BackgroundEducational meetings are widely used for continuing medical education. Previous reviews found that interactive workshops resulted in moderately large improvements in professional practice, whereas didactic sessions did not. ObjectivesTo assess the e ects of educational meetings on professional practice and healthcare outcomes. Search methodsWe updated previous searches by searching the Cochrane E ective Practice and Organisation of Care Group Trials Register and pending file, from 1999 to March 2006. Selection criteriaRandomised controlled trials of educational meetings that reported an objective measure of professional practice or healthcare outcomes. Data collection and analysisTwo authors independently extracted data and assessed study quality. Studies with a low or moderate risk of bias and that reported baseline data were included in the primary analysis. They were weighted according to the number of health professionals participating. For each comparison, we calculated the risk di erence (RD) for dichotomous outcomes, adjusted for baseline compliance; and for continuous outcomes the percentage change relative to the control group average a er the intervention, adjusted for baseline performance. Professional and patient outcomes were analysed separately. We considered 10 factors to explain heterogeneity of e ect estimates using weighted meta-regression supplemented by visual analysis of bubble and box plots.Continuing education meetings and workshops: e ects on professional practice and health care outcomes (Review)
BackgroundDistress and burnout among medical and psychology professionals are commonly reported and have implications for the quality of patient care delivered. Already in the course of university studies, medicine and psychology students report mental distress and low life satisfaction. There is a need for interventions that promote better coping skills in students in order to prevent distress and future burnout. This study examines the effect of a seven-week Mindfulness-Based Stress Reduction (MBSR) programme on mental distress, study stress, burnout, subjective well-being, and mindfulness of medical and psychology students.MethodsA total of 288 students (mean age = 23 years, 76% female) from the University of Oslo and the University of Tromsø were randomly allocated to an intervention or control group. The control group continued with their standard university courses and received no intervention. Participants were evaluated using self-reported measures both before and after the intervention. These were: the ‘General Health Questionnaire, Maslach Burnout Inventory Student version, Perceived Medical School Stress, Subjective Well-being, and Five Facet Mindfulness Questionnaire’ and additional indices of compliance.ResultsFollowing the intervention, a moderate effect on mental distress (Hedges’g 0.65, CI = .41, .88), and a small effect on both subjective well-being (Hedges’g 0.40, CI = .27, .63) and the mindfulness facet ‘non-reacting’ (Hedges’g 0.33, CI = .10, .56) were found in the intervention group compared with the control group. A higher level of programme attendance and reported mindfulness exercises predicted these changes. Significant effects were only found for female students who additionally reported reduced study stress and an increase in the mindfulness facet ‘non-judging’. Gender specific effects of participation in the MBSR programme have not previously been reported, and gender differences in the present study are discussed.ConclusionFemale medical and psychology students experienced significant positive improvements in mental distress, study stress, subjective well-being and mindfulness after participating in the MBSR programme.Trial registrationNCT00892138
Study objective-The aim was to validate information about diabetes mellitus collected by questionnaire in a large epidemiological survey.Design Participants-All inhabitants in the municipality answering "yes" to the question on diabetes (n = 169) and the persons with the same sex born closest before and after each diabetic patient and answering "no" to the diabetes question (n = 338) were included.Measurements
This trial and its accompanying qualitative evaluation suggest that self-directed, computer-assisted learning may be an alternative format for teaching EBM. However, further research is needed to confirm this and investigate alternative educational models.
Mind‐body interventions to manage stress‐related health problems are of widespread interest. One of the best known methods is mindfulness‐based stress reduction (MBSR), and MBSR courses are now offered by health services, as well as in social and welfare settings. In this systematic review, we report on the effects of MBSR interventions on health, quality of life, and social functioning. From the more than 3,000 potentially relevant references identified in two extensive searches, we included 31 relevant studies with an overall total of 1,942 participants, each of whom had been randomised to receive MBSR or other treatment strategies (most often a waiting list control). We utilised all outcome data published in the selected studies using a new statistical method for calculating the effect size. This method addressed the problems presented by the interdependence of many measurements of outcomes. 26 of the 31 studies were identified as having data suitable for meta‐analysis. MBSR was found to have a moderate and consistent positive effect on mental health outcomes in both patients selected with somatic problems and with mild to moderate psychological problems, and among participants recruited from community settings. MBSR interventions improved outcomes measuring different aspects of personal development and quality of life. The effects on somatic health outcomes were somewhat smaller. No adverse effects were described. Few studies were found that evaluated the impact of MBSR on social functioning, such as the ability to work. Key messages Mind‐body interventions to manage stress‐related health problems are of widespread interest. One of the best known methods is mindfulness‐based stress reduction (MBSR), and MBSR courses are now offered by health services, as well as in social and welfare settings. In this systematic review, we report on the effects of MBSR interventions on health, quality of life, and social functioning. From the more than 3,000 potentially relevant references identified in two extensive searches, we included 31 relevant studies with an overall total of 1,942 participants, each of whom had been randomised to receive MBSR or other treatment strategies (most often a waiting list control). We utilised all outcome data published in the selected studies using a new statistical method for calculating the effect size. This method addressed the problems presented by the interdependence of many measurements of outcomes. 26 of the 31 studies were identified as having data suitable for meta‐analysis. MBSR was found to have a moderate and consistent positive effect on mental health outcomes in both patients selected with somatic problems and with mild to moderate psychological problems, and among participants recruited from community settings. MBSR interventions improved outcomes measuring different aspects of personal development and quality of life. The effects on somatic health outcomes were somewhat smaller. No adverse effects were described. Few studies were found that evaluated the impact of MBSR on so...
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