Continuing Medical Education Programs Research Articles

A Brief Review on Good Clinical Practice and its Training Methods

Abstract The field of clinical research continues to advance, and for ethical conduct of research, researchers need to have a strong foundation in good clinical practice (GCP). GCP guidelines are internationally recognized standards that govern the conduct of clinical trials, ensuring the protection of human subjects and the generation of reliable data. However, novice researchers or postgraduate medical students who would delve into research activities may face difficulty getting avenues for GCP training. Hence, in this brief review article, we discuss the significance of GCP in the field of clinical research with a glimpse of its history, development, and key principles. We provide a list of online courses, benefits, and disadvantages of those courses, and a list of organizations that conduct GCP workshops or continued medical education programs in India.

Redefining the Role of Medical Affairs Professionals as Innovators and Leaders in Industry-Led Medical Education.

Medical affairs professionals are pivotal players at the intersection of medical innovation and practice in the pharmaceutical industry. They are uniquely positioned to translate complex medical knowledge into actionable insights for internal and external stakeholders. Industry-led continuing medical education (CME) programs, guided by these professionals, hold the potential to markedly improve clinicians' application of evidence-based medicine (EBM) in clinical settings, thereby elevating patient care outcomes. However, current CME techniques often overlook the integration of diverse disciplines such as educational theories, cognitive psychology, information mastery, and implementation science, which are important for effective real-time decision-making in patient care. This gap in integrating implementation science is vital, as it is key in ensuring that medical innovations are not just developed but also effectively implemented and efficiently utilized in clinical settings. In this opinion article, we aim to highlight the crucial yet often underrecognized role of medical affairs professionals in shaping robust and practical CME programs within the industry. We explore emerging trends and approaches in medical education and CME based on the principles of adult education. Additionally, we explore how medical affairs professionals can effectively drive the adoption of EBM in clinical practice. This exploration aims to provide insights into enhancing CME programs, with medical affairs professionals at the forefront of innovation and leadership in bridging gaps in clinical practice.

Significant improvement of physicians' knowledge and clinical practice: an opportune, effective, and convenient continuing medical education program on functional dyspepsia.

This cohort study aimed to explore the effect of a one-day online continuing medical education (CME) on the improvement of physicians' knowledge and clinical practice on functional dyspepsia (FD). Physicians were invited to participate in this CME via medical education applications. FD training videos made in advance were sent to participants via a weblink. Before and after training, participants were required to finish the FD knowledge test and provide case information of FD patients. McNemar test, Wilcoxon rank-sum test, Freidman test, Chi-square test, quantile regression, and generalized estimating equations (GEE) were used to perform statistical analysis. There were 397 of 430 (92.33%) physicians finished this CME program. The total score of the FD knowledge test after training was significantly higher compared with before training [488.3 (468.3-510.0) vs. 391.7 (341.7-450.0), p < 0.001]. Particularly, physicians from primary hospitals show more increase in total scores than physicians from secondary and tertiary hospitals. According to the GEE model, receiving this online training was an independent predictor of physicians' choice of upper gastrointestinal endoscopy in patients with FD [OR 1.73, 95%CI (1.09-2.73), p = 0.020], especially in PDS. Also, it was an independent predictor of physicians' choice of acid-suppressive drugs in patients with FD [OR 1.30, 95%CI (1.03-1.63), p = 0.026], especially in EPS and PDS overlapping EPS. This one-day online CME program effectively and conveniently improved physicians' knowledge and clinical practice, providing new ideas for future CME and facilitating precise clinical management of FD patients with different subtypes especially in primary hospitals.

Understanding antibiotic knowledge, attitudes, and practices: a cross-sectional study in physicians from a Colombian region, 2023.

