Continuing medical education has been widely criticized as ineffective; most such criticism is directed at the assumption that the mere transmission of information on new research findings is sufficient to change physician performance Eight studies published during the 1970s report changes in physician behaviour (and, in one, improved patient outcomes) as a result of CME organized on sound educational principles, including systematic effort to evaluate program effectiveness and learner achievement It is also suggested that additional information on CME effectiveness is likely to be obscured by the form in which much medical literature is presented

The effectiveness of continuing medical education: eight research reports.

Objectives Despite the broad range of continuing medical education (CME) offerings aimed at educating practicing physicians through the provision of up-to-date clinical information, physicians commonly overuse, under-use, and misuse therapeutic and diagnostic interventions. It has been suggested that the ineffective nature of CME either accounts for the discrepancy between evidence and practice or at a minimum contributes to this gap. Understanding what CME tools and techniques are most effective in disseminating and retaining medical knowledge is critical to improving CME and thus diminishing the gap between evidence and practice. The purpose of this review was to comprehensively and systematically synthesize evidence regarding the effectiveness of CME and differing instructional designs in terms of knowledge, attitudes, skills, practice behavior, and clinical practice outcomes. Review methods We formulated specific questions with input from external experts and representatives of the Agency for Healthcare Research and Quality (AHRQ) and the American College of Chest Physicians (ACCP) which nominated this topic. We systematically searched the literature using specific eligibility criteria, hand searching of selected journals, and electronic databases including: MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, The Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Abstracts of Reviews of Effects (DARE), PsycINFO, and the Educational Resource Information Center (ERIC). Two independent reviewers conducted title scans, abstract reviews, and then full article reviews to identify eligible articles. Each eligible article underwent double review for data abstraction and assessment of study quality. Results Of the 68,000 citations identified by literature searching, 136 articles and 9 systematic reviews ultimately met our eligibility criteria. The overall quality of the literature was low and consequently firm conclusions were not possible. Despite this, the literature overall supported the concept that CME was effective, at least to some degree, in achieving and maintaining the objectives studied, including knowledge (22 of 28 studies), attitudes (22 of 26), skills (12 of 15), practice behavior (61 of 105), and clinical practice outcomes (14 of 33). Common themes included that live media was more effective than print, multimedia was more effective than single media interventions, and multiple exposures were more effective than a single exposure. The number of articles that addressed internal and/or external characteristics of CME activities was too small and the studies too heterogeneous to determine if any of these are crucial for CME success. Evidence was limited on the reliability and validity of the tools that have been used to assess CME effectiveness. Based on previous reviews, the evidence indicates that simulation methods in medical education are effective in the dissemination of psychomotor and procedural skills. Conclusions Despite the low quality of the evidence, CME appears to be effective at the acquisition and retention of knowledge, attitudes, skills, behaviors and clinical outcomes. More research is needed to determine with any degree of certainty which types of media, techniques, and exposure volumes as well as what internal and external audience characteristics are associated with improvements in outcomes.

Effectiveness of continuing medical education.

As trends in medical care delivery shift from the inpatient to the outpatient setting, it is important that practices in medical education adapt accordingly. The environment of the teaching clinic should be warm, considerate of the needs of students, faculty, patients and their parents, and should allow ample time for discussion and independent learning. It may be difficult to cultivate such an environment in a medical school setting, if patient flow is uncontrolled. We piloted a simple program of telephone reminders for parents of children with appointments. Telephone reminders increased appointment compliance and improved the educational process.

Regulating patient flow for educational benefit in the pediatric teaching clinic: promoting learning through telephoned reminders

The learning process in medical education.

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The learning process in medical education.