Kevin Kruse President It’s time for our industry to take inspiration from the EBM movement. I modestly suggest that the pharmaceutical sales-training industry start to practice “evidence-based training.” In 1996, in an editorial published by the BMJ (British Medical Journal), David Sackett, M.D., offered a simple definition of “evidence-based medicine” and urged his colleagues to adopt its tenets. Put simply, evidence-based medicine (EBM) is the deliberate use of evidence in making decisions about patient care. Less than 10 years after Dr. Sackett’s article, EBM is a fast-growing global movement complete with its own journals, conferences, and advocates. But isn’t that what doctors have always done? There are all those clinical trials, medical journals, and scholarly conferences that review the latest results from different treatments. They’re swimming with evidence, right? Of course, we know that the actual practice of medicine is based more on expert opinion and individual case studies than true “evidence.” In fact, the core of physician training is the apprenticeship model, where they shadow senior doctors during patient rounds and sit in on “grand round” lectures. In one study of thrombolytic therapy by Victor Montori, it was found that medical textbooks and expert opinion lagged the data in journals by almost 10 years. (“Respiratory Care,” 2001.) The Need for New Evidence I believe that the field of pharmaceutical sales training is much worse off than the field of medicine. We’ve learned our craft from experts, case studies, and decades-old laboratory research. Consider the following: • There is a lot of research and literature on various learning styles, but nobody has yet validated them with pharmaceutical sales representatives. • We routinely make choices about media, design, and instructional tactics, but how many of these tactics have been validated in head-to-head comparison studies versus alternate techniques? • Much has been written about the “transfer problem.” Companies spend a billion dollars a year training their representatives, but how often do they actually measure the transfer of new skills in the field? How much do they invest in retention and pull-through strategies as a percent of the total budget? What’s worse is that our profession seems to tolerate fictitious information and sloppy research. Have you read that often used statement, “People only remember 10% of what they read, and 30% of what they hear?” It’s bogus. Made up. Embarrassingly passed on again and again. (For more details, visit work-learning.com/chigraph.htm.) Practicing EBT It’s time for our industry to take inspiration from the EBM movement. I modestly suggest that the pharmaceutical sales-training industry practice EBT — “evidence-based training.” EBT can be defined simply as the conscientious and explicit use of the best current evidence in the design of sales-training programs. By applying the principles of EBT to design pharmaceutical learning programs, the results become measurably better. Trainers need to benchmark surveys of pharmaceutical reps as adult learners; fund independent head-to-head studies that evaluate various instructional tactics; and research learning economics and focus on the “transfer problem.” Pharmaceutical companies sell their products to physicians using science and solid clinical data. Isn’t it time they held their training suppliers to a similar standard? AXIOM Professional Health Learning, Yardley, Pa., addresses the three sciences that are critical to the success of innovative medical education and training: the science of medicine; the science of instruction and adult learning; and the science of digital technologies. For more information, visit axiom-health.com.

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