Implications for undergraduate and graduate education derived from quantitative research in continuing medical education: lessons learned from an automobile

Abstract

The purpose of this paper is to highlight key factors influencing the effectiveness of continuing medical education (CME) and to explore implications for undergraduate and graduate medical education. We briefly present the results of a recent systematic review of CME on physician performance and on health care outcomes and explore the earlier phases of medical education from three perspectives: needs assessment, type of educational intervention (format), and evaluation. First, it appears that needs assessment may play an increasingly important role in graduate and undergraduate education, especially given the diversity of students and residents in their prior training and experience. Second, educational interventions including practice-based systems such as reminders are more effective than more traditional interventions such as conferences (didactic presentations) and printed materials, at least in the CME setting. Lectures and printed materials may be an efficient way of delivering content, but alone may be insufficient to change practice even in undergraduate education. Third, the issue of evaluation, from both the micro (student) and macro (program) levels has implications for undergraduate and residency education. In CME, the issue of competency assessment has begun to be addressed in a rigorous and planned manner, derived in part from the area of remedial education. The paper concludes with a call for a similar attempt to answer the basic question “Do undergraduate and graduate education really work”?