Antibiotic resistance has been identified as a global health threat. Knowledge, attitudes, and inappropriate prescription practices of antibiotics by physicians play a crucial role in this problem. In Colombia, research addressing this issue is scarce. A cross-sectional study involving 258 physicians was conducted. A scale with questions on sociodemographic aspects, level of education, satisfaction with antibiotic education received, and knowledge, attitudes, and practices was administered. The scale was designed for each item to be analyzed individually or as a total score ranging from 0 to 100 (0 being the lowest and 100 the highest). 31.5% of physicians rated the education received on antibiotics as fair to poor. The knowledge score was 80.1 (IQR 70.5-87.5); however, 25.2% agreed to some extent that amoxicillin is useful in treating most respiratory infections, and 15% agreed that antibiotics are effective in treating upper respiratory infections. Attitudes scored 80.2 (IQR 75.0-86.5), with 99% stating that bacterial resistance is a public health problem in Colombia, but only 56.9% considering it a problem affecting their daily practice. Practices scored 75.5 (IQR 68.8-81.2), and 71.7% affirmed that if they refuse to prescribe antibiotics to a patient who does not need them, the patient can easily obtain them from another physician. General practitioners were found to have lower scores in all three indices evaluated. The study reveals enduring misconceptions and concerning practices in antibiotic prescription, particularly among general practitioners. Enhancing knowledge necessitates the implementation of continuous medical education programs that focus on updated antibiotic guidelines, and resistance patterns. Fostering positive attitudes requires a culture of trust and collaboration among healthcare professionals. Practical enhancements can be realized through the establishment of evidence-based prescribing guidelines and the integration of regular feedback mechanisms. Moreover, advocating for the inclusion of antimicrobial stewardship principles in medical curricula is crucial, emphasizing the significance of responsible antibiotic use early in medical education.

Harvard Medical School Global Mental Health: Trauma and Recovery Course: What is the Global Impact? Three Year’s Results

Purpose: This paper describes and documents an innovative blended learning Global Mental Health: Trauma and Recovery certificate training course. This course combines a two-week face-to-face training in Orvieto, Italy with a five-month follow-up online virtual training as a learning experience for global health care practitioners. Continuing medical education (CME) accreditation is offered upon completion. This course utilized an innovative blended learning model with a community of practice approach, a combination of lectures and discussions, and online in-depth group case study discussions. Methodology: Data was collected by self-reported anonymous evaluation by participants of three continuous years of the CME Global Mental Health: Trauma and Recovery certificate training course sponsored by Harvard Medical School. One hundred fifty-five participants (n= 39 in 2011; n = 57 in 2012; n=59 in 2013) underwent a pre- and post-course evaluation to determine sustained confidence in performing medical and psychiatric care to traumatized patients and communities, as well as to determine their learning of the Global Mental Health Action Plan (GMHAP). Results: Over the course of three independent years, a total of 155 participants were evaluated. There was evidence for significant improvement in their confidence levels in all clinical areas (diagnosis; treatment of trauma; use of psychotropic medication) when comparing baseline to completion of the six-month course. All ten dimensions of the GMHAP and nine medical and psychiatric aspects of treatment revealed significant improvement in confidence levels. Regression analysis also indicated similar results after the adjustment of demographic covariates. Physicians and participants with mental health and social work background had significantly higher confidence. Participants who were MD’s or psychiatrists had higher confidence in most of the categories of confidence except for self-care, understanding culture, collaboration, and policy and financing. The model showed no difference in learning based upon gender and level of development of country of origin. Conclusion: The evaluation of this blended learning CME program provides evidence of significant enhancement of clinical practice and planning skills in health care practitioners working with highly traumatized patients and communities worldwide. This successful training over the past 18 years has gone far to achieve the health and mental health capacity building as requested by the Ministers of Health from post-conflict societies in the historic Rome meeting in 2004.

Medical Conferences and Continuing Medical Education Programs: Meet, Eat, and Learn—The Untold Story

Medical Conferences and Continuing Medical Education Programs: Meet, Eat, and Learn—The Untold Story

Microvascular Aging and Eicosanoids-Women's Evaluation of Systemic Aging Tenacity ("You are never too old to become younger!") Specialized Center of Research Excellence on Sex Differences Career Enhancement Core: Building the Future.

