Write Medicine

Defining Competencies for CME/CE Writers

September 19, 2022 Alexandra Howson PhD Season 4 Episode 27
Write Medicine
Defining Competencies for CME/CE Writers
Show Notes Transcript Chapter Markers

In this episode of Write Medicine, I'm joined by Don Harting to talk about CME writing competencies. What are the knowledge, skills, and attitudes that those writing CME/CPD content need to develop in order to create content that connects with and educates health professionals?

Medical writers often ask CME writers where to find training and how to get started in CME writing. Don says that clients share with him how challenging it is to find skilled writers for CME-related work. Don and his co-investigator Haifa Kassis think the medical writing field needs a competency model as a basis for training programs and skill-building that is directed toward the need for codified expertise in CME writing. They're using a Delphi process with a panel of experts to determine what those competencies might be. 

We discussed:
✔️ Changing practices for writing needs assessments
✔️ What a competency model for CME/CPD writers might entail
✔️ Why a competency model for CME/CPD writers is important
✔️ Key deliverables for CME writers
✔️ The role of Delphi method in determining competencies—what it is and how it can be used
✔️ Ranking function in Delphi
✔️ Anticipated outcomes from the Delphi approach
✔️ Ethics and fair balance in content development


  • Norman Dalkey and Delphi method
  • Clemow D et al. Medical writing competency model—Section 1: Functions, tasks, and activities. Ther Innov Regul Sci. 2018;52(1):70-77
  • Clemow D et al. Medical writing competency model—Section 2: Knowledge, skills, abilities, and behaviors. Ther Innov Regul Sci. 2018;52(1):78-88
  • LockyerJ, Bursey F, Richardson D, et al. Competency-based medical education and continuing professional development: A conceptualization for change. Med Teach. 2017;39 6): 617-622
  • Khurana MP et al. Digital health competencies in medical school education: a scoping review and Delphi method study. BMC Med Ed. 2022;22(1):129

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writers, cme, delphi, competency model, competencies, panelists, assessments, medical, develop, clients, field, world, haifa, health professions, consensus, needs assessment, references, hear, people, delphi method


Don Harting, Alexandra Howson


Alexandra Howson  00:00

Hello and welcome to Write medicine. I'm your host, Alex Howson. And today, I'm here with Don Harding, a CME writer, and we're going to be talking about competencies for medical writers in the continuing medical education continuing professional development field. Welcome, Don.


Don Harting  00:46

Thank you. Thank you, Alex. It's a pleasure to be here.


Alexandra Howson  00:49

So please, let's start by telling listeners, who you are and what you do.


Don Harting  00:56

Well, first, once again, thank you so much for asking me to be a guest here. It's really a pleasure. I have very much enjoyed listening to your podcasts as I prepare lunch for myself over the past several weeks and months, and I've really enjoyed getting to know your guests better. And I find your podcasts very easily listening and thought provoking. And I just like to keep coming back to them over and over again. So it's a real pleasure and an honor to be here today. So thank you, you asked me to introduce myself a little bit, I'll try to do that and try not to go on too long. I consider myself kind of a refugee from the newspaper journalism field. That was my first career. And I left that career back in around 2007 2008, with a lot of help from the American Medical Writers Association. And if you hear me refer to them again, I'll be calling them AMWA. AMWA helped me make the transition from kind of mainstream healthcare journalism to medical writing. And then they also opened my eyes to the whole existence of what I like to call CME writing, but which could more accurately be described as developing content for the in the field of accredited continuing education in the health professions. And one of my first jobs was as a medical writer, developing needs assessments in the oncology space. For a company in Atlanta, I was working remotely living in Pennsylvania. But I was working remotely for a company called I medics down in Atlanta, Georgia, and I was developing oncology needs assessments full time for several years. And they sent me to my first Alliance meeting. And that was another epiphany that really opened my eyes to the existence of the whole field of accredited continuing education in the health professions. And I think that's when I started reading the journal, The Journal of accredited education, excuse me, the Journal of continuing education in the health professions. And so, I don't know there's much more to it than that, obviously. But that'll get you started. If you have any follow up questions, I'd be happy to answer those for you.


