Submitted by Marianna Shershneva on

Madhavpeddi AR, Walter JL, Wells JR, Jehnet M. From theory to practice: Evaluating the integration of adult learning theory in continuing medical education activities. J Contin Educ Health Prof. 2026. PMID: 41452159. DOI: 10.1097/CEH.0000000000000636.

Abstract

The underpinnings of adult learning theory are foundational to continuing medical education (CME). Several widely studied learning theories are relevant to medical providers including deliberate practice, situated learning theory and community of practice, social cognitive theory and self-determination, adaptive expertise, and experiential learning theory. The Accreditation Council for Continuing Medical Education recognizes 11 types of CME activities each integrating these learning theories to some degree. Provider preferences are shaped by accessibility, cost, flexibility, and opportunities for networking leaving many balancing the convenience of online programs with the value of in-person interactions. The degree to which learning theories are integrated within CME activities is widely understudied despite their interwoven relationship and association to provider preferences. This analysis aims to (1) evaluate the degree various CME models integrate learning theory; (2) identify theory-led strengths and limitations of CME models; and (3) extrapolate themes for CME planners to strengthen theory integration. The three most common types of CME activities are enduring material (ie, web-based courses, web-based courses with simulation), live courses (ie, conferences, webinars, simulations), and regular scheduled series (ie, Project Extension for Community Healthcare Outcomes, speaker series). Integration of learning theory across 7 CME models was evaluated through a content analysis using a trichotomous classification system (fully integrated, partially integrated, or no integration). Results varied, with Project Extension for Community Healthcare Outcomes and live simulations having the highest degree of theory integration. A thematic analysis identified five themes for improving theory integration including feedback mechanisms, structured self-reflection, adaptability to promote autonomy, repeat exposure to complex skills, and practice of humility.

Questions

  1. In your experience, is theory integration in continuing education (CE) for healthcare professionals typically intentional or implicit? Is “full integration” of all theoretical elements necessary, or even desirable, for every CE activity?
  2. The researchers found that webinars had the lowest theory integration among the activity formats they studied. Do you agree with this assessment? What design changes could improve theory integration in webinars?
  3. This study identified five key themes for improving theory integration in CE: feedback mechanisms, structured self-reflection, adaptability to promote autonomy, repeat exposure to complex skills, and practice of humility. Which of these themes/strategies is most feasible to implement in your education planning and teaching? Why?

 

Comments

cakorib cakorib replied on

 In my experience, theory integration in CE is mostly implicit; planners borrow pieces of adult learning principles without mapping them deliberately. I don’t think “full integration” is necessary for every activity, but being explicit about the one or two theories you’re leaning on would make outcomes easier to evaluate. Webinars often end up as passive slide decks, so I agree they can score low unless you build in deliberate practice, polling with feedback, and short reflective prompts. The most feasible theme for me is structured self-reflection, since it’s easy to add a two-minute post-session prompt and follow-up question. Also, I keep seeing irrelevant spam links such as  top Aviator casino apps show up in learning portals, which undercuts the sense of community and psychological safety these models depend on.

cakorib cakorib replied on

cakorib cakorib replied on

i agree that “full integration” isn’t always the goal; what matters is aligning the activity format with a clear learning intention and then measuring it. webinars can be low on theory integration when they’re lecture-only, but simple changes such as case branching, fast feedback loops, and brief commitment-to-change prompts can raise the bar. in our system we also fight off-topic link drops, and i’ve had to remove https://livedealerindia.com/ and https://live-crazy-time.org/ and https://lightningdicegame.com/ from chat transcripts because they derail discussion and undermine psychological safety. the most feasible theme for my planning is feedback mechanisms, since even short polling plus facilitator debrief can create deliberate practice without adding much time.

cakorib cakorib replied on

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cakorib cakorib replied on

<!--td {border: 1px solid #cccccc;}br {mso-data-placement:same-cell;}--> i think theory integration in ce is usually implicit, mostly because planners are constrained by time and platform templates rather than intent. full integration doesn’t feel necessary for every activity; picking one target theory and designing assessments around it is more realistic. i agree webinars tend to score low when they’re monologic, but adding brief case pauses, chat-based peer comparison, and immediate feedback on answers would help. the most feasible strategy for my team is feedback mechanisms, since even a few well-timed polls plus facilitator debrief creates a practice loop. we’ve also had to clean weird off-topic link drops in session chats, including https://oneblackjack.org/ and https://freebetblackjack.net/ which distracts learners and chips away at psychological safety.

cakorib cakorib replied on

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Axness Axness replied on

Repeat practice is probably the hardest thing to build into CE, but it's also what helps the most. One session is rarely enough for more complicated skills. -hypackel

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Allison Penton replied on

This is a fantastic breakdown of how learning theories apply to CME. It really highlights the gap between what we know about learning and how it's actually implemented. I'm especially interested in how this applies to more interactive, game-like learning scenarios, almost like a Pokerogue and Pokerogue Dex for medical education – imagine a randomized, adaptive learning path!

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