The objective of the National Institutes of Health Office of Research in Women's Health (NIH/ORWH) Specialized Center of Research and Career Enhancement (SCORE) program is to expedite the development and application of new knowledge that affect women, to learn more about the etiology of these diseases, and to foster improved approaches to treatment and/or prevention. Each SCORE has a Career Enhancement Core (CEC) that serves to meet the career enhancement needs of translational science in the study of sex differences. The Microvascular Aging and Eicosanoids-Women's Evaluation of Systemic aging Tenacity (MAE-WEST) ("You are never too old to become younger!") Specialized Center of Research Excellence (SCORE) on Sex Differences will study pro- and anti-inflammatory responses and small vessel aging traits. As part of our SCORE CEC, we have advanced several initiatives to embed consideration of sex as a biological variable (SABV) into the infrastructure of our two CEC institutions. Unlike other professions, ongoing physician education through continuing medical education (CME) activities is required and embedded in the practice of medicine. The MAE-WEST SCORE in collaboration with the CSMC Clinical Scholars Program, the Center for Research in Women's Health and Sex-differences and the CSMC CME Office requires SABV and as Diversity, Equity, and Inclusion components in all CSMC CME programs. Clinical practice is also increasingly guided by evidence-based guidelines, with Class I recommendations resulting from clinical trials rather than expert consensus. It is essential that women be included in clinical trials proportionate to the prevalence and burden of disease. The MAE-WEST SCORE has developed our own unique CEC for providing novel educational, networking, funding opportunities, and translation to practice support. The developed best practices have found novel ways to enhance studies of women's health and SABV. We welcome visitors on-site and virtual to share with the broader academic and practicing community.

118-OR: From Learning to Planning for Change—How Continuing Medical Education Drives Clinician Intention to Implement Changes in Diabetes Care

Objective: The effectiveness of continuing medical education (CME) in improving clinician knowledge and competence in the management of type 2 diabetes (T2DM) has been widely demonstrated. The current study builds upon existing literature by investigating the pathway by which CME drives clinician intention to implement changes in T2DM management. Methods: Data from 6 accredited online T2DM CME programs targeting global diabetologists/endocrinologists (diab/endos) and primary care physicians (PCPs) launched in 2021 were analyzed. An objective knowledge/competence assessment was completed by a control group sampled from the target audience prior to the launch of each of the programs (n=301) and by a test group sampled from learners following participation (n=304). Post-education confidence improvement and intention to change were also measured in the test group. Significance of all between-group differences reported was tested using chi-square statistics. Results: The education had a large effect size in improving clinician knowledge and competence managing T2DM (control vs test group correct response rate: 63% vs 92%, P &amp;lt; .001; Cohen’s d=1.21). Within the test group, 81% increased confidence in managing T2DM, and 73% planned to make clinical practice changes. Knowledge/competence did not directly predict intention to change, but those with improved confidence were more likely to plan for clinical practice change (79% vs 45%; P &amp;lt; .001). While knowledge/competence did not predict confidence improvement for diab/endos, PCPs who answered all questions correctly were more likely to report improved confidence (82% vs 56%; P &amp;lt; .01). Conclusions: CME may indirectly drive clinician intention to implement practice changes via its impact on confidence for both diab/endos and PCPs. The role that knowledge and competence play in the pathway from CME to intention to change may vary for these two groups of clinicians. Disclosure P.Chen: None. C.Mardis: None. S.Gawade: None. A.Wiggins: None. Y.Oliver: None. Funding Eli Lilly and Company

A standardized scoring system for conflict of interest determination and mitigation for AASLD-sponsored continuing medical education events.

Continuing medical education (CME) is essential to increase the knowledge, skills, and professional performance of health care providers. To keep the content of CME relevant and balanced, conflict of interest (COI) determination and mitigation is essential. While the Accreditation Council for Continuing Medical Education provides oversight and guidelines, each organization that sponsors CME programs has its own protocol for COI. To standardize and simplify the American Association for the Study of Liver Diseases' approach to COI, we propose a standardized COI disclosure scoring system for all CME programs to notify the audience of any conflicts and how such conflicts can be mitigated.

