Journal of CME最新文献

{"title":"It is Time to Include Cost-Effectiveness in CME Outcomes Measurement.","authors":"Derek T Dietze, Jeff Frimpter","doi":"10.1080/28338073.2025.2565919","DOIUrl":"10.1080/28338073.2025.2565919","url":null,"abstract":"<p><p>Our profession has an established reputation for advancing clinical knowledge, professional growth, and patient care, and we continue to share and refine best practices. One important aspect of value has received little attention - whether educational resources are used as efficiently as possible to achieve meaningful outcomes. This paper builds on a recent systematic review of the literature which found that only a small fraction of the CME professional literature measures or even mentions costs or concepts related to cost-effectiveness. This paper offers insights into how the field has been hesitant to explore cost-effectiveness, including realistic challenges related to data access and analysis, complexity, and perceived misalignment with the educational mission. This paper also highlights real opportunities and practical steps to consider cost-effectiveness in CE/CME in a way that mitigates risk while maximising learning. By looking at cost alongside traditional educational outcomes, providers may better demonstrate the full value of our work. Evaluating cost-effectiveness is not about turning education into a financial exercise. It is about showing that the precious resources available to CE/CME are allocated as wisely as possible to improve patient care. This perspective can help CME providers take a proactive leadership role in demonstrating an entirely new dimension of educational value in an environment increasingly focused on value.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2565919"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"To Step Outside the Limits of Our Work\": Physician Perspectives on Arts-Based Approaches in Continuing Medical Education.","authors":"Kamna S Balhara, Korie Zink, Elizabeth Fitzsousa, Margaret S Chisolm","doi":"10.1080/28338073.2025.2560265","DOIUrl":"10.1080/28338073.2025.2560265","url":null,"abstract":"<p><p>The arts and humanities (A&H) have been identified as essential across the continuum of medical education, and have been integrated across a variety of settings for learners in undergraduate and graduate medical education. Despite the possible benefits of A&H-based education for practicing physicians, and the increasing demand for medical education faculty to provide such content to their learners, A&H programming in continuing medical education (CME) remains limited, and less is known about the feasibility, acceptability, and potential impacts of such interventions in CME. This study describes physicians' perceptions of the value and impact of an art-based CME intervention. Four stand-alone CME sessions using pedagogy from the visual arts were conducted over Zoom. A mixed-methods approach (post-session surveys, thematic analysis of focus groups) was applied to assess perceptions of relevance and role of arts in CME, and potential mechanisms for impact. Sixty physicians (North America, Europe, and Asia) registered for at least one session. 100% of survey respondents (<i>n</i> = 35) supported continued integration of arts-based approaches in CME. Over 90% found it relevant to their clinical practice, their roles as educators and their well-being. Participants highlighted how unique aspects of arts-based education facilitated positive impacts on clinical skills, openness to new perspectives and renewal and joy, but noted its \"nontraditional\" aspects as potential barriers. This study suggests that, while unfamiliarity and scepticism may inhibit use of A&H in CME, physicians may view arts-based CME as a unique way to enhance clinical skills and critical thinking while supporting well-being and a growth mindset amongst established educators.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2560265"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Web-Based Medical Education on Rhythm Control in Atrial Fibrillation: Retrospective Case-Control Analysis.","authors":"Margaret Harris, Katie S Lucero, Nicholas Sidorovich, Sarah Bomba","doi":"10.1080/28338073.2025.2560266","DOIUrl":"10.1080/28338073.2025.2560266","url":null,"abstract":"<p><p>Antiarrhythmic drug (AAD) therapy remains underutilised in patients with atrial fibrillation (AF), despite guideline recommendations. Web-based continuing medical education (CME) may improve clinician knowledge and performance, buteffect on real-world practice is less clear. This study evaluated the impact of CME on knowledge, competence, and confidence in rhythm control with AADs, and assessed real-world AAD use among cardiologists, internal medicine (IM), and general practitioners (GP). The study included two phases. Phase 1 assessed CME outcomes in a pre/post study of 207 US physicians. Phase 2 examined practice patterns through a retrospective, matched comparison of 501 physicians with claims data. Phase 1 demonstrated a 22% improvement in guideline-based AAD knowledge (59% vs 72%, <i>p</i> < .001), a 57% increase in competence tailoring rhythm control strategies (30% vs 47%, <i>p</i> < .001), and a 79% increase in confidence with AAD therapy (19% vs 34%, <i>p</i> < .001). In Phase 2, the intervention group had a 3.20% increase in AAD use compared with 1.71% increase in the comparison group, with 6% more patients receiving AADs post-education. Web-based CME on guideline-based AAD selection improved physician knowledge, competence, and confidence, and increased real-world AAD utilisation.