The effects of continuing medical education on family doctor performance in office practice: a randomized control study

Abstract

A randomized controlled study was conducted to determine if specifically designed continuing medical education in the fields of cardiovascular and cancer medicine could change doctor office behaviour significantly. Thirty-one volunteer family doctors from 25 offices participated. Six (three cardiovascular and three cancer) learning objectives were defined. Two educational formats were selected as the independent variables: (1) group interaction opportunities (face-to-face and teleconference); and (2) concisely written newsletters. Chart measures of doctor performance prior to and 6 and 12 months following education served as the dependent variables. The family doctors receiving education were found to perform the recommended behaviours significantly more than those who did not receive the education (P less than 0.05) at 6 months post-education. This difference was maintained at the 12-month post-educational period for one of the educational programmes offered. A carefully planned programme of continuing medical education will result in favourable changes in the office practice of volunteer doctors. These changes can persist for as long as 12 months. Adherence to several essential learning principles is required.

Identifying barriers and tailoring interventions to improve the management of urinary tract infections and sore throat: a pragmatic study using qualitative methods

“…To address perceived patient expectations this study used small focus groups comprised of both patients and health care providers[28]. In another study there was an explicit attempt to involve learners by conducting a formal assessment of participant learning needs[29]. A review of audit and feedback versus alternative strategies extracted data regarding barriers to changing practice in the 12 studies identified.…”

The Future of Continuing Medical Education

“…In this set of studies, almost two thirds (35 studies) met their objectives. Of these, 30 studies 3,6,8,10,[12][13][14][15][16][17][18][19][20]22,24,28,[31][32][33][34][35][36]40,42,44,[47][48][49][50]99 continued to meet their objectives over the long term. A further five studies 96,98,103,104,107 met objectives but did not report evaluation timing, and two studies 58,59 displayed mixed results.…”

Educational responses to practice‐based learning: Recent innovations in medicine

“…The chart audit, a careful review of information within a patient's health record using predefined criteria, is also an innovative tool used for many hospital and office quality-assurance activities. Several approaches to the use of the chart audit have been recorded (Gerbert, Countiss, and Gullion, 1983;Gullion, Adamson, and Watts, 1983;and Jennett and others, 1988). It requires peer and expert consensus on criteria and standards and provides an information baseline by which performance levels can be measured at specific times.…”

“…Practitioners can identify what their learning needs are and can measure their individual performance against those of peers in a nonthreatening, confidential manner. Jennett and others (1988) found that thirty-one family physicians in office practice could learn and adopt new behaviors in cardiovascular and cancer medicine by engaging in an innovative educational program that consisted of face-to-face and teleconference dialogues with consultants, along with the study of group performance behavior and the sharing of newsletter information. Practice issues identified for learning were discussed by family practitioners, peers, and consultant experts at designated times and through the use of newsletters.…”