical Education (CME) you should strongly consider apportioning part of your budget to eCME. The reasons are quite simple:

  1. Half of all CME in Canada is now done on-line and this percentage is increasing1, 2, 6, 8, 12, 14, 15
  2. eCME is cost-effective 3,4,5,6
  3. eCME is proven to change behaviour 3,9

In other words, investing in eCME provides an ROI that traditional formats cannot match. The evidence:

Half of all CME is now done on-line and statistics show that this percentage is increasing1 2, 6, 8, 12, 14, 15

In the past five years physicians have shifted towards using online sources of information. This shift has been significant and universal: 95% of Canadian physicians now use the internet for professional reasons. 70% now access the internet at least daily and spend 8 – 12 hours per week on-line. 6,7,8

Meanwhile the use of ALL traditional communications vehicles – journals, sales representatives, live meetings, conferences, etcetera, have declined between 16 and 25%! 1,2, 6, 8, 12, 14

With respect to eCME, the Accreditations Council for Continuing Medical Education (ACCME) data shows live-CME declined by 40% between 2002 and 2006, with a corresponding increase in eCME. Data from Manhattan Research (US) and MD Insight (Canadian) shows that 50% of all CME is now done on-line and 71% of physicians intend to further decrease their participation in live CME.

In a recent 2008 survey of 500 Canadian primary care physicians, 85% indicated they participated in eCME over the previous 12 months and 41% participated at least monthly 17. The study also shows eCME is one of the top online activities among GPs. A 2010 follow-up to this survey is expected to be published shortly.

A typical mdBriefCase course will have more than 2,000 participants, which makes this single course bigger than ANY live CME in Canada. 11, 1 3, 15



David Schmeler
1-(416) 488-5500 x237

Janet Kimura
1-(416) 488-5500 x221

Kirk Fergusson
1-(416) 488-5500 x225

Nick Antoniadis
1-(416) 488-5500 x248



François Bousquet
1-(514) 995-2964

Stéphane Mallette
1-(514) 290-8998

eCME is much more cost-effective than live CME3,4,5,6

A typical eCME course costs less than 10% of the cost of a live event on a cost per participant basis. With a limited (or even unlimited) budget can you afford not to consider this alternative?

Average participant cost per live event = $400*
Average participant cost per mdBriefCase/rxBriefCase event = $25-45
* Does not include program development - includes honoraria, room, catering, event accreditation

eCME has proven to change behaviour significantly more than live CME 3,9

eCME has a significantly greater effect on behaviour than live CME. This has been demonstrated in several studies summarized in a Met-analysis published in JAMA which concluded "Internet-based learning is associated with large positive effects compared with no intervention. In contrast, effects compared with non-Internet instructional methods are heterogeneous and generally small, suggesting effectiveness similar to traditional methods."

Another major study was also published in JAMA. It concluded that "Appropriately designed, evidence-based online CME can produce objectively measured changes in behavior as well as sustained gains in knowledge that are comparable or superior to those realized from effective live activities." This study concluded that the reason eCME is more effective is higher rates of engagement and retention.

Other recent studies;

  • Outcomes Inc., conducted a randomized, controlled study of 3,500 physicians in 2006 looking at the effect on behaviour of a variety of forms of CME. The study showed eCME had 3 times the effect live meetings had and almost 15 times the effect of dinner meetings.
  • The Quaime study, reported by Prof. Peter Henning of the Institute for Computers in Education, Karlsruhe, showed a 25% average individual knowledge gain for print learners, and 50% for e-learners. Each group completed a pretest, an identical learning module (hard copy and audio CD for print learners, online for e-learners) and a posttest. The print learners reduced test failures from 70% pretest to 20% posttest; the e-learners from 85% pretest to 0% post test.
  • Evaluating Online Continuing Medical Education Seminars: Evidence for Improving Clinical Practices by Christine M. Weston, PhD. The purpose of this study was to evaluate the potential for online continuing medical education (CME) seminars. Primary care physicians (113) participated in a randomized controlled trial to evaluate an online CME series. Physicians were randomized to view either a seminar about type 2 diabetes or a seminar about systolic heart failure. Following the seminar, physicians were presented with 4 clinical vignettes and asked to describe what tests, treatments, counseling, or referrals they would recommend. Physicians who viewed the seminars were significantly more likely to recommend guideline-consistent care to patients in the vignettes. For example, physicians who viewed the diabetes seminar were significantly more likely to order an eye exam for diabetes patients (63%) compared with physicians in the control group (27%). (Am J Med Qual 2008;23:475-483) Johns Hopkins University, Baltimore, Maryland
  • In "A controlled trial of the effectiveness of internet continuing medical education" by Linda Casebeer te al, looked at a sample of 5,621 U.S. physicians. The average effect size was .75, an increased likelihood of 45% that participants were making choices based on clinical evidence. This likelihood was higher in interactive case-based activities 51% (effect size.89) than for text-based clinical updates, 40% (effect size .63). Effectiveness was also higher among primary care physicians than specialists. CME physician participation was associated with making diagnostic and therapeutic choices based on clinical evidence.
  • mdBriefCase and our sponsors have conducted a number of “ROI” and behavioural change analyses using a variety of methodologies with similar findings.

We have the right partners

We are the exclusive on-line CE partner for the Canadian Urological Association (CUA), The Canadian Obesity Network (CON), Society of Obstetricians & Gynecologists of Canada (SOGC), the Canadian Society of Endocrinology & Metabolism (CSEM), The Chronic Pain Association of Canada (CPAC), The Family Physician Airways Group of Canada (FPAGC), The Canadian Diabetes Association (CDA), the Canadian Rheumatology Association (CRA), The Canadian Pain Society (CPS), Canadian Pediatric Society (CPS), the Canadian Association of Physician Assistants (CAP), The Canadian Society of Hospital Pharmacists (CSHP).

CanadianRheumatologyAssociation CanadianDiabetesAssociation CanadianObesityNetwork ShulichUniversity CanadianPaediatricSociety
SocietyOfObstetriciansAndGynaecologistsOfCanada CanadianUrologicalAssociation QueensUniversity FamilyPhysiciansAirwaysGroupOfCanada CanadianPainSociety CanadianSocietyOfEndocrinologyAndMetabolism

  1. ACCME 2006 Annual Report. Medscape Physician Survey
  2. Manhattan Research "Taking the Pulse", 2008
  3. Online CME; Randomized controlled study conducted by Outcomes, Inc. 2006
  4. WebMD Business Intelligence, 2007
  5. IMS Canada 2007
  6. WebMD Health Forum Survey 2006
  7. MD Insight, eFactor Survey 2007
  8. Manhattan Research HEALTHforum 2007 Research
  9. Comparison of the Instructional Efficacy of Internet-Based CME With Live Interactive CME Workshops A Randomized Controlled Trial Michael Fordis, JAMA Vol. 294 No. 9, September 7, 2005
  10. CMA Study June 2004,
  11. mdAnalytics eCME in Canada Nov 2008
  12. Primary Care Today May, 2007
  13. Medical Post June 2007
  14. ACCME 2007 Annual Report
  15. 2008 Canadian ePhysician Market Research - Essential Research Inc.
  16. Evaluating Online Continuing Medical Education Seminars: Evidence for Improving Clinical Practices by Christine M. Weston, PhD Am J Med Qual 2008;23:475-483) Johns Hopkins University, Baltimore, Maryland
  17. Essential Research, Essential Physician Version 1.0, 2008