Introduction

Medical writers are vital partners in creating high-quality, evidence-based content for continuing medical education/continuing professional development (CME/CPD) activities and programs. Writers who specialize in CME/CPD often have a clinical, research or academic background. Some have been trained as journalists, instructional designers or even financial analysts. Effective medical writers are highly skilled in searching and synthesizing the scientific and clinical literature. They know how to apply adult learning principles to content and communicate with different health professionals. Many writers can also offer strategic direction to educational content development.

Despite an existing pool of experienced writers, education providers struggle to find writers with the specialized knowledge and skills needed to excel in CME/CPD. Conversely, writers struggle to find providers who know how to work with them effectively. Together, CME/CPD providers and writers can create powerful, evidence-based education. But first, they need to establish a collaborative rhythm. This article describes common challenges in the education provider/writer "fit" and offers resources that providers can use to onboard and collaborate with freelance medical writers who specialize in CME/CPD.

What Do Medical Writers Do in CME/CPD?

There is a perception in the CME/CPD community that faculty are mostly responsible for developing the content that supports teaching for live activities and enduring materials. This is often not the case. For instance, writers are often tasked to reduce the 180 slides that faculty submitted for a one-hour contact activity to a more manageable number to optimize learning. Alternatively, writers are hired to build a supporting slide deck from scratch. Writers offer specialized expertise in synthesizing evidence and simplifying complexity to ensure accessible, accurate content that supports learning and are adept at working with faculty to identify key teaching messages. Writers also develop interactive patient cases, interactivity quizzes, pre- and post-activity assessment questions, outcomes reports, white papers, needs assessments and more. To create high-quality educational content, writers must blend scientific/clinical aptitude, writing ability and instructional know-how, while grasping the nuances of accredited CME/CPD (Table 1).

Table 1. Medical Writer Skills and Deliverables

Medical writers support the development of various CME/CPD deliverables, including:

• Conduct literature reviews.
• Build interactive patient cases.
• Develop and refine learning objectives.
• Craft outcomes reports and white papers.
• Distill complex research into accessible narratives.
• Improve faculty-generated slide decks and presentations.
• Identify and substantiate clinical performance practice gaps.
• Create engaging pre- and post-activity assessment questions.
• Quickly get up to speed with therapeutic areas and disease states.

To do these tasks well, writers cultivate expertise in:

• Research proficiency
• Adult learning principles
• Strong writing proficiency
• Scientific and health literacy
• Deep understanding of clinical care
• Logically organizing complex topics
• Storytelling and engaging communication
• Meticulous attention to detail and accuracy
• Quickly absorbing new medical information
• Upholding ethical and accreditation standards
• Integrating the latest evidence and data to content
• Translating medical terminology into plain language
• Collaborating with different stakeholders in the CPD field
• Capacity to work under tight deadlines while maintaining accuracy

Challenges Finding Writers

Education providers note that it is challenging to find writers with the skills Table 1 summarizes. There are at least three challenge categories, which are especially acute in the context of writing needs assessments.

Content. A 2019 survey fielded to CME/CPD practitioners cited common content challenges in writing needs assessments.[1] These challenges included inaccurate referencing, poor narrative structure, unsupported claims and gap statements, and an inability to identify and integrate relevant data sources. Providers also point to the challenge of finding writers who are confident working in the accredited landscape.

Process. Education providers point to process challenges they experience with freelance medical writers. For instance, providers I spoke with for this article reported that on occasion they are forced to significantly revise needs assessments after writers have submitted a final version. They lament that many writers offer no or only one round of edits for a given scope of work.

Workflow. Workflow is an additional challenge that many providers face when working with writers. Unscheduled funding opportunities with 30-day deadlines from the date of publication are especially difficult to resource.

Challenges for Writers

On the other side of the equation, writers identify barriers that affect their ability to deliver quality work, especially in the context of needs assessments.

