Quality assessment in continuous medical education

Abstract

Medical performance is subject to quality control. Continuous advanced training (CAT) and continuous medical education (CME) are essential, and quality must be checked and assured in respect of structure (contents, organizational form, framework, demands on teachers), process (CAT, interaction between teachers and participants) and results (satisfaction and acceptance, increased knowledge, influence on medical treatment, improvement of the success rate of medical treatment). In emergency medicine the necessity for CAT (e.g. certified proof required for working as an emergency physician) and a desire for CME (the individual task of the physician) must be differentiated. The diversity of forms for CAT/CME reflects the qualification as an emergency physician, 'Fachkundenachweis Rettungsdienst' offers measures for quality assessment. The recommendations for obtaining the 'Fachkundenachweis Rettungsdienst,' valid until now date from the year 1983, were set in very different ways by the individual countries medical boards. This led to our problems in the comparability of the essential CAT. The quality of the structure has now been improved by establishing new and uniform requirements for clinical activity, specification of particular knowledge, number of supervised calls for the emergency car as well as participation in interdisciplinary CAT courses, dealing with general and special aspects of emergency medicine. The aim of these measures is not the (senseless) regimentation of CAT training measures, but the qualified transfer of specific medical knowledge and treatment guidelines. On qualifying, the physician must make a personal effort to obtain a qualification of this kind. Conventional forms of learning must therefore be set aside in favour of modern teaching methods (e.g. problemorientated learning). This will lead to a better acceptance of CAT/CME measures. It is essential for quality of the process that the teachers' education meets the following requirements: relevant knowledge of preclinical emergency medicine, didactic abilities, employment of relevant teaching techniques, flexibility in presentation, extensive experience in emergency medicine as well as an enthusiasm for high-quality education. Questionnaires can be used to evaluate the satisfaction and acceptance of the participants, as well as their rating of individual speakers. The results are decisive in planning future CAT/CME measures. The transfer of knowledge can be estimated at the end of advanced training by questionnaire.