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2560266"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Integration of Patient Perspectives in Surgeon Education: Awareness, Engagement and Barriers to Implementation.","authors":"Hazal Fiskeci Vardar, Manoj Khatri, Claire Thornber, Kokeb Andenmatten, Jane Thorley Wiedler, Monica Ghidinelli","doi":"10.1080/28338073.2025.2552555","DOIUrl":"10.1080/28338073.2025.2552555","url":null,"abstract":"<p><p>Integrating patient perspectives in medical education is increasingly recognised as critical for patient-centred care. However, many continuing professional development (CPD) programmes - particularly in surgical education - lack a structured approach to involve the patient perspective. This study explored faculty awareness, exposure, engagement and perceived barriers to integrating patient perspectives in surgeon education. We conducted an initial interview with a surgeon educator and a patient advocate to promote awareness and inform the design of an online questionnaire to be distributed to surgeon faculty. The questionnaire assessed familiarity with patient inclusion in education, frequency of involvement in educational activities, collaboration with patient organisations and perceived importance and barriers. We received 68 responses from surgeon faculty across 32 countries. While 77.7% were familiar with the concept of patient inclusion, only 54.4% had attended education that included patient perspectives in the past 5 years and 44.1% had involved patients in designing or delivering education. The most cited barriers for patient inclusion were lack of awareness (64.7%), institutional culture (45.6%), time constraints (42.7%), and concerns about liability or ethics (36.8%). Despite perception of low current levels of integration by 85.3% of respondents, the overall importance of incorporating the patient perspective in surgical education was rated high (average 3.57/5). Suggestions for improvement included partnerships with advocacy groups, use of patient stories, and involving patients in curriculum development. We can conclude that faculty recognise the value of integrating patient perspectives in surgical education, but practical implementation in CPD remains limited. Addressing cultural, ethical and institutional barriers and promoting collaboration with patient organisations may support more meaningful and sustained integration of patient perspectives in surgical education.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2552555"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Alliance for Continuing Education in the Health Professions' Position on Artificial Intelligence in CPD.","authors":"Andrew Crim, R Michelle Skidmore, Andrew D Bowser, Nuria W Negrao, Amy Edouar, Bhaval Shah, Brian McGowan, David Mullins, Gregory D Salinas, Jasleen K Chahal, Betsy Woodall, Pam McFadden, Marie Judkins, Kathleen Weis","doi":"10.1080/28338073.2025.2545647","DOIUrl":"10.1080/28338073.2025.2545647","url":null,"abstract":"<p><p>The rapid advancement of artificial intelligence (AI) technologies has profound implications for continuing professional development (CPD) in healthcare. Recognising the need for guidance in this evolving landscape, the Alliance for Continuing Education in the Health Professions (the Alliance), a global association of CPD professionals and stakeholders who share and implement best practices across healthcare settings and professions, has developed a position statement on the ethical use of AI in CPD. This article outlines the process of creating this statement, its key principles, and the rationale behind its development. The statement, developed through a collaborative effort involving an AI task force and the Alliance board of directors, provides a framework for CPD professionals to navigate the integration of AI technologies responsibly. The position statement emphasises appropriate utilisation, privacy protection, transparence, compliance, human oversight, bias elimination, accessibility enhancement, and ongoing education about AI. As the field continues to evolve, this position statement serves as a crucial starting point for ensuring that AI's potential in healthcare education is harnessed ethically and effectively. <b>Use of Artificial Intelligence:</b> Generative artificial intelligence was used in the development of this article. Claude and ChatGPT were used for general editing of the initial article draft. Napkin.ai was used to create images.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2545647"},"PeriodicalIF":0.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Education Design Matter? Evaluating an Evidence-Based Continuing Education Intervention on Genomic Testing for Primary Care; a Pre-Test Post-Test Study.","authors":"Sharon Mitchell, Felix M Schmitz, Janusz Janczukowicz, Ann-Lea Buzzi, Noëlle Haas, Tanja Hitzblech, Julia Wagenfuehr, Idris Guessous, Sissel Guttormsen","doi":"10.1080/28338073.2025.2526234","DOIUrl":"10.1080/28338073.2025.2526234","url":null,"abstract":"<p><strong>Background: </strong>: Quality continuing education (CE) interventions should be effective, fit-for-purpose, and flexible for healthcare professionals. However, variability in the quality of reported interventions limits their impact. Education providers must ensure well-designed learning experiences to maximise efficiency and relevance. This study details the systematic design of a genomic testing learning intervention, incorporating practical exercises and aligning with educational principles to evaluate its impact on knowledge acquisition, self-efficacy, and skills performance.