The study of healthcare professionals' perspective towards the quality of diabetic care services in Abha.

The aim of this study was to investigate the relationship between organizational characteristics and diabetes care from the perspective of health care professionals (HCPs) in Abha, Kingdom of Saudi Arabia. A cross-sectional, self-reported survey of healthcare professionals was done. The study comprised a total of 106 HCPs from various departments involved with diabetes patient clinics or service providers. The electronic data collecting form was used to gather the data. The study revealed a stronger association between the availability of bed facilities and better glycemic control. Moreover, the majority of HCPs believes that urbanization and sedentary lifestyles are the main contributors to the rise of diabetes mellitus in Saudi Arabia. Depending on organizational features, the regulations that are available for monitoring defaulter patients and running continuous medical education (CME) programs are vastly different. The main cause of the reported lack of medications for managing diabetic care was described as being a problem with the central medical supply store's drug supply, which was influenced by the type of health sector. Facilitating change at all levels, including patient education, HCPs education, and organizational development, can improve the quality of treatment. The current study can provide insight into the focus of interventional strategies to deliver diabetes patients with high-quality patient care.

Continuing Medical Education Increases Knowledge, Competence, and Confidence Related to the Use of Non-Oral Acute Migraine Therapies Among Neurologists (P13-2.003)

Continuing Medical Education Increases Knowledge, Competence, and Confidence Related to the Use of Non-Oral Acute Migraine Therapies Among Neurologists (P13-2.003)

Nurses' knowledge, perceived challenges, and recommended solutions regarding premature infant care: A mixed method study in the referral and tertiary hospitals in Dar es salaam, Tanzania.

There has been an increase in preterm birth of about 2% in a span of 14 years (2000-2014) mainly from Asia and Sub-Saharan Africa. Nursing care is very crucial and a lack of knowledge of health care providers is a contributing factor to morbidity and mortality. With the increasing number and investment of preterm infants towards attaining sustainable development goals (SDG) 3.2, nurses' knowledge adequacy, challenges and solutions on their care needs to be affirmed. A mixed method study was conducted between September 2020 to January 2021 in the neonatal units of four hospitals in Dar es Salaam. Self-administered structured questionnaire was used to assess adequacy of knowledge set at 50% or more for the three main domains 1) Essential newborn Care 2) Infection prevention and management 3) Special care and monitoring. A phenomenological design using a structured interview guide focused on challenges and recommended solutions in acquiring on-the- job training on the care of preterm infants. Quantitative data were analyzed using SPSS version 23 and qualitative data were thematically categorized. Out of 52 of nurses who participated and providing care to preterm infants; 48.1% came from a tertiary hospital, (84.6%) were females, only 28.8% aged more than 40 years and 23.1% had less than one year of experience. Overall, 55.8% of the nurses had never received on job training. Adequate knowledge among nurses was 94% on essential newborn care, 80.8% on infection prevention and management and 36.5% on special care and monitoring of preterm infants. Generally, immediate actions of helping baby breath (HBB) and cord care scored poorest. Components on special care and monitoring which had lowest scores included blood glucose monitoring, temperature monitoring and acceptable daily weight gain. Being more than 41 years old, a female nurse and working in the neonatal unit for at least 1-3 years were more likely to determine adequacy of knowledge on infection prevention and management. Lack of schedule and ways to identify those who require training were among the challenges mentioned in the focus group discussion. The findings demonstrate an urgent need of instilling knowledge, skills and competences among nurses providing preterm care in our hospitals. Most nurses had not attended training on the care of premature infant. Special care and monitoring were most poorly performed. The recommended solutions included continuous medical education (CME) for all nurses through hospital and government commitment and encourage mentorship within and between hospitals. Nurses who are female, older than 41 years and those with 1 to 3 years of experience should be considered when planning for CME and mentorship program on infection prevention and management.

