Table 3.

Moore’s expanded outcomes framework

Original (expanded) CME framework	Miller's framework	Description	Source of data
Participation (level 1)		The number of physicians and others who participated in the CME activity	Attendance records
Satisfaction (level 2)		The degree to which the expectations of the participants about the setting and delivery of the CME activity were met	Questionnaires completed by attendees after a CME activity
Learning (declarative knowledge level 3a)	Knows	The degree to which participants state what the CME activity intended them to know	Objective: pre- and post-tests of knowledge
			Subjective: self-report of knowledge gain
Learning (procedural knowledge level 3b)	Knows how	The degree to which participants state how to do what the CME activity intended them to know how to do	Objective: pre- and post-tests of knowledge
			Subjective: self-report of knowledge gain
Learning (competence level 4)	Shows how	The degree to which participants show in an educational setting how to do what the CME activity intended them to be able to do	Objective: observation in educational setting
			Subjective: self-report of competence; intention to change
Performance (level 5)	Does	The degree to which participants do what the CME activity intended them to be able to do in their practices	Objective: observation of performance in patient care setting; patient charts; administrative databases
			Subjective: self-report of performance
Patient health (level 6)		The degree to which the health status of patients improves due to changes in the practice behaviour of participants	Objective: health status measures recorded in patient charts or administrative databases
			Subjective: patient self-report of health status
Community health (level 7)		The degree to which the health status of a community of patients	Objective: epidemiological data and reports changes due to changes in the practice behaviour of participants
			Subjective: community self-report

Reproduced from Moore et al. J Contin Educ Health Prof. 2009;29:1-15, with permission of Wiley [13].

CME, continuing medical education.