Beyond Technical Updating: Why Civic Reasoning Matters in Continuing Medical Education

ABSTRACT

This letter responds to Erlande’s framing of civic education as community capacity building for primary care by arguing that its relevance also extends to continuing medical education (CME). In post-infodemic practice, clinicians need not only updated technical knowledge but also the ability to address misinformation, communicate uncertainty, and engage communities marked by uneven trust in expertise. The letter suggests that CME should more explicitly incorporate locally grounded public problems, communication training for contested digital environments, and reflective attention to accountability to marginalised communities. Civic reasoning, in this view, is part of contemporary professional competence rather than an optional addition to CME.

Dear Editor,

Erlande and Prasetio’s recent letter, “Civic Education as Community Capacity Building for Primary Care”, makes a timely and valuable contribution by encouraging continuing medical education (CME) to think beyond narrow content delivery [1]. Its argument, however, also invites a broader conclusion. In the aftermath of the COVID-19 infodemic, clinicians do not simply need refreshed technical knowledge; they increasingly need the capacity to interpret contested claims, communicate uncertainty, and engage patients whose decisions are shaped long before the clinical encounter [2,3].

This shift matters because professional competence is now exercised partly in civic space. Patients often arrive with risk narratives, therapeutic promises, conspiratorial frames, and suspicions about institutions that have circulated through digital and social networks before any consultation takes place. Under these conditions, a clinician may be fully current on evidence yet insufficiently prepared to address the social life of that evidence: how it is challenged, misunderstood, rejected, or selectively reinterpreted in public. That gap is not peripheral. It affects prevention, adherence, shared decision-making, and the credibility of expertise itself [3–5].

For that reason, CME should be understood not only as a mechanism for updating knowledge, but also as a site for cultivating civic reasoning in practice. I use civic reasoning here in a practical rather than ideological sense: the ability to translate evidence into public-facing conversations, recognise how health claims circulate in local information environments, and respond in ways that preserve dignity while rebuilding trust. Framed this way, civic reasoning is not optional enrichment. It is part of what contemporary clinical competence now requires.

Three implications for CME design follow. First, activities should engage real public problems more deliberately rather than rely exclusively on the decontextualised transfer of content. Cases involving vaccine hesitancy, online treatment myths, or distrust in health institutions are no longer exceptional scenarios; they are part of routine practice [2,3]. Second, communication training should address misinformation and uncertainty directly. Clinicians need structured opportunities to practice how to elicit the source of a patient’s belief, distinguish concern from defiance, and correct falsehoods without escalating defensiveness or humiliation [4]. Third, CME should include reflective attention to accountability: not only to evidence, but also to communities whose experiences of medicine are shaped by unequal trust, unequal access, and unequal recognition [5].

Primary care is a particularly important setting for this discussion because it is where broad public controversies become concrete decisions about vaccination, screening, chronic disease management, and follow-up. In those encounters, misinformation is rarely a simple deficit of facts. It may be bound up with prior exclusion, community memory, or frustration with institutions. CME that prepares clinicians only to recite evidence, but not to recognise why evidence is mistrusted, risks narrowing education to transmission when practice increasingly demands interpretation, relationship-building, and judgement in context.

This is not an argument to politicise CME. It is an argument to acknowledge that clinical work is already embedded in public reasoning and public trust. JCME has previously highlighted the need for CME/CPD systems to remain responsive when the conditions of practice change rapidly [6]. The challenge now is that the disruption is not only organisational or technological, but epistemic. Care is delivered in environments saturated with competing claims about authority, risk, and truth.

Erlande and Prasetio, therefore, open an important line of thought. If CME is to remain genuinely practice-relevant, it should help clinicians become not only better consumers of evidence, but also better public reasoners with it.

Funding Statement

The author(s) reported there is no funding associated with the work featured in this article.

Disclosure Statement

No potential conflict of interest was reported by the author(s).

Data Availability Statement

No new data were generated or analysed in support of this manuscript.