Identifying the intended audience is key to developing an effective CME. The planned audience will influence all aspects of the educational activity, from modalities to property location and credit types offered. Knowing the audience in conjunction with the learning gap, will also allow one to be able to formulate various aspects of the CME; this includes learning objectives, course content, marketing strategies, overall goals of the event, and preferred learning styles. A well-tailored instructional design is paramount as a recent study of CME preferences demonstrated significant differences in learning style preferences based on gender and medical specialty [23]. These variations in learning styles emphasize the recommendation to combine different educational modalities in a single CME event, which would allow greater educational flexibility for the attendees and better meet the needs of the audience related to the learning objectives [23,24]. It is worth noting, there is controversy regarding the validity of using learning styles when designing adult education; further research is needed to further explore the merits and limitations of learning styles [25].

Predicting the intended audience will also help in selecting the ideal location and venue destination for the CME. Health care professionals choose to attend a conference for multiple reasons, often traveling with nonconference participants (that is, family or friends). Thus, selecting a destination that has a distinguishable name brand and providing attractive activities for the nonconference participants, can positively impact course registrations. When selecting the location and creating the event program schedule it is crucial to consider the ease of access of the area (flight itineraries and ground transportation) and the local attractions and amenities that the venue and the surrounding area offer to participants and nonparticipants.

When creating CME, one must explore the current educational marketplace [26]. To achieve this, perform a competitive assessment; a competitive (“needs”) assessment is a strategic tool, exploring the current state of the marketplace (that is, competition) [26]. A competitive assessment will help to identify the types of consumers that would most likely be interested, what the perceived positive traits in CME offerings are, and the strengths and weaknesses of the current competition. By researching the competition, one will be better able to differentiate the proposed event from the others, by focusing on specific details or gaps that are present in the marketplace.

The key to performing a competitive assessment is to identify what specific and actionable questions need to be answered [27]. By asking the “right” questions, a competitive assessment will also highlight the preferred modalities of the educational offering, associated operating costs, support or funding opportunities, and current industry standards for pricing of the CME.

Most of the information for the competitive assessment can be obtained from analyzing previous similar course programs, web-based searches, or by using companies that coordinate CME offerings [27]. Once the necessary information has been gathered, create an easy-to-read report that highlights the findings. The report should also provide actionable recommendations and foreseeable challenges. The competitive assessment should be updated (at least annually) in order to continually innovate the CME, mitigate risk, and be aware of changes in the competition [27].

Determining the actual location and timing of the CME depends on accurately predicting the intended audience. By knowing the target audience, you will be in a far better position to select preferred destinations, timing options, program topics, and educational credit types that would attract a wide array of attendees.

While reviewing the competitive assessment, attention should be given to the timing of the proposed CME, the timing of similar educational offerings, and the timing of holidays. It is best to avoid offering a CME event during the week of a national holiday, spring break, or faith observance, as well as to keep several weeks of buffering between the proposed CME and related well-established, high impact CME offerings (such as national meetings).

In a recent survey, CME attendees indicated that they preferred to have courses during the work week, in the mornings, rather than during the weekend (personal communication by ABM, MD, Mayo Clinic Updates in Internal Medicine attendee survey, October 2020). As a result, the day of the week, time of day, and time zones should all be considered when determining the timing of the CME. Time zones are also especially important when incorporating a digital component to an event; a significant time zone difference can deter learners from attending hybrid, synchronous (simultaneous in-person and digital offerings) events that start early or end late in the digital learner’s time zone. Incorporating asynchronous (previously recorded) content would permit learners to review content at their own pace [28].

In terms of venue sourcing, this can be done by either contacting properties (hotels, resort, and conference centers) directly or using a property sourcing company. Textbox 1 outlines the key factors when sourcing properties.

By using a sourcing company, one would be able to capitalize on any available resources and preexisting industry relationships that the sourcing company has with different sites or brands as well as bulk-price negotiation. Leveraging their expertise within the industry will help one negotiate lower rates and determine ideal properties and destinations best suited for the intended audience. Sourcing companies will provide one with a report enabling a quick comparison across multiple properties, brands, destinations, and dates. Another benefit to using a sourcing company is that in the event there are issues onsite, the sourcing company is able to intervene and help resolve issues promptly.