Alexandra Howson  03:22

Yeah, so I think that's that's a good start. And you talked a little bit about your journey into CME/CE or CME/CPD, there are so many terms in this field that are really one. That is one of the issues that that kind of fold into the topic of competencies, to some extent, yes.


Don Harting  03:46

We'll be coming back to that. Yeah. So


Alexandra Howson  03:49

tell us what your interest is in competencies for medical writers in continuing medical education?


Don Harting  03:58

Well, okay, I'll be getting to that very shortly. But it occurs to me that I left out something kind of important when I was trying to describe about where I came from, or what I go ahead. And that is partly because my first needs assessments were all about oncology, I kind of developed a specialty in the hematology oncology space. And so I'm constantly writing about hematology oncology. And it's really a fascinating topic that I love to write about, because it's, it's a continuing story. It kind of uses my journalism skills, which is you know, when you're a journalist you you tell the story, you and you follow this story, you don't just tell the story once you follow a story over a period of time. And in the hematology oncology space, you're constantly updating the stories like When last we left you there was no cure for you know, hepatocellular carcinoma, but today, we have effective treatments. And it or it might be for melanoma or might be hopefully soon it will be for glioblastoma, and it's exciting and those kinds of things really float my boat I love to be able to do Talk about or excuse me write about breakthroughs in cancer medicine. And so that's kind of a, that's kind of my wheelhouse. That's what I really enjoy doing. And I enjoy serving clients who asked me to do that for them. Now, with respect to what you talked about competencies, yes, you're right. That's a topic of great interest to me, I forgot when I was doing myself intro to mention that for a number of years, with the help of other co investigators, I was surveying the field with respect to best practices for writing CME needs assessments. We started in 2014. And we were fortunate to have had the chance to display our work at both the Alliance meetings and annual meetings for a number of years. And that I think that's kind of what got me interested into. We're interested in the field of, well, you know, what are best practices for writing these needs assessments, what what are considered industry standard practices, you know, and what is kind of outside the pale, you know, outside the norm, in all kinds of areas in terms of the sources we use, the evidence we provide, how we present it, the rigor or lack thereof, of the of the evidence, the types of references, we cite, all kinds of things that it gets down into the nitty gritty of the evidence that we produce to show that there is a gap in clinical practice gap or a learning need, and how that varies from writer to writer from client to client, but also how it varies over time. The kinds of references that we might cite today might not have been cited 10 years ago, either because it wasn't thought to be professionally acceptable, or because those references didn't exist. And now I'll find myself citing a YouTube video. And in my reference, Jose, the key portion of this video starts at minute 30. And it ends at minute 56. And this is where the key opinion leaders clearly states the practice gap. And I think it's safe to say that I might not have cited a reference like that 10 or 15 years ago. So this idea of how best practices have evolved, and also how best practices are changing, and also how the competencies of the medical writer who likes to consider himself or herself competent to do this work needs to change. Another example is how the reference how we manage our references. I mean, now, I mean, think about all the Reference Manager software applications that are out there. I mean, I can hardly keep them straight. But you know, I have to learn EndNote I have to learn Ms. Word, Microsoft Word, I have to learn Mendeley. Pretty soon, I'm gonna have to learn Zotero. And there are others that I haven't even mentioned that probably other people who are listening to this podcast, know far better than I do. So and these things I need to learn so that I can keep my clients happy, because these are the way these are the ways my clients manage references for their needs assessments. So this kind of gets a full idea of of key competencies.