</p><p><strong>Methods: </strong>: The intervention, conducted in a skills laboratory in Bern, Switzerland, included an interactive online learning module based on learning science principles. Participants engaged in simulated patient (SP) encounters to apply their skills, followed by an informal debriefing session with SPs and content experts. A pre-test post-test study design measured applied knowledge (patient scenario test), self-efficacy (confidence ratings), and skills performance (SP assessments). Wilcoxon tests assessed improvements, Mann-Whitney U tests identified group differences, and Pearson's r calculated effect sizes.</p><p><strong>Results: </strong>: Sixteen participants enrolled, including general practitioners (<i>n</i> = 8) and 4th year medical students (<i>n</i> = 8). In total, the balance of female/male participants was 9(=female)/7(=male), with an overall age of <i>M</i> = 35.9. After the intervention, participants had significantly higher applied knowledge scores (<i>W</i> = 98, |<i>z</i>| = 2.89, <i>p</i> = .004; <i>r</i> = .72), self-reported significantly higher confidence in genomic testing skills (<i>W</i> = 134, |<i>z</i>| = 3.41, <i>p</i> < .001; <i>r</i> = 0.85) and had significantly higher skills performance scores (<i>W</i> = 107, |<i>z</i>| = 2.02, <i>p</i> = .044; <i>r</i> = .50).</p><p><strong>Conclusion: </strong>: A well-designed learning intervention in genomic testing significantly improved applied knowledge, self-efficacy and skills performance in primary care. These findings underscore the importance of structured CE programmes, highlighting instructional design as a key factor in optimising learning outcomes.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2526234"},"PeriodicalIF":0.0,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative Cognition: Strengthening Learning with Progressive Content Delivery.","authors":"Carley Yawn, Logan Van Ravenswaay, Krista Marcello, Sarah Nisly","doi":"10.1080/28338073.2025.2532247","DOIUrl":"10.1080/28338073.2025.2532247","url":null,"abstract":"<p><p>Cognitive research consistently demonstrates that spaced repetition enhances memory consolidation and retrieval by reinforcing learned material over time. This study applies the Precede-Proceed Model of Learning framework to examine how predisposing, enabling, and reinforcing educational strategies support sustained knowledge retention among healthcare professionals. The analysis focused on three accredited continuing professional development (CPD) programs conducted between 2022 and 2024. Participants engaged in educational activities that included baseline pre-test and post-activity post-test assessments, with exposure categorized based on prior interaction with related content. Learners were stratified into groups by timing and frequency of exposure to the material. The primary outcome measured was improvement in test performance across sequential learning engagements. Results indicated that learners who accessed educational content prior to the activity demonstrated a significantly higher mean pre-test score of 31% (<i>n</i> = 443) compared to 27% (<i>n</i> = 1,416) among those who viewed it afterward (<i>p</i> = 0.041). Furthermore, repeat learners, regardless of content timing, achieved greater knowledge gains, improving by 34% (<i>p</i> < 0.001), in contrast to a 26% improvement among first-time learners (<i>p</i> < 0.001). These findings highlight the additive value of progressive and repeated exposure in CPD programs. By analysing longitudinal engagement patterns, this study reinforces the importance of strategically structured educational design to foster enduring clinical competence.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2532247"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of an Instrument for Measuring Equality, Diversity and Inclusivity (EDI) in Medical Education Teaching Resources: The GRADES10.","authors":"Zachary Hollenberg, Claire Parkin","doi":"10.1080/28338073.2025.2525692","DOIUrl":"10.1080/28338073.2025.2525692","url":null,"abstract":"<p><p>Higher education institutions around the world have a responsibility to diversify their course content. This is an important consideration to ensure that students are prepared to serve a diverse population once they graduate, however, a lack of diversity representation in medical school curricula in particular, is reported in the literature. A paucity of reliable resources to support creating more inclusive content is also reported. This study developed and validated a diversity measurement instrument, designed to look at representation in the areas of gender, religion, age, disability, ethnicity/race, sexuality, and socio-economic status. Early prototypes were sent to experts for validity testing and using their feedback, improvements and iterations were made to the instrument until the final instrument was agreed: the GRADES10©. The instrument was then applied to a variety of medical education resources to test for rater-reliability. An accompanying user guide was developed to support users with the application of the GRADES10© in practice. Face validity was conducted by 10 experts on several iterations of the instrument from the early prototype (GRADESs7), until the final agreed GRADES10©. Rater-reliability was calculated