Baylor University Medical Center Proceedings April 2014, Volume 27, Number 2 | Page 85

Table. Examples of narrative critiques and the associated CME outcome
Category

Quotes

Offered no substantive reasoning
as to why the presentation was
useful; rejected for CME credit

• Beautiful preamble on the history of vaccines—very related to my interests.
• Very interesting epidemiologic data on clothing and infectious disease.
• Helpful presentation for clinician-historians.

Provided substantive reasoning;
received CME credit

• Wow! A beautiful example of how a good observer who questions assumptions can discover something entirely new.
Teaches me to look past assumptions.
• I am a physician and historian; understanding the origins and controversies regarding disciplinary boundaries’ history
is crucial for my teaching and for my knowing how to bridge disciplinary boundaries in my medical school teaching—
where I will be teaching about the non-“science” factors in the development of medical specialties—as well as in
practice in collaborating in care with other specialties.
• Reinforces clinical inclination to have a great skepticism about surgical referral unless one has positive knowledge of a
surgeon’s skill and judgment.
• Use to consider timing of medications.
• Increased perspective on duty-hour limitations and stresses on medical trainees.
• Thoughtful analysis of the epidemiology of CHD [coronary heart disease] this past century. Helps me to think about
changing risk factor profiles in my patients over those decades.
• Great paper! Raises issues of celebrity endorsements of public health initiatives and potential personalities to distort the
real agenda through pseudo-scientific arguments.
• Contemplate play as a therapeutic intervention. Contemplate human reflex to mock disability embedded in children’s games.
• An important discussion about malaria, health, control and treatment. It brought out the need to explore humanism in
the care and treatment of this disease for the overall public health. Should help me understand and incorporate humanism into the care of patients. This is also important to medical administration skills and expands my understanding of
public health research. Also illustrated the importance of cost and value in health.
• Raised issues about the real health aspects of obesity on medical care and health in general that will help me address
obese patients in practice and the true impact of their weight on their health.
• Henle-Koch causal rules—it was nice to put a name to this idea. I am often disabusing patients of causal relationships
based on their faulty connections between two events with only a temporal relationship which does prove causality. I
frequently review causality with my patients. I can do so more confidently now. I also give talks that rely on data from
observational epidemiology—where causality is typically controversial.
• Narcotic prescription writing is often a distasteful and unpleasant problem in my office. I am reminded to maintain a skepticism
of complaints, seek objective evidence to support my diagnosis behind the pain and be alert, as always, for diversion.

Substantive comments on
socially and politically charged
topics showing the clinically
empowering information imparted; received CME credit

• Evolution of patient-centered choice in sperm selection—interesting case study for any patient-centered approach—
social forces of women’s health movement and gay-lesbian movement.
• Fascinating discussion of drug and pharmaceutical policy. Makes one reconsider the impact of racism on drugs of choice.
• This session was informative for my medical school teaching in the medical humanities, particularly the medicalization
of social problems, the stigmatizing of poverty and “otherness” and the ways medical interventions have been used
(disproportionately to certain groups in the population) punitively. It will inform my practice especially regarding the differential tendency to medicalize (or dismiss) particular conditions differently in different populations (health disparities).
• The interaction of the drug industry and the tobacco industry on recommendations to quit smoking for all patients will
help me counsel my own patients concerning tobacco use.
• The stress for women over the years in assessing appropriate pregnancy options—including abortion—continues into the
present. Helping my female patients cope with present and past trauma related to this will be helped by understanding the
political climate concurrent with their traumas.

which 20 (87%) were approved. The average number of CME
hours awarded was 3.98 hours. Had all 370 CME requests been
granted, the average would have been 14.23 hours per physician
requestor. Fourteen talks did not elicit a request for CME.
Follow-up
In retrospect, we realized that one category was noticeably absent from the form: teaching. We believe that should physicians
learn something or discover information that does not clearly fit
April 2014

into the above categories but enhances their ability to teach medical
students, residents, or colleagues, they should be awarded CME
credit. I