Alexandra Howson  08:17

Yeah, and often as when you're working, if you're, if you're working as a freelance medical writer, in CME/CPD, you're often working with a range of different clients. And some of those clients don't necessarily have solid systems in place for collecting, storing and retrieving references. And so as a writer, you have to you're in a position to really educate your clients about what some of these best practices might be. Let's talk a little bit about I mean, we are here to talk about competencies. And as you know, the alliance, the Alliance for continuing education in the health professions, has spent a lot of time and effort over the last 10 or 15 years have at least two time points, in fact, to develop national learning competencies for CME /CPD professionals, but as you and I both know, writers have not actually been explicitly addressed in those competencies. So I'm curious. I know that your work in the needs assessment arena has led to your broad interest in competencies but I'm curious to hear a little bit more about what you see as a competency model for CME/CPD writers and why that model is important.


Don Harting  09:59

Well, thank you for asking. Alex, I really couldn't ask for a better question at this point. And what you're asking is very, very top of mind for me right now. It's also very top of mind for my co investigator, hypha casies, MD, of pharma physician, now a medical writer who lives in Boston, and she and I are developing this competency model together. And I'm not even sure where to start. Because I don't want to take over, you know, I don't want to speak for an hour. I guess. What I'd like to say is, I kind of rehearsed this quote a little bit, so forgive me, but we're trying to stand on the shoulders, shoulders of giants and continue to move the field ahead. When it comes to competencies for medical writers. We didn't start this, we're kind of surfing a wave in a way. And in a way, the wave really got started in 2017, with the publication of a competency model for medical riders, and the lead author on that article was David clemco. And he had like, maybe 20, or 30, co authors. These are the giants on whose shoulders were standing because they published the first competency model for medical writers writ large. And then after that came a kind of a follow on article. And it's actually less of an article than a training outline, I guess that was published by amla, which is a training outline for regulatory writers. So they tried to kind of narrow the focus a little bit from medical writers writ large, to regular regulatory writers. And I'm not sure the background of all your listeners, but just very briefly, for the benefit of listeners who may not be that familiar with a medical writing field, I think of medical writers is a very broad spectrum of which it has a very, there are subcategories, and probably probably the largest subcategory of memberships or the regulatory writers. And then there are also publication writers. And I see you nodding there. So I think you're in basic general agreement with this categorization. And then we call ourselves CME writers were a small subset of the of the larger set. And then you might say maybe patient, patient, education, materials, writers. And then there are many others that please forgive me if I'm leaving your specialty out of this broad brushstrokes composition here, but in any case, regulatory writers are leading because they're the most numerous. And but we're trying to follow the lead of those who develop competency a competency model for regulatory writers by doing something similar for what we're calling CME writers or sometimes CME/CPD writers. Does that kind of answer your question or not so much?


Alexandra Howson  12:52

Yes, no. So I want to follow up there. So there's what I'm hearing is that there's a push from within the profession or within the field of medical racing to develop competency models. And your interest there is in really kind of digging into a competency model for a very niche or niche specialty, which is medical writing and CME/CPD. But for why our competency model, what are you why are competencies required at all? What do you see as the importance of being able to articulate competencies for medical writers in this specialty?


