Abstract
To the Editor. —Dr Davis and colleagues are to be commended for their excellent review of randomized trials evaluating the impact of continuing medical education (CME) interventions on physician performance. 1 Their conclusion that traditional CME interventions are minimally effective at altering physician behavior unless accompanied by an enabling change in the practice environment is inescapable and is consistent with the conclusions of other recent overviews. 2-4 However, we take issue with the inclusion of enabling technologies such as reminder systems under the rubric of CME. Although reminder systems clearly enhance the effectiveness of educational interventions, they do not qualify as educational interventions any more than adjuvant chemotherapy ought to be considered a surgical intervention simply because it improves the survival of patients with certain types of cancer who undergo surgery. There are several important conceptual differences between educational interventions and informatics interventions (ie, reminder systems and other forms of
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