Content. While there are never excuses for sloppy writing, it can be tricky for inexperienced or rushed writers to find valid data, identify relevant sources, or substantiate clinical gaps.[1] At the same time, tight deadlines, no or poor-quality templates, and indeterminate editorial direction can test even the most experienced of writers.

Process. Rushed turnaround times and no documented process for revision are both factors that compromise quality. Writers often have to educate new-to-market or boutique providers about realistic revision cycle expectations, including how many rounds of revisions to anticipate, who will be involved in the revision process, or how revision comments will be collated and communicated to the writer. While there is no industry standard here, experienced writers typically offer two rounds of revision — one major and one minor. When expectations around revision cycles are mismatched, both parties are likely to feel frustrated. Clear communication about revision and other expectations is key.

Writers also report instances where providers are ambiguous about the scope of work, lack a documented process for content development, or do not share relevant materials with writers at project startup. Typical scenarios with process deficits include when the provider:

1. Asks the writer to develop concise gap statements from a very long laundry list of need statements.
2. Hires a writer to develop a needs assessment on a disease state without any strategic direction.
3. Does not review draft work in a timely fashion.
4. Adds last-minute requests that the writer feels obliged to meet.

Workflow. Writers who can effectively integrate scientific evidence while maintaining accessibility are in high demand. As a result, skilled writers are typically scheduled four to eight weeks in advance (sometimes more). They often do not have the ability to accommodate short notice projects with a rapid turnaround, such as a call for grant application (CGA) with a 30-day window.

Resources to Optimize Provider/Writer ‘Fit’

Clarify content direction. Without a clear brief and foundational materials, writers are left to drive the conversation about scope and do significant additional sleuthing that might not be included in their compensation. Providers can avoid poor content direction by sharing key information at project startup. At a minimum, this information should include educational strategy, descriptions of the target audience, activity format, key guidelines and clinical trials, and templates.

Document the scope of work. A documented agreement or scope of work should precisely detail the project parameters and tasks, timeline, remuneration, payment schedule and revision cycles.

Communicate often. Providers can also establish effective communication channels with writers that include regular check-ins, feedback loops and promptly addressing emergent concerns. Successful partnerships depend on clear communication, setting expectations upfront, and developing trust over time.

Consider retainers. Providers who respond to short notice CGAs as part of their educational planning strategy can build internal capacity by cultivating a stable of trusted medical writers, perhaps by offering retainers to writers with specialist knowledge in relevant disease states. There are different models for retainer relationships that optimize the benefits for both parties.

Table 2 describes a starter checklist that providers can share with writers at project start-up to promote collaboration. Without this basic information, writers work in the dark.

Table 2. Sample Project Startup Checklist

Conclusion

Creating credible content with integrity is a collaborative endeavor. Medical writers bring a unique blend of scientific expertise, communication skills, research capabilities and attention to detail to the creation of accredited CME/CPD content. Their contributions are important in ensuring that health professionals receive accurate, evidence-based and engaging educational materials. Yet there are no clear pathways for medical writers to develop their expertise in CME/CPD. Since most writers work freelance, they are often excluded from internal training for employees at education provider organizations. The labor of medical writers might even be invisible to many CME/CPD professionals. By communicating clearly, aligning expectations and building strong relationships, providers and writers can work collaboratively to create high-quality CME/CPD content that is current, accurate and aligned with standards of care.

References. 1. Harting D, Bowser A. Worst Practices for Writing CME Needs Assessments: Results From a Survey of Practitioners. AMWA Journal. 2019; 34(2):51-54.

A former trauma operating room nurse and academic, Alexandra Howson PhD, CHCP, has contributed to CME/CPD as a writer, educator and qualitative researcher since 2010. A frequent presenter at the Alliance Annual Conference, Alex was chair of the Alliance Research Committee from 2018-2021 and served as faculty for the CHCP prep course in 2020. She teaches Fundamentals of Medical Writing Ethics on the Professional Medical Writing Certificate program at the University of Chicago and provides specialist CME/CPD training and professional development for medical writers. Alex hosts Write Medicine, a weekly podcast that explores best practices in creating education content for health professionals.