Creating course objectives is the next step in developing a CME. By using the information from your general needs and competitive assessment, one should formulate the overarching goals of the CME program and objectives. Objectives should be specific, actionable, measurable, and relatable to the intended audience. It is recommended to create simple objectives, typically only 1 learning verb followed by a discrete knowledge or skills that springs from the gap analysis [22]. When writing measurable objectives, clearly indicate how the CME will measure the change in knowledge, behavior, or attitude.

While planning a CME course, one needs to consider the accreditation agencies specific to the target audience. Health care professionals are governed by different licensure board agencies, based on the respective specialty, which can have vastly different accreditation requirements and costs (Table 2) [22,29-32].

In addition, each state could have different regulations, guidelines, and CME requirements. To combat this variability, many of the specialty boards are now organized under the joint accreditation system of Accreditation Council for Continuing Medical Education (ACCME), which helps to streamline regulatory and accreditation procedures for interprofessional education [33]. All accrediting agencies require formulating course objectives, as well as educational and practice gap statements [29-32]. The educational gap statement highlights the overall educational need for the content being delivered. The practice gap is designed to describe and compare what is currently being practiced with what should be practiced. Clearly written educational and practice gaps are designed to guide the program development to achieve the documented objectives [22]. One should create this foundational component of the course, identifying what is the problem that the education offerings want to address, why this problem exists and how the education will help fill this gap.

The decision of which types of credit to offer is entirely dependent upon the intended audience. A course that offers multiple credit types (such as American Medical Association, American Board of Internal Medicine Maintenance of Certification, and American Academy of Family Physicians) can attract various subspecialties to the same CME.

The educational program is based on the overall purpose of the event, specific learning objectives, and clinical knowledge or practice gaps. The topics must be innovative, timely, and fill an educational gap that currently exists [34]. Using an iterative process with multiple stakeholders (course directors, CME administrators, and content experts) present, create a comprehensive list of potential educational topics and then discuss the benefits and limitations of each. This is particularly important while creating education for an interdisciplinary multispecialty audience. As the individual merits of each topic are assessed, ensure that each fulfills the course objectives and fits into the larger construct of the educational purpose and offering [22]. Topics that align with one’s objectives can be grouped together in a logical order, which will help to form a cohesive educational itinerary or program. Topics that do not meet these thresholds should be eliminated from the program.

Once the course objectives and educational topics are finalized, move on to speaker selection. Many factors are involved with speaker selection, including identification of content experts, content delivery skills, inclusion and diversity, institutional priorities, and scheduling availabilities [35]. Be mindful of any gender or racial disparities in the speaker roster. Furthermore, sending an announcement to gauge the level of interest that individuals at your institution might have for future speaking opportunities can lead to additional potential speakers and content experts. Faculty evaluations completed by the course participants can also assist in determining future speakers that resonate with the attendees.

CME is an expensive undertaking with a very large overhead. Upfront resource identification and allocation is needed for developing and operationalizing the educational event. Many expenses (including deposits, marketing strategy, and printing educational materials) are incurred prior to the event. However, the 2 largest expenses, food or beverage and audiovisual, are not incurred until the CME begins [36]. By comparing data from previous events with similar audience demographics, one can create a realistic budget and effectively manage expenses. In fact, the initial step to position a course for successful budget management occurs during the competitive assessment. It is during the competitive assessment that resources such as CME planning staff, audio visual staff, accreditation fees, marketing fees, and clinical course leadership time should be assessed.

The post–COVID-19 era is characterized by more diverse types of educational offerings, with web-based and hybrid CME events becoming much more common [37]. Budgeting for a web-based or hybrid synchronous event should include the cost of the additional technology necessary to successfully deliver the content digitally. Initially, there will be some upfront additional expenses, given that many CME courses have never had a web-based presence. After the initial purchase of the equipment, ongoing expenses will include continued maintenance and operation of the equipment and upgrading the technology as needed. Though there exists a perception among attendees that web-based events should be offered at a lower cost due to the reduction of travel and food, a high-quality web-based or hybrid CME will require greater resources and technology, which will ultimately drive up the costs of producing the CME [38]. It is important to develop and provide a high production value for hybrid or live streaming educational events.