Don Harting  13:37

Well, I right now, I really wish my co investigator Haifa Kassis was on this call. Because she's really, between the two of us. This is her wheelhouse far more than it is mine. My wheelhouse on this project is the method we're using. And I'm really hoping that you're going to ask about oh, how what methods are you using? Don? How are you trying to identify these comments? It's because there will feel much more there I'll feel much more at home. But in general what I would say and this is something that I've learned from Haifa who sent me an article in from medical teacher data 2017 lead author Jocelyn Lockyer, who was one of my favorites, because Jocelyn Lockyer was all about needs assessments, you know, when I was doing my literature reviews on needs assessments, so anyway, my understanding of competency based education is kind of an answer to the time based education where it's really more about what you can do and the competencies that you can prove that you can do, as opposed to how much time you spent in school. And, and competency based education, they have these things called entrustable professional activities, at least in the in the area of physician activity, physician education, which kind of translate to things that we can trust you to do on your own. In other words, once you've read receive the training and the education. Once you have the knowledge and the skills, we can trust you to do this on your own. And so we are kind of translating that into deliverables. Medical writers are given assignments, we are assigned to write on these assessments. So we are entrusted with a professional activity, which is to develop a needs assessment, and we get it on day one, and we deliver it on day 14 Or day 21. And it's a professional activity, and that's a deliverable. And so in our competency model, what we're trying to do is identify, well, what are some of these key deliverables in addition to the needs assessment? Is it the slide deck? Is that the monograph is that these interactive, excuse me, these interactive patient case simulation? Is it the White Paper, is it some other deliverable that we've never heard of, but is really hot and is going to be, you know, de rigueur in the next three to five years. That's one of the the escape room or the podcast script. Because one of the the approach that we're taking is what are the competencies that will be needed by the next generation of CME/CPD writers, not just the writers of today, but the writers of tomorrow, because we want our work to have some shelf life. We don't want it to be out of date as soon as it's published. So we are going to be asking our expert panelists during the rounds of the Delphi to try to help us identify what are the key deliverables that will be needed that these the next generation of CME/CPD writers will need to develop, be able to develop along with the key bits of knowledge, knowledge topics, the key skills, and the key attitudes that they will need to have developed in order to be able to excel in in the field of developing content for accredited continuing education in the health professions.


Alexandra Howson  17:08

So you throw that that thread of how you're approaching your development of the competency model. So let's talk about that. And and when you're talking about that, I think it would be really helpful for listeners if you describe and define what you mean by the Delphi. I call it a Delphi model.


Don Harting  17:27

Okay. Sure. Sure. Is that how they pronounce it in Scotland by any chance?


Alexandra Howson  17:32

It's probably Northern European. Yeah.


Don Harting  17:36

Okay. So thank you so much for teeing this up. Now. So this question, I really do love the Delphi and I call it the Delphi because I think it's a way of approaching a topic that you might not otherwise be able to approach and get some pretty reasonable, have a pretty reasonable chance of success and having meaningful data. For those of you who don't know, the Delphi method is takes its name from the Delphic Oracle back in Greece, when people would consulted for prophecies of the future. And then it was used, and we kind of renamed by Norman Dawkey. In the 1950s, I think it was when he worked for the RAND Corporation when they were trying to forecast the effect of technology on atomic warfare. And then it's been used many other ways. It lately it's been used a great deal in health services research, not just in the United States, but all over Europe and all over the world. It's used in Australia and all over the world. So basically, you form a panel of experts that we call our Delphi panel, and there's no set number to the number of exact, you know, correct number for Delphi panelists, we hope to have about 30. But that's could be 20. It could be 200. There's no real right or wrong number of panelists. But you ask these panelists, your questions, over a period of rounds, and now it could be two rounds could be four rounds. We plan to have three rounds. And we tried, we aim. This is a hope at this point hasn't been done. Our aim is to derive a consensus among the panelists. Well, what are the most important things that Pete CME the next generation of CME writers need to know? What are the most important skills that they will need to have? What are the most important attitudes? And finally, what are what will be the key deliverables that they will be asked or assigned to right? And then we don't know. Does that answer your question? Alex, I think in terms of the method that's, you know, we plan to quantify our quantification or you know, quants analysis. This is very, very simple. Basically, we're going to be asking these panelists to number their agreement on a scale of one to five. And if you basically, were copying a Delphi study that we found on PubMed that comes from Denmark, the Danish Danish med schools came up did a Delphi to try to figure out what the doctors of the future that is the physicians of the future will need to know about digital health. And they use the Delphi method and we're, we're not, we're using it as a model. We're not like, you know, copying that study word for word, but we're using that as a model. And we plan to have graphics that show the degree to which people are Delphi panelists agree that such and such a knowledge topic is will be essential for the successful CME writer of the future.


Alexandra Howson  20:58

So you're essentially asking your panelists to rank or use a Likert scale to, to kind of rank what the most important lately topics are? And then once, once you have that ranking in that quantification, is there a discussion elements to the Delphi or the Delphi model that you're using? Are you expecting your panelists? Well, we hope you we hope interact with each other in some way.