Factors Associated with Psychotropic Medications Literacy among Community Pharmacists.

Background and objectives: Community pharmacists play an important role in ensuring the patient's adherence to medications, thus achieving therapeutic outcomes. The present study had two aims: to measure the extent of knowledge that community pharmacists had about psychotropic medications and to determine the factors associated with higher knowledge scores. Methods: A cross-sectional design was employed, using a structured online questionnaire. The study instrument assessed demographics, general practice characteristics related to psychotropics and a battery of factual questions that assessed the knowledge of pharmacists about psychotropic medications using closed-ended responses. A total knowledge score consisting of the sum of correct responses was calculated; the passing score was 75%. A total of 676 pharmacists completed the survey. Results: Only 20% passed the threshold score (75%) for the factual knowledge questions, and only (11.0%) were very comfortable with their knowledge of psychotropic agents. A total of 49.0% of the respondents felt that they had been adequately trained to counsel patients on psychotropic agents. According to the regression model, pharmacists who reported higher knowledge were more experienced (0.63, (0.26-1.0), p < 0.001), reported studying the topic in the pharmacy school (0.77 (0.27-1.26), p = 0.002) holding a Doctor of Pharmacy (Pharm D) degree (0.24 (0.05-0.43), p = 0.01), and reported a higher perceived knowledge (0.29 (0.01-0.38), p = 0.038). Conclusion: Community pharmacists reported poor knowledge of psychotropic medications, and continuous medical and professional education programs are mandatory.

Primary care providers' knowledge, attitudes, and practices related to prediabetes in China: A cross-sectional study.

The management of prediabetes has great clinical significance, and primary care providers (PCPs) play important roles in the management and prevention of diabetes in China. Nevertheless, little is known about PCPs' knowledge, attitudes, and practices (KAP) regarding prediabetes. This cross-sectional study aimed to assess the KAP regarding prediabetes among PCPs in the Central China region. This cross-sectional study was conducted using self-administered KAP questionnaires among PCPs from Central China region. In total, 720 PCPs completed the survey. Most physicians (85.8%) claimed to be aware of the adverse effects of prediabetes and reported positive attitudes toward prediabetes prevention, but the PCPs' knowledge of prediabetes and management practices showed substantial gaps. The prediabetes knowledge level and practice subscale scores of the PCPs were only 54.7% and 32.6%, respectively, of the corresponding optimal scores. Female PCPs showed higher prediabetes knowledge level scores (p = 0.04) and better practice scores (p = 0.038). Knowledge and attitude scores were inversely correlated with participants' age and duration of practice (p < 0.001). The PCPs who served in township hospitals had significantly higher knowledge and attitude scores than those who served in village clinics (p < 0.001). Furthermore, knowledge and practice scores increased with increasing professional titles. Recent continuing medical education (CME) attendance had a significant positive influence on knowledge of prediabetes (p = 0.029), but more than four-fifths of the surveyed PCPs did not participate in diabetes-related CME in the past year. Substantial gaps were observed in PCPs' knowledge and practices regarding prediabetes in the Central China region. CME programmes were under-utilized by PCPs. Structured programmes are required to improve PCPs' prediabetes-related knowledge and practices in China.

Knowledge, Attitude, and Practice Regarding Fibromyalgia Among Primary Care Physicians in Tabuk, Saudi Arabia.