Marketing strategies should be reviewed throughout the life cycle of the activity. Marketing expenses can be one of the more expensive aspects of hosting a CME event [36]. Types of marketing include email, direct mail, website, paid search, web-based calendar, print and web-based journals, industry specific organizations, and social media. Careful consideration of the intended audience will help to identify the most effective marketing strategies. The intended audience’s marketing preferences can differ based on the specific course and audience demographics. According to a recent physician survey, 84% of physicians report email and direct mail as the top 2 marketing techniques leading to course registration [39].

The above survey also noted that physicians received marketing information 2-3 times before deciding to attend a CME event [39]. This highlights the need to develop a multiphase, multimodal media (that is, email, web links, brochure, and social media) strategy. When deploying a multimodal marketing campaign, use similar messaging in the different marketing approaches [40]. Further, word-of-mouth marketing can be influential. Word-of-mouth marketing can be face-to-face or via social media. A recent study demonstrated that word-of-mouth via social media was more influential than direct face-to-face communication [41].

Marketing strategies should also be tailored, based on generational demographics of the target audience [42]. In general, there are 3 generational demographics that most likely attend CME events: baby boomers (born 1955-1964), Gen X (born 1965-1976), and millennials (born 1977-1992) [43]. Understanding generational similarities, differences, and preferences can guide the marketing strategies. According to a 2018 study, millennials prefer email (77%) and web-based searches (65%) as sources for event information, while Gen X prefer print media via direct mail (65%), followed by email (59%), and web-based searches (59%) [44]. Though millennials are most likely to engage in social media sites, digital activity by Gen X and baby boomers continues to grow [44]; thus, it is important to target these groups digitally as well. Furthermore, while Gen X is a smaller population compared to millennials or baby boomers, they actually have the largest CME-related spending power, making it a highly sought-after demographic group [44].

In order to track this information, one should implement conversion tracking for digital marketing tactics. Conversion tracking identifies how well an advertising campaign is performing by tracking web-based traffic from digital marketing that leads to actual registrations. Furthermore, it is recommended to ask how the attendee learned about the event during the registration process; this information can then be used to guide future marketing strategies [39].

The overall goal of your marketing campaign is to increase registrations. Thus, the course website and web-based registration platform are an integral part of the marketing campaign. The website will function as a centralized space from marketing, to registration, through claiming credit. Figure 1 is an example of the layout of a course website. Textbox 2 offers various effective suggestions when creating a CME course website [45].

Disorganized or incomplete websites reflect poorly on the course and could deter attendees from registering. The participant’s interaction with the course website can influence the overall perception and success of the course as it would be the first (general information and registration) and last (evaluation and credit claiming) impression an individual would have with the CME [45]. Multiple vendors exist in the domain of website development and administration for CME activities, however it is essential for the organizers and owners of the content to keep close supervision of the branding and functionality of the platform.

Commercial support is often sought to offset the expense of planning, marketing, and running the CME. Commercial support can be in several forms, including grants, scholarships, vendor displays, sponsored events, or in-kind contributions. Each commercial entity has their own application process to apply for funds. Leveraging established relationships and contact points between one’s institution and industry could significantly facilitate this process.

This expense mitigation however comes with an implicit appearance of commercial bias and conflicts of interest [46]. To prevent overt bias or conflicts, all team members should follow the ACCME Standards for Integrity and Independence in Accredited Continuing Education policies, that put forth strong regulations when involving commercial support [47]. Compliance with these policies and formal documentation of mitigating plans are required by all accrediting agencies. Additionally, policies under the 2010 “Sunshine” provisions require extensive disclosure reporting for speakers, event planners, authors, and other participants; all relationships and conflicts of interest must be documented, made available, and resolved prior to the educational event [48].