Abstract
BackgroundThe internet has had a strong impact on how physicians access information and on the development of continuing medical education activities. Evaluation of the effectiveness of these activities has lagged behind their development.MethodsTo determine the effectiveness of a group of 48 internet continuing medical education (CME) activities, case vignette surveys were administered to US physicians immediately following participation, and to a representative control group of non-participant physicians. Responses to case vignettes were analyzed based on evidence presented in the content of CME activities. An effect size for each activity was calculated using Cohen's d to determine the amount of difference between the two groups in the likelihood of making evidence-based clinical decisions, expressed as the percentage of non-overlap, between the two groups. Two formats were compared.ResultsIn a sample of 5621 US physicians, of the more than 100,000 physicians who participated in 48 internet CME activities, the average effect size was 0.75, an increased likelihood of 45% that participants were making choices in response to clinical case vignettes based on clinical evidence. This likelihood was higher in interactive case-based activities, 51% (effect size 0.89), than for text-based clinical updates, 40% (effect size 0.63). Effectiveness was also higher among primary care physicians than specialists.ConclusionPhysicians who participated in selected internet CME activities were more likely to make evidence-based clinical choices than non-participants in response to clinical case vignettes. Internet CME activities show promise in offering a searchable, credible, available on-demand, high-impact source of CME for physicians.
Highlights
The internet has had a strong impact on how physicians access information and on the development of continuing medical education activities
The continuing medical education (CME) participant sample represents 1377 primary care physicians and 1241 physicians specializing in other areas
Physicians specializing in clinical areas other than primary care have a narrower focus for medical information seeking and may have higher levels of baseline knowledge than primary care physicians on specific topics, contributing to differences in effect size
Summary
The internet has had a strong impact on how physicians access information and on the development of continuing medical education activities. The internet has had a strong impact on how physicians access information, and many have reported the influence of this information on their medical decision making [1,2]. The internet offers opportunities to facilitate improvement in the quality of care through physician maintenance of certification [4,5]. Internet CME activities offer advantages over traditional methods of CME delivery; internet CME is a credible 'any time, any place' form of education, providing increased accessibility to busy physicians [7,8,9,10,11]. Other advantages may include increased engagement in the educational process, ease of use, cost effectiveness, hyperlinked navigation, and the ability to view content that may be continually updated
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