Adequately informed family physicians have the greatest potential to correctly identify the diagnosis of fibromyalgia (FM) and develop an initial treatment plan. Therefore, it is substantial to determine the levels of weakness and inaccuracy among primary care physicians regarding FM diagnostic criteria and management strategies. This study aimed to assess the knowledge, attitude, and practices regarding FM among primary care physicians in Tabuk, Saudi Arabia. This cross-sectional study included family physicians who were board-certified or registered in the family medicine training program and working at the government family healthcare centers in Tabuk. A pre-designed, structured questionnaire was distributed either in written form or as an online survey. This study included 52 primary healthcare physicians. Twenty-two (42.3%) participants incorrectly recorded localized pain as a diagnostic symptom, and 45 (86.5%) incorrectly recorded nonsteroidal anti-inflammatory drugs (NSAIDs), prednisolone, and/or opioids as drugs that are used for treating FM. Only 59.6% were confident in recognizing the symptoms of FM, and 55.8% were confident in differentiating FM from other similar diseases. The primary healthcare physicians working in the government's primary healthcare centers in Tabuk City, Saudi Arabia, have low levels of knowledge about diagnostic criteria and treatment strategies for FM. These findings highlight the need for continuous professional development involving family physicians in the primary healthcare setting with suitable continuous medical education (CME) programs concerning FM.

KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING FIBROMYALGIA AMONG PRIMARY CARE PHYSICIANS IN TABUK, SAUDI ARABIA

Background: Adequately informed family physicians have the greatest potential to correctly identify the diagnosis of fibromyalgia (FM) and develop an initial treatment plan. Therefore, it is substantial to determine the levels of weakness and inaccuracies of primary care physicians regarding FM diagnostic criteria and management strategies. Aim: This study aimed to assess the knowledge, attitude, and practices regarding FM among primary care physicians in Tabuk, Saudi Arabia. Methods:This cross-sectional study included family physicians who were board-certified or registered in the family medicine training program and working at the government family health care centers in Tabuk. A pre-designed, structured questionnaire was distributed either in a written form or as an online survey. Results: This study included 52 primary healthcare physicians. Twenty-two (42.3%) participants incorrectly recorded localized pain as a diagnostic symptom, and 45 (86.5%) incorrectly recorded nonsteroidal anti-inflammatory drugs, prednisolone, and/or opioids as drugs that are used for treating FM. Only 59.6% were confident recognizing symptoms of FM and 55.8% were confident differentiating FM from other similar diseases. Conclusions: The primary healthcare physicians working in the governments primary healthcare centers in Tabuk city, Saudi Arabia have low levels of knowledge about diagnostic criteria and treatment strategies of FM. These findings highlight the need for continuous professional development involving family physicians in the primary health care setting with suitable continuous medical education programs concerning FM.

Participants’ knowledge gain, feedback, and organizers’ experience after online symposium organized for continuous medical education

Background: Worldwide lockdown and restrictions due to COVID-19 pandemic prohibited gathering of people, which affected the academic activities and learning, especially in professional courses. During the COVID-19 pandemic, online academic events became popular due to necessities, and also convenience. Effectiveness of such online academic events is still not substantially proven. Aims and Objectives: The objective of this study was to assess the participants’ knowledge gain, feedback, and organizers’ experience after online symposium organized for continuous medical education (CME). Materials and Methods: We conducted a 2-day electronic symposium (E-Symposium) as part of CME program, collected data from the participants before and after the symposium regarding their knowledge gain and feedback. Results: Our data analysis proved that E-Symposium resulted in significant knowledge gain of the participants, which was highest for faculty, followed by PhD scholars and postgraduate students. More than 80% of participants gave positive feedback and wished to participate in more such online events. Our results confirm that online academic events are successful in medical education and benefit the participants. Conclusion: Academic events organized with online platforms provide good opportunities for both teachers and students to gain knowledge, especially during pandemic and times of social restrictions.

Influence of Cardiologists’ Demographic Profile on Overall Satisfaction Towards Marketing Mix Strategies