Don Harting  21:29

Yes, thank you. Yes, we hope that that will happen. And that is, that's one, that's why we have the rounds. We hope that there will be some discussion between especially between rounds two, and three, the first round is open ended, where people will be invited to suggest knowledge topics or skills or attitudes or deliverables that we haven't listed already. Because we we start with a list and you know, and say, Hey, is this list complete? Or are they have we missed something, and if we miss something, you know, tell us and we'll add it next time and so on the second round, people will rate the importance of these various knowledge, skills, attitudes, and deliverables. Then between the second and third rounds, hopefully, panelists will read. And as we ask them to rank, we ask them why, why are you ranking this so highly? Why do you feel so strongly about this, either positively or negatively? And hopefully, when other panelists the 29 other panelists, read why you, Mr. Panelist feel so strongly that such and such a knowledge topic absolutely has to be top, top of the list, everybody has to know this or not, you know, totally irrelevant, this does not belong in the curriculum, that will stimulate discussion, among other panelists. And one of the key aspects of the Delphi is the anonymity of the panelists, there is no way to associate a name with a position a name with an argument. Therefore, we try to get we try to the purpose of this is to try to weigh the merits totally on their excuse me weigh the arguments totally on their merits, and not on the prestige or lack thereof, perceived lack thereof, of the person who is putting forth the argument, it's sort of a way to democratize the the the the mechanics of the consultation, because I think we all know that if you know, five or six people or 10 or 12 people get in a room, there becomes an you may know a lot more about this than I do. Alex because because of your sociology background, but there tends to be kind of a deference to the senior person in the room, or the most powerful person in the room or the most, you know, whatever prestigious or whatever. And that person can kind of tend to guide the group consensus in the direction he or she wants it to go. But we're trying to avoid that with the Delphi.


Alexandra Howson  24:03

No, I think that's a really great point actually, again, I think especially especially when being in the room now is the power dynamics are so cuts by gender and sexuality and race and ethnicity and other power indicators and power markers. It can be extremely challenging to moderate and facilitate a discussion that does actually lead to consensus.


Don Harting  24:38

And just said, you just said a mouthful, can I repeat that back because I just I heard you say that these days. The power dynamics of in groups are so I can't I can't remember the word you used. fraught maybe or the high profile that between the the gender, the sexuality, the seniority or whatever all these other markers that It can be difficult to actually develop a consensus among a group of individuals is Is that accurate? Absolutely.


Alexandra Howson  25:06

Well, you know, there are different channels for power, as, as you know. And so when you're in that group situation, you really need a moderator who knows how to manage group dynamics in a discussion based setting in order to kind of lead that group to consensus, you know, over a period of time, where, and in contrast, this Delphi or Delphi model, opens up an opportunity for a more democratic and anonymized and opens up an


Don Harting  25:45

opportunity for meritocratic and anonymized and meritocratic discussion of the options.


Alexandra Howson  25:52

And I think the other thing that is important is certainly, and it may not pertain to the kind of consensus that you're hoping to achieve. But when you look at guideline, you know, expert consensus guideline developments in the clinical world, there's some pretty college like oncology, there's some pretty good research to show that the, the groups that tend to comprise the members of consensus, guideline panels are, you know, the power dynamics are very interconnected. And weblike. And so their connections to industry, for instance, are very deep, and complex. And those connections, we don't talk about this very much. And we don't want to think about it very much. But those connections have some bearing on the direction that discussion often takes even clinical practice guidelines, settings that are consensus based. So it's very important to have a methodology, as you're describing that tries to mitigate any kind of influence that would be hard to untangle post hoc. So what what do you see you've talked a little bit about how you're approaching the development of the model. What do you hope to achieve with a competency model for writers, you did mention curriculum? So I'm assuming that at some point, you are envisaging a curriculum that addresses the competency needs? But?


