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Moore's 7 Levels of CME Outcomes Measurements

In the world of certified CME (continuing medical education), outcomes measurements have become a critical component. It is an ACCME (Accreditation Council for Continuing Medical Education) requirement to measure outcomes in all certified CME activities.

Donald E. Moore Jr., PhD from Vanderbilt University School of Medicine has outlined a framework for the assessment of continuous learning and traditionally this has been presented as a pyramid consisting of 6 different levels:

  1. Participation
  2. Satisfaction
  3. Learning
  4. Performance
  5. Patient health
  6. Population health

Moore DE. A framework for outcomes evaluation in the continuing professional development of physicians. In: Davis D, Barnes BE, Fox R, eds. The Continuing Professional Development of Physicians: From Research to Practice. Chicago, Ill: American Medical Association; 2003.

Earlier this year, Moore published a paper titled, "Achieving desired results and improved outcomes: Integrating planning and assessment throughout learning activities." Here, he makes some modifications to this six-level framework and we now have 7 levels for CME outcomes measurements. The main changes are:

• Level 3 is now broken up to 3A and 3B

  • 3A = Declarative knowledge
  • 3B = Procedural knowledge

• Competence was a new addition and became Level 4 (shifting everything else up)
• Performance is now Level 5 (used to be Level 4)
• And Level 6 “population health” was renamed “community health”

So, here’s the new 7-level pyramid for CME outcomes measurements:

1. Participation
2. Satisfaction
3. Learning
3A = Declarative knowledge
3B = Procedural knowledge
4. Competence
5. Performance
6. Patient health
7. Community Health

Moore DE Jr, Green JS, Gallis HA. Achieving desired results and improved outcomes: integrating planning and assessment throughout learning activities.J Contin Educ Health Prof. 2009 Winter;29(1):1-15.


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