How Do You Identify a Practice Gap for CME Activities

An essential skill for medical communicators involved in creating materials for continuing medical education (CME) activities is learning to identify a practice gap by conducting a gap analysis.

Practice problems, or gaps, represent the difference between what a learner/practitioner currently knows and practices and what they should know and do.

The first step to writing effective CME materials is learning to identify a practice gap and defining the learning objectives by conducting a gap analysis.

What Is a Practice Gap?

Just like it sounds, a practice gap is a problem that can theoretically be solved by education or training. It can be

• A knowledge gap (clinicians don’t know something)
• A competence gap (clinicians don’t know how to do something)
• A performance gap (clinicians are not doing something in practice)

All educational activities are built around practice gaps, to bridge the difference between what is currently being practiced and what can be done to optimally treat patients.

The American College of Surgeons has this to say about the importance of this process: “Conducting a gap analysis helps to identify the necessity for the educational activity, which frames the resulting learning objectives, selection of the appropriate teaching methods, format to achieve these objectives, and implementation of evaluation/assessment methods to measure the effectiveness of the educational activity.”

Continuing medical education (CME) activities are designed to address gaps, leading to better clinical practices and patient outcomes. 

The American College of Surgeons’ website lists the following examples of gaps that could be addressed by CME activities.

• Lack of knowledge regarding safe prescription of opioids
• Lack of proficiency in communicating with leadership at a learners’ hospital
• Problems with patients missing screenings or vaccines
• Inadequate tools for patients to manage postoperative pain

Medical writers use a gap analysis to identify these and other practice gaps.

Creating a Gap Analysis

Consider one way to identify a practice gap. It’s the space between what is currently happening and what should be happening.

In this video, “Addressing Practice Gaps,” Steve Singer PhD, Vice President for Education and Outreach for the Accreditation Council for Continuing Medical Education, discusses ACCME’s evidence‑based system for identifying practice gaps when planning educational activities.

Singer suggests starting by asking the following question:

“What’s the practice‑based problem we want to address?”

What Do We Mean by Practice‑based?

Any professional activity that a health professional does is their practice: caring for patients, research, teaching, leading a team. CME activities are not just about which tests and medications to prescribe; they are about all the facets of a health care professional’s working life.

How Do You Find Gaps?

Medical writers can help learners to identify their own gaps by asking patients, practitioners, and experts, using some of the following tools:

• Surveys, including patient care audits, faculty feedback, and quality improvement data
• Case‑based questions
• Participant feedback, including previous needs assessment results and evaluations from previous CME activities
• Published research on trends in health care or national clinical guidelines, new clinical trials, meta‑analyses and systematic reviews, new drug/device approvals 
• Regulatory body guidelines, such as state licensure requirements and board requirements

Questions to Ask When Conducting a Gap Analysis

The American College of Surgeons suggests asking the following questions of your colleagues and teams to shape a gap analysis:

• What areas in practice do you and your colleagues find challenging? (difficult cases, leadership skills, public health problems, safety concerns, systemic limitations)
• What factors are contributing to the problem? (for example, insufficient funds, training, or institutional barriers/bias)
• What does the learner need to do differently to improve their practice?

The Importance of Learning Objectives

When developing a CME activity, the intervention should be designed to increase knowledge, competence, or performance. It’s important to clearly state what the learners will be able to do after they complete the CME activity. Once you identify the learning objective, you can design the instructional activity to best convey the knowledge to close the practice gap.

Of course, once the educational activity is designed and completed, you’ll need to measure and assess whether the learners met the learning objective.

The result of all this work: fewer practice gaps, more satisfied learners, and a healthier world.