How Moore’s Outcomes Taxonomy Enhances CME Value

Outcomes demonstrate whether CME activities really improve patient care. To measure outcomes, the ACCME relies on a taxonomy developed by Donald E. Moore of the Vanderbilt University School of Medicine. Here’s how that taxonomy – often visualized as a pyramid – breaks down:

  1. Participation
  2. Satisfaction
  3. Learning
    • 3A. Declarative Knowledge
    • 3B. Procedural Knowledge
  4. Competence
  5. Performance
  6. Patient Health
  7. Community Health

It’s not difficult to conceptualize the basic significance of these levels. By drilling down, however, we can improve our understanding of what each level means and what problems it solves for CME learners and providers.

Let’s consider levels 4, “Competence,” and 5, “Performance” to better understand how individual levels advance outcomes measurement on the whole.

Level 4: Learner competence

Moore’s taxonomy works like a staircase. When learners demonstrate success at one level, they “climb” to the next. One cannot assess learners’ competence (Level 4), for instance, until they have learned something (Level 3) to be competent in.

Level 4 offers a bridge between the knowledge acquired through CME activities and real-world performance. Let’s say a CME learner takes part in an activity addressing skin cancer detection. If the number of biopsies taken by the learner increases after participating in the activity, Level 4 offers evidence that the CME activity impacted the learner’s performance.

Or suppose there were fewer biopsies, but cancer detection was nonetheless more accurate and frequent. CME providers can still demonstrate that the learner showed competence in a CME activity dedicated to the issue prior to the change in performance.

Level 5: Learner performance

A similar dynamic holds true for Level 5, which assesses the learner’s performance following participation in a CME activity.

Before considering whether patient health improved post-CME (Level 6), we must first assess whether the learner modified his or her approach to an issue covered in a CME activity (Level 5). To continue with the skin cancer example, we might ask the following question: “Has the learner’s approach to skin cancer biopsies changed since taking part in the CME activity?” If we can determine that it has, only then can we start linking CME knowledge to patient health.

Once again, progress advances one step at a time. When we determine that the learner’s real-world performance incorporates knowledge acquired through CME, we can start looking at how that performance affects patients.

Demonstrating value

By following Moore’s outcomes taxonomy, CME providers have a yardstick by which to gauge the success of education programs.

Measuring outcomes, therefore, not only improves patient care, but also helps providers evaluate the strengths and weaknesses of CME activities. This means they can make meaningful changes to improve CME on the whole.

Outcomes also show the medical community that CME is working. What better way to demonstrate the value of your education programs than with documented improvements in learner performance and patient health?