Don Harting  27:42

Well, that's a great question. First of all, I just want to Yeah, first, the first response is a real gut check. Because we, we can't try to do more than we can do, if you know what I mean. It's like Haifa and I are working like as volunteers. And like, we have clients, we have families, we have full time jobs, we have jobs, we have homes. And we're doing this our free time. And so we have to be really careful about what we say we're going to do and try to do and and be careful not to over promise and under deliver. So at this point, I think it's fair to say that what we do plan to do is to present the method at an law and then present the method at the alliance and then present our results at AMA and then present our results at the Alliance, and then to submit a manuscript for publication in a peer reviewed journal. And then also, we were promising to present our preliminary results in a poster form to every one of the Delphi panelists, who will also be asked to serve for free, you know, no honorarium, no financial incentive, they're going to try to have to take you know, couple of hours out of their day or week in order to, you know, read responses from 29 other people. So, with respect to, but the honest answer to your question, Alex, is that after this is published, and after this is done, I am really looking forward to delivering instruction according to the model. I'm at the age now, you know, I just qualified for Medicare, I'm starting to think about teaching and training the next generation of CME CPD writers. And I'm very much looking forward to delivering instruction according to this model, which, you know, hopefully will, you know, have some evidence base to it. And, hopefully, you know, make make the world a little bit better place for having for having done the research.


Alexandra Howson  29:54

And that's why a lot of writers work in this field is to contributes their own skills to making the world a better place in in some way or another. Is there anything else we haven't covered in relation to the competency model that you want to share before we wrap up?


Don Harting  30:21

Good question. We can get a pretty good, a pretty good. Over overview. I again, I wish my co investigator Haifa could be here because she she's like super smart. She probably has all kinds of ideas, other ideas of things to follow up on. I'm trying to think if she were here, what would she want to emphasize? Well, we


Alexandra Howson  30:45

can solve that problem by having Haifa on the show. Okay.


Don Harting  30:50

Assuming she'll say yes, but I'm just trying to think. I think one of the things that I'm not sure exactly how to bring this up, but I think it needs to be raised. And that is. I think when we get into the attitudes, I think that's going to be essential. And also when we start talking about what I'll use the word ethics, what ethical positions or attitudes, ethical attitudes will be needed for the CME/CPD writers of the future. I have heard it said by one of my clients that there's no need for the needs assessment to be fair, balanced, so long as the instruction that is delivered under the grant is fair, balanced. Now, that's not how I was trained. I was trained, that not only does the instruction need to be fair, balanced, but the needs assessment also needs to be fair balanced. And my concern is that perhaps the next generation of CME/CPD writers may not be fully appreciative of the need for fair balance in a needs assessment or what what could be the consequences of the lack of fair balance and a needs assessment? I think that this is, my hope, actually, is that this will be the topic of some discussion among the Delphi panelists, and perhaps, with the promise of anonymity among the panelists, they will feel free to tell it like it is, because we work in a very unusual world. And it is potentially a very controversial world. And that is we are trying to educate clinicians, about best practices to improve patient outcomes. When push push comes to shove, the money that we get paid to deliver this education, in many cases, comes from pharmaceutical companies, and they have a product to sell. And they have a fiduciary responsibility to their shareholders to maximize profits and returns, that at the end of the day is where the money comes from. The government is not funding these activities, there is not a pot of money within CMS to provide continuing education for physicians. And if we only used money that was from the government to support these educational initiatives, they would be far fewer and far poor. So I think we live in this world where there is a tension. And I, my dream is that these cars, this competency model that we publish, will reflect that reality, and neither be Pollyanna and be rejected outright by people who work in the field every day and say, you know, no funder is ever going to go for that. That's never going to get support. That's never going to fly that program is never going to see the light of day because nobody's going to fund it. You know, there's that argument. But then there's the other argument that says, Oh, my word this this program is so tailored to increase prescriptions of drug X at the expense of drug why? Because it panders to the commercial supporter, and we don't want to go down that route either. I'm very much hoping that our competency model will reflect the real world needs to find balance. In the creation and the crafting of the content for commercially supported continuing education for members of the health professions,


