In reviewing the extent to which its CME program achieved its expected results as stated in its mission, the provider recognized that it had been designing activities to change learner knowledge, but not competence, performance, and/or patient outcomes. It also found that it did not know if the activities designed to change knowledge contributed to changing competence or performance or patient outcomes as stipulated in its mission statement. In its self-study narrative and survey interview, the provider acknowledged this issue and articulated changes it would make to its planning processes to ensure that activities are designed to change learners’ competence, performance, and/or patient outcomes.