Primum non nocere….

They made a big deal about those two birds. Apparently Betty and her mate were the subjects of a test to determine whether crows could learn how to extract meat from a test tube with a wire. The birds were presented with two wires, one straight and the other bent into a hook. The experiment did not last long. As soon as the crows learned that only the bent wire was effective, the dominant male commandeered the tool. Betty’s response was to bend the remaining wire by wedging it into a crack in the cage, adjusting it until she had a functional tool. The folks at Oxford University are normally quite reserved, but they were excited this time. The observation proved that birds not only use tools but also can fabricate them. I didn’t think it was such a big breakthrough because, at least on our farm, we have all sorts of livestock who keep outsmarting us. The more interesting aspects to the story are that 1) Betty learned when and what she needed to know, 2) she improved with practice, 3) and her learning was measured by outcomes. These basic principles of education, even applicable to crows, differ from our approach to the continuing education of physicians. Currently, we simply mandate the process. In North Carolina, physicians must document 150 hours of practice relevant CME every three years in order to stay up to date. b) Each person licensed to practice medicine in the State of North Carolina shall complete no less than 150 hours of practice relevant CME every three years in order to enhance current medical competence, performance or patient care outcome. At least 60 hours shall be in the educational provider-initiated category as defined in Rule .0102 of this Section. The remaining hours, if any, shall be in the physician-initiated category as Our Ecosystem