Alexandra Howson  35:10

I'm glad you raised the issue of ethics. I do think it's a very important issue. I actually teach writing and edit medical writing and editing ethics at University of Chicago and the Professional Certificate Program. And I'm often struck by how how surprised students are at the range of ethical considerations in developing medical content, not only in the world of CME, but in other areas of medical writing as well. And I think it's worth it's worth reiterating that the ACCME standards of content do actually reiterate fairly forcefully the need for fair balance in all content associated with developing CME/CPD activities and programs and like you, I would definitely consider the needs assessment as part of that content development process, because often, with a very well written needs assessment. You're laying the foundation for the content development for the activity of the program itself. 

Don Harting
You're right, the ACGME does have new standards for integrity. In continuing education. You're right, you're absolutely right. However, the ACGME also does permit the pharmaceutical companies to to put out RFPs and does not prohibit accredited providers from responding to RFPs. And I'm not sure when was the last time you looked at an RFP. But I would encourage you to do that.


Alexandra Howson  39:03



Don Harting  39:08

some of them are quite clearly tailored to the to the supporters commercial interests. It's not and there's no other way to put it.


Alexandra Howson  39:17

I don't think that's new by any means.


Don Harting  39:22

But no, I'm not I'm not suggesting that it is new, but I am suggesting that it is confusing. When the ACCME says that there's a that the determination of learning objectives should be done separately, or independent of the commercial interests of the supporter. And then to try to reconcile that statement with some not all but some of these RFPs that come out that appear directly related to you know, increasing sales after a product launch.


Alexandra Howson  40:00

I'm sure that's the case, there's always scope in responding to an RFP in challenging or at least expanding on and providing a wider view on what what learning objectives should be based on what you're seeing in the in the process of developing the needs assessment. So I've certainly seen RFPs that have been fairly on the edge there in terms of what you're describing. But the needs assessment that's been developed, has been has been much broader in order to address the issue of fair balance. And I think as medical writers, that's what you're seeing right? Is medical writers need to know what fair balance looks like. And one of the competencies in terms of ethics is being able to identify when they are being asked to do something that is inappropriate in terms of, though the wider set of standards for transparency and integrity that not only sec me lay down, but also the other accreditation bodies.


Don Harting  41:27

Which kind of brings me back to how I got started trying to benchmark best practices and writing these assessments is because you know, rightly or wrongly, I have this imaginary picture in my mind of individual medical writers, highly educated, working part time as freelancers in their spare bedroom in Illinois, or Nebraska, or Colorado or Washington, by themselves. For a client, who is trying to win a grant to develop some education. And if that client is asking them to, we'll use the word focus that needs assessment in a way that's not fair balanced. How much strength does that Freelancer working on a dining room table or in a spare bedroom have to push back with this client and say, Listen, no, I'm sorry. That's not. That's not ethical. That's not how we do things. That's, that's not the professional way to do this. The client says no, cut to the chase. You know, there may be six or seven drugs in this marketplace. Just talk about one just talk about two or, or when you do talk about him. Talk about the funders drug for seven paragraphs and talk about all the other drugs for one paragraph. I mean, that's the kind of thing that I think we need to talk about, you know, well, what are best practices? How, what is best practice for a fair balanced discussion of competing therapies in a therapeutic setting?


Alexandra Howson  43:06

Well, hopefully, in the development of this competency model, we'll find some answers to that question. And in the meantime, Don Harding, thank you so much for sharing your perspectives with listeners of Write Medicine.

Introduction to Don
Changing practices for writing needs assessments
What a competency model for CME/CPD writers might entail
Why a competency model for CME/CPD writers is important
The role of Delphi method in determining competencies—what it is and how it can be used
Ranking function in Delphi
Anticipated outcomes from Delphi approach
Persistent importance of ethics and fair balance in content development