What Is a Learner?

By Caroline Pardo, PhD, CHCP, FACEHP, General Manager, Haymarket Medical Education; Katie Stringer Lucero, PhD, Director, Outcomes and Insights, Medscape Education; and Chris Hoffman, MS, Group Vice President, Strategy, Grants, Outcomes and Analytics, Medscape Education


The answer to this question at face value seems very simple: A learner is someone who participates in an educational activity. Then, what does participate mean?

And on down the rabbit hole we go.

You may have read about or have been involved in discussions related to the rising level of interest in our Alliance community on outcomes measurement and definitions. For example, the organizers of the Outcomes Standardization Project (OSP), each one a leader in our community, have initiated a laudable effort to explore, identify and then advocate for a common terminology within continuing education (CE). We concur that definitions should be agreed upon and shared broadly by stakeholders in our community so that we know what we are describing, aggregating and comparing when we are communicating about education activities and outcomes. If common definitions can be reached, then we are better enabled to further appreciate what “good” looks like, because medical education designers, supporters and providers—professionals in our community—need to have a shared response to the question, “What does good look like?” 

After some discussion among our own colleagues and peers, we are providing some additional perspective for consideration by our Alliance community. 

Why us? The authors of this article each work within organizations that maintain widely used CE learning platforms. More importantly, we are longtime volunteers across a multitude of Alliance committees, groups and conferences—evidence that we care deeply about our industry and its evolution to meet the future needs of healthcare professional learners. We have an eye to the broad set of users who would be impacted by changes in shared taxonomy in our field. Therefore, our comments are being offered, not in opposition to, but as a request for thoughtful consideration on the part of our community regarding the potential future impacts of adopting changes to the definitions upon which we have built our programs—including their evaluation and our industry reporting. Because we are, at present, lacking full community involvement in the consideration of the impact of these changes, we are seeking to raise and broaden awareness of this important subject among fellow Alliance stakeholders. 

We respectfully offer the following questions for consideration:

  • Are commercial and medical education company provider perspectives sufficient to represent the entirety of the medical education provider community on topics as important as our shared taxonomy? 

Without speaking on the specific methodology of the OSP, the fact is that, to date, the OSP has not been fully endorsed by key stakeholders within the medical education community. Medical societies, academic medicine and technology organizations have not been involved thus far in the development and consideration of the taxonomy to the breadth and depth to which medical education companies and commercial supporters have been involved. There are other notable taxonomy projects that have been initiated by organizations and bodies, such as the Speaking the Same Language (StSL) project within the Industry/Supporter Special Interest Group of the Alliance. The Alliance community would benefit from exposure to and shared vetting of these separate efforts, as well as the efforts of other organizations and groups, to organize and validate taxonomies or lexicons for all medical education stakeholders. The absence of crucial stakeholders within the medical education community so far to collaboratively consider and offer important insights on the broader, perhaps yet unrecognized, impact of any shift in applied taxonomy—as recommended by the OSP or any other body—is a gap in our community. It would seem prudent to ensure that those perspectives are collected and considered prior to full endorsement and adoption of any taxonomy. 

  • What are the implications of only a subset of organizations within the Alliance community adopting any one set of definitions?

The implications in practice of the adoption of any set of definitions, including the yet unknown latent impacts of the application of any taxonomy, that has not been fully vetted has the potential to create even greater variation within industry reporting. Variation already exists within the Physician Activity Reporting System (PARS) because there are no firm and shared definitions of learners, making activity metrics analysis already an “apples and oranges” exercise. If consensus is not reached on one set of definitions for the CE community, then the variation will problematically persist. This is why it is critical that our industry collectively addresses this variation, which impacts the validity and reliability of the data upon which national agencies, societies, commercial supporters and policymakers make decisions. This is the most fundamental of concerns that we propose should be considered within our industry at this point in time.

We hope all who read this article are motivated to engage in discussions on this topic, which may serve to accelerate the consensus building across the Alliance that we described, based on the weight of the potential implications to impact our industry. Until all stakeholders in the medical education community are gathered at the same table on an issue as important as our shared taxonomy, there will not be widespread use of shared terms and meaning and, thus, there will be a continued gap in our ability to effectively tell our stories regarding the value of CE. A fundamental question for our industry now is: How can we accelerate a process to bring stakeholders to the table to advocate for a shared language?

We look forward to being engaged in this discussion with our Alliance community.

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