Perception and misperception

I heard just the other day that some people were not happy with an article that ran in our July/August issue titled, "Do Lectures Deliver?" I heard that some thought the survey the article was based on explored the many educational delivery mechanisms and came up with live meetings as the winner. But that's not the case. The survey we conducted was limited to only exploring live-meeting options because 1) We had to keep it short enough that the docs would actually fill it out; and 2) since the forms were disseminated at live meetings, participants obviously like that format enough to attend, and might be biased in their answers against other types of educational activities as a result. I'm sorry that I didn't make that clear at the outset.

I also apologise if my attempt at being provocative at the beginning of the article, i.e., "Do they know something we don't?" when it comes to lectures motivating physicians to change behavior, was misleading. The answer to that question later in the article was not about knowledge, but perception, and those are two different things. A better question would have been, "How do their perceptions mesh with what we know?"

What our survey results found was that, when it comes to live meetings, the docs preferred lecture with Q&A over purely didactic lecture, case-based sessions, interactive activities, and informal discussion with colleagues--a perception that may run counter to some CME providers' beliefs. They also said that they believe that lecture with Q&A beat other live meeting formats in terms of persuading them to change their behavior. In their minds, purely didactic lecture was the least preferred and least likely behavior-changing format, something I've heard very few CME providers disagree with. The survey did not extend to checking those perceptions against reality by measuring whether these perceptions bear out in their post-activity behavior. I have heard criticism that measuring perception is really beside the point--it's only the results that count.

I disagree. I think exploring the beliefs and perceptions of physician learners is important, even if it doesn't get a reality check against patient records. As we all know, perceptual problems plague this business, and those of the docs are no less impactful than those of anyone else. In fact, they're among the most important of all, because those perceptions and beliefs stand in the way of progress toward more effective education, especially in live meetings, where these perceptions have had generation upon generation cementing them into place. And as we all know, change is hard. If you want to inject more interactivity and learner-to-learner education into your activities, I think it's important to know what you're up against. And it underscores the importance of, when doing something different than the standard lecture with Q&A, doing it impeccably so you don't further reinforce the perception that "it doesn't work" and firm up that wall between perception and the reality of what has been proven to increase learning, improve physician behavior and, ultimately, improve patient care.

That's my story and I'm sticking to it--unless you can convince me otherwise. I'd love to hear your thoughts on this.

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