by intraclass correlation coefficient (ICC) and Cronbach's Alpha measure of internal consistency. The GRADES10© instrument was shown to have an ICC of 0.83% (SD 0.725-0.907) <i>p</i>= < .0001, and Cronbach's Alpha of 0.97. Overall, this study has shown that the validated GRADES10© instrument is able to measure diversity in medical teaching resources reliably. The GRADES10© has the potential to contribute to creating a more inclusive learning environment by allowing its users to apply a diversity metric to their educational materials, to identify gaps and areas for improvement. If applied by medical schools and organisations offering continuing medical education courses in future, the GRADES10© may impact the grassroots of medical education diversification, which may have a beneficial effect on medical student and doctors' attitudes, experiences and ultimately on patient care.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2525692"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Simulation with ChatGpt: A Revolution in Medical Education?","authors":"Aziel Alejandro Peralta Ramirez, Sergio Trujillo López, Gonzalo Armando Navarro Armendariz, Sayil Alejandra De la Torre Othón, Marcial Ramin Sierra Cervantes, Juan Antonio Medina Aguirre","doi":"10.1080/28338073.2025.2525615","DOIUrl":"10.1080/28338073.2025.2525615","url":null,"abstract":"<p><p>Clinical simulation is key in medical education, but its traditional implementation is costly and complex. This study explored the use of ChatGPT (generative AI) to create interactive clinical scenarios and evaluated students' perceptions of this innovative tool. An exploratory, cross-sectional study was conducted with 32 fourth- and fifth-year medical students. A case of acute coronary syndrome was designed, where ChatGPT (GPT-4) acted as a virtual patient, dynamically responding to students' questions and decisions. After the simulation, participants completed a survey with 20 Likert-scale items and open-ended questions. The results showed high satisfaction: more than 90% considered the case clear and realistic, 94% positively evaluated the virtual patient's responses, and 88% perceived the difficulty as appropriate. Additionally, 97% found automated feedback useful. Qualitative comments highlighted the immersion and safety of the experience, allowing students to practice without fear of making mistakes. Some suggestions included adding greater clinical depth and adjusting the case difficulty. ChatGPT is a promising tool for clinical simulation, offering realistic and challenging scenarios that students perceive as beneficial for developing clinical reasoning and decision-making skills in a safe environment. Automated feedback was highly valued. However, this study is exploratory, and further research with larger samples is needed to validate its educational impact and address challenges such as content supervision and the ethical integration of AI in medical education.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2525615"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking the Impact of Single Continuing Educational Activities: Navigating Complexity Through Insights from Real-World Evaluation and Contemporary Literature.","authors":"Robert Schaefer, Joerg Stein, Louise Niven, Mia Hill, Onno Kaagman, Anja J Gerrits, Pan Chen, Yvonne Oliver, Eugene Pozniak, Cara L Mcfarlane, Denise Thom, Arne Stachmann, Giovanni Torsello, Reinhard Griebenow","doi":"10.1080/28338073.2025.2498292","DOIUrl":"https://doi.org/10.1080/28338073.2025.2498292","url":null,"abstract":"<p><p>Real-world evaluation data strongly suggest that substantial multi-level heterogeneity of continuing education (CE) audiences, though considered highly desirable, poses severe challenges to the assessment of what a single CE activity might have contributed to either improve or maintain achievements or prevent change for the worse. This relates in particular to change in higher levels of outcomes, such as performance, patient health, and/or community health. This sets narrow limits to the design of an objective, reliable and reasonably valid assessment of change in evaluating the effectiveness of a single CE activity. Although CE may be more effective in leading to consistent behaviour in homogeneous groups with regard to background and motivation, trying to reduce the various levels of heterogeneity would be an unrealistic, and also unwanted, approach. Thus, we still have to trust physicians (and other healthcare professionals) to exercise their professionalism in pursuit of individual opinion forming trajectories in the best interests of their patients. However, providers may also choose some more targeted approaches to influence the mindset even in heterogeneous learner groups: - integrating not only knowledge and competence but also current performance gaps into pre-/post-tests - increasing opportunities for discussion will allow optimal matching of the individual needs of participants with the CE content. When reported, unprecedented numbers of participants' questions (>50 per webinar) have been processed during and/or after an e-learning activity, and even higher numbers of interactions might be expected in demand use of e-learning material. Thus, e-learning in combination with long-term faculty engagement has promising potential for sustainable competence.</p>","PeriodicalId":73675,"journal":{"name":"Journal of CME","volume":"14 1","pages":"2498292"},"PeriodicalIF":0.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}