This study aims to investigate the influence of cardiologists’ demographic characteristics on their satisfaction towards marketing mix strategies (MMS) employed by pharmaceutical industries in Bangladesh. Cardiologists (156) were asked to rate the importance of variables of MMS indicating their degree of agreement with satisfaction statement using a 5-point Likert scale. The variables of marketing mix (4Ps) that can be ranked as top 5 out of 14 variables according to their Spearman correlation coefficients are - brand image (r = 0.532); selling skill of medical representatives (r = 0.507), place of retail pharmacy (r = 0.484), promotional policies (r = 0.476) and continuous medical education program for doctors (r = 0.345). Though the overall mean satisfaction score of females (M = 4.06, SD = 0.87) is higher than that of male (M=3.84, SD =1.02), the difference is not significant; p = 0.260, Cohen’s d = 0.217 showed the effect is small. Experience above 10 years was labeled as high (41%), otherwise low (59%). Experience had substantial influence on perceived satisfaction towards promotion. Finally, overall satisfaction scores varied based on academic qualification of cardiologists; p &lt; 0.05, and Eta-squared = 0.068 implies medium effect. The highest overall satisfaction score was attained for D. Card and others (M = 4.32, SD = 0.82) and the lowest is for MD (M = 3.57, SD =10.9). Cardiologists’ satisfaction score towards product (the lowest is for MD and the highest is for D. Card and others); p &lt; 0.05; Eta-squared = 0.05 (small effect) and promotion (the lowest is for MBBS and the highest is for D. Card and others) vary significantly according to their academic qualification, p &lt; 0.05; Eta-squared = 0.095 implies medium effect. Dhaka Univ. J. Pharm. Sci. 21(2): 205-215, 2022 (December)

Continuing Medical Education Improves Physician Communication Skills and Increases Likelihood of Pediatric Vaccination: Findings from the Pediatric Influenza Vaccination Optimization Trial (PIVOT)-II.

This study evaluated the impact of a continuing medical education (CME) program that emphasized actionable information, motivation to act, and skills to strengthen physician recommendations for seasonal influenza vaccination in children 6 through 23 months of age for whom influenza immunization rates are suboptimal. Physicians were randomly assigned to an accredited CME program or to no CME. Participants completed pre- and post-study questionnaires. Influenza immunization rates were compared between groups. A total of 33 physicians in the CME group and 35 in the control group documented 292 and 322 healthy baby visits, respectively. Significantly more parents immunized their children against influenza after interacting with CME-trained physicians than those with no CME training (52.9% vs. 40.7%; p = 0.007). The odds ratio for vaccination after visits with CME-trained physicians was 1.52 (95% confidence interval 1.09 to 2.12; p = 0.014), which was unaffected by the socioeconomic status of parents. Parents who discussed influenza vaccination with CME-trained physicians were 20% more likely to choose an approved but publicly unfunded adjuvanted pediatric influenza vaccine. The percentages of physicians reporting the highest levels of knowledge, ability, and confidence doubled or tripled after the CME intervention. Significantly more parents immunized very young children after interacting with physicians who had undergone CME training.

Challenges and opportunities for general practice specific CME in Europe – a narrative review of seven countries

BackgroundSeveral changes have led to general practitioners (GPs) working in a more differentiated setting today and being supported by other health professions. As practice changes, primary care specific continuing medical education (CME) may also need to adapt. By comparing different primary care specific CME approaches for GPs across Europe, we aim at identifying challenges and opportunities for future development.MethodsNarrative review assessing, analysing and comparing CME programs for general practitioners across different north-western European countries (UK, Norway, the Netherlands, Belgium (Flanders), Germany, Switzerland, and France). Templates containing detailed items across seven dimensions of country-specific CME were developed and used. These dimensions are role of primary care within the health system, legal regulations regarding CME, published aims of CME, actual content of CME, operationalisation, funding and sponsorship, and evaluation.ResultsGeneral practice specific CME in the countries under consideration are presented and comparatively analysed based on the dimensions defined in advance. This shows that each of the countries examined has different strengths and weaknesses. A clear pioneer cannot be identified. Nevertheless, numerous impulses for optimising future GP training systems can be derived from the examples presented.ConclusionsIndependent of country specific CME programs several fields of potential action were identified: the development of curriculum objectives for GPs, the promotion of innovative teaching and learning formats, the use of synergies in specialist GP training and CME, the creation of accessible yet comprehensive learning platforms, the establishment of clear rules for sponsorship, the development of new financing models, the promotion of fair competition between CME providers, and scientifically based evaluation.