Category Archives: CME Online

Clinical cases and Articles submitted by Members

Continuing Medical Education

By  Dr. N.P Senanayake

Maintaining lifelong knowledge and skills is essential for safe clinical practice. Continuing medical education (CME) is an established method that can facilitate lifelong learning. It focuses on maintaining or developing knowledge, skills and relationships to ensure competent practice (1).

Continuing medical education (CME) is important for professional development among health personnel (2). Educational institutes can provide the opportunity for lifelong learning by conducting a CME programme of continuing medical education (3). The manual of the International Association for Medical Education (the AMEE guide), defines CME as any activity that is intended to maintain, develop or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession(4).

The primary purpose of CME is to improve doctors clinical performance that ultimately influences the quality of the health outcome.  In addition, it decreases professional isolation and sustains interest and confidence (2). CME can take the form of reading journals, attending lectures and seminars, rounds, small group work, audit, informal consultations with colleagues, interactive computer programs and practice visiting. 

CME has received increasing attention because of the major changes that it has undergone in recent years - in terms of teaching methods, expectations for results and learning objectives. The effectiveness of CME plays a key role changing the practices and behaviour of clinicians (5).


CME is considered a core component of continuous professional development (CPD). The term CPD addresses a wide range of skills, including education, training, audit, management, team building and communication. The terms CME and CPD are often used interchangeably. In reality CME contributes to CPD.


Recently, the emphasis of CME has shifted from improving knowledge to improving skills, performance and patient outcome through altering clinician practice behaviours (6). Therefore, clinicians are increasingly engaging in learning activities that provide specialist teaching beyond didactic lectures (7). The CPD activities of practicing clinicians are being integrated with practice based learning and improvement (PBLI). Consequently, newer CME methods are being designed to include the concept of PBLI. These CME methods use multimedia, multi-technique and multiple exposures to maximize compliance with PBLI (8). The award of CME points contributes to improved participation at clinical meetings and conferences.  


Evolving professional, social and political pressures highlight the importance of lifelong learning for clinicians. Continuing medical education (CME) facilitates lifelong learning and is a fundamental factor in the maintenance of certification. Successful CME must be truly continuous and not opportunistic, erratic or casual. Despite limited evidence, CME appears to be useful at the acquisition and retention of knowledge, attitudes, skills, behaviours and clinical outcomes. Improved CME practice must in turn lead to continuing critical reflection, practice modification and implementation with a focus towards the excellence of patient care (1). 


The role of CME in the improvement of clinical practice is currently well established. It is evident that CME will play an even greater role in future clinical practice. Therefore, it is our responsibility to conduct comprehensive CME programs to educate the clinicians and to ensure quality assurance in clinical practice.



Dr. N.P Senanayake

Senior Lecturer in Microbiology

Faculty of medicine

General Sir John Kotelawala Defence University




  • Ahmaed K, Wang T, Ashrafian H, Graham T, Darzi A, Athanasion T. The effectiveness of continuing medical education for specialist recertification: CUAJ 2013; 7:266-72.

  • Anwar H, Batty H. Continuing medical education strategy for primary health care physicians in Oman: Lessons to be learnt. Oman Medical Journal 2007; 22:32-35.

  • VanNeiwenberg L, Goosseas M, Lepeleire J, Schoenmakers B. Continuing medical education for general practitioners: A practice format. Post Graduate Medical Journal 2016;92: 217-222.

  • Humway JM, Harden RM. AMEE Guide No. 25: the assessment of learning outcomes for the competent and reflective physician. Med Teach 2003; 25:56984.

  • Cantillon P, Jones R. Does continuing medical education in general practice make a difference? British Medical journal 1999; 318:1276–9.

  • Davis D, Galbraith R. Continuing medical education effect on practice performance: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based    Educational Guidelines. Chest   2009;135:42S-48S. 

  • Davis DA, Thomson MA, Oxman AD, et al. Evidence for the effectiveness of CME. A review of 50 randomized controlled trials. JAMA 1992;268:1111-7. 

  • Sachdeva AK. The new paradigm of continuing education in surgery. Arch Surg 2005;140:264-9. 







Short Case 1/OCT

Dr.L.Shamithra Madhumali Sigera, 
Senior Registrar-Mycology

A 56 years old male presented with a 8 month history of a verrucoid cutaneous lesion on his right lower limb. Irrespective of on and off treatment, the lesion slowly progressed. There is no regional lymphadenopathy.   He could not recall any prick injury or trauma to the site. He is a carpenter from Matara area(Figure 1 ).



A biopsy  was taken from the lesion and sent for mycological and histopathological studies. 

The figure 2 shows the direct microscopic view of the  biopsy from the lesion ( 10% KOH).

  • What is the structure seen in the direct smear?C:\Users\User\Desktop\IMG_20171013_190724.jpg

The figure 3 shows the macroscopic view of the fungus   isolated from  the culture.