Dynamic computer simulation models: New methodology for continuing medical education

Abstract

Structural changes in the health care delivery system are creating new opportunities for continuing medical education (CME). In this article, we review the evolving role of CME and outline how computer simulation methodology can be used to facilitate selfdirected and group learning, and illustrate this approach with three applications: adolescent smoking prevention programs, smoking cessation programs in managed care organizations, and costcontainment efforts in cardiovascular surgery.Key Words: Cardiovascular surgery, computer simulation, continuing medical education, health systems reform, smoking cessation Continuing medical education (CME*) leadership may provide a vital link between practicing physicians, administrators, and policy makers as the search escalates for effective strategies to contain cost while ensuring quality of health care.' Much of the change in the delivery of health services today involves the introduction and use of new technologies and practices. Recent studies, however, have shown that this process of technology transfer often results in uneven adoption and use of diagnostic and therapeutic interventions by clinicians.'-4 Numerous strategies have been proposed to improve the efficiency and cost effec-*The term CME, as used throughout this article, includes the continuing education of physicians and other health professionals. tiveness of technology transfer and clinical decision making.5-'0 There are few data that document the scientific validity of these approaches. Many of the traditional CME approaches applied to changing practice behavior have proven to be limited in their effectiveness. Promising new approaches are being developed. Recent studies suggest that carefully focused, needs-based CME may significantly decrease inappropriate variation in the use of clinical tests and treatments."Traditional CME strategies have focused on supporting the individual physician's care of a single patient. In the current health care environment, emphasis has shifted to providing preventive services and care for defined populations. Because of the change in the health care environment, the learning needs of health care professionals have changed. New technologies are required to facilitate learning by physicians and other professionals. In this paper, we illustrate how computer simulation can be used to complement more traditional CME strategies.Our discussion covers three major topics. First, we review the evolving role for continuing education for health professionals in light of health systems reform. Second, we briefly outline the con-32

Zur Lage der anästhesiologischen Weiter- und Fortbildung in Deutschland

“…Nationale Behörden und Standesorganisationen gehen dabei unterschiedliche Wege [67].Viele Autoren halten jedoch eine administrativ verordnete, obligatorische Überprüfung von Fortbildung für demotivierend und damit ineffizient [84,88]; stattdessen werden neue Fortbildungsmodelle, die den Arzt motivieren und gleichzeitig die Effektivität steigern, gefordert und auch entwickelt, z. B. das "Maintenance of Competence Program (MOCOMP)" des Royal College of Physicians and Surgeons in Kanada [1,16].…”