Interactive Continuing Medical Education Research Articles

Identifying and Addressing Knowledge and Confidence Gaps Regarding the Management of Patients with Sickle Cell Disease Via Engaging Continuing Medical Education

Introduction: While there have been recent advances in therapeutic options for the management of patients with sickle cells disease (SCD), hematology providers remain challenged by how to deliver an individualized approach to care, negatively impacting patient outcomes. To address this practice gap and identify drivers that underlie persisting challenges, an interactive continuing medical education (CME) activity was developed and implemented. Methods: Vindico Medical Education provided an interactive web-based CME activity on CME.Healio.com that was available for credit for one year starting August 31, 2022. The activity included opportunities for interaction with the content to encourage engagement, transfer knowledge, improve confidence, and encourage appropriate practice patterns. Impact of education was measured by comparing paired pre- and post-test responses. Results: As of July 2023, 221 hematology/oncology providers, including 116 MDs and advanced practice providers (APPs) and 105 nurses, who each see an average of 4 patients with SCD per month participated in the education. At baseline, scores on questions related to the latest evidence regarding new SCD therapies were low in both professional cohorts - an average 30% for MD/APPs and 16% for nurses. Moreover, 95% of HCPs in both cohorts lacked confidence in their knowledge of these agents and their appropriate use. This lack of knowledge and confidence translated into practice gaps. Specifically, 48% of those involved in treatment decisions indicated in the pre-test that they had never used a newer option for SCD management, and only 17% reported that they always consider the latest evidence when individualizing treatment for patients. On a post-test, however, the MD/APP and nurse cohorts scored an average of 81% and 84%, respectively, indicative of a robust impact of the education on clinician knowledge. Similarly, there was a 41% absolute increase in clinician confidence in understanding the latest evidence. These gains in knowledge and confidence translated into post-education planned practice improvements, with completers 22% more likely to apply this knowledge to clinical decision-making. Conclusion: Hematology/oncology providers lack knowledge and confidence regarding the latest evidence in SCD treatment. While the use of interactive CME led to robust gains in knowledge and confidence, follow-up case-based education is needed to facilitate the application of knowledge to practice while continuing to improve clinician confidence.

Engaging Continuing Medical Education Reveals Persisting Knowledge and Practice Gaps in FLT3-Positve AML

Introduction: Given the rapid evolution of testing and treatment of FMS-like tyrosine kinase 3 (FLT3)-positive AML, oncology providers are challenged by how to administer the latest evidence-based care. Additionally, while the use of patient-reported outcomes (PROs) can improve patient care, they are underutilized in oncology practice An interactive continuing medical education (CME) activity was provided to assess baseline attitudes and practice patterns while also addressing identified gaps in knowledge and skills regarding the management of patients with FLT3-positive AML. Methods: Vindico Medical Education provided a web-based CME activity available on myCME.com and for credit from December 31, 2021 to December 30, 2022. The activity included opportunities for interaction with the content to encourage engagement, transfer knowledge, improve confidence, and assess current practice patterns. Impact of education was measured by comparing paired pre- and post-test responses. Results: As of July 2022, 216 hematology/oncology providers who each see an average of 8 patients with AML per month participated in the education. These providers scored an average 26% on a pretest for topics related to the evaluation of patients with AML the impact of FLT3 mutations on prognosis and management, and the use of PROs in practice. Post-learning, providers scored 49%, highlighting the impact of the education on knowledge gaps, but also demonstrating persisting gaps. Specifically, post-test scores remained lowest regarding the implications of FLT3 mutations on patient outcomes and treatment strategies for these patients. Notably, while 65% of these providers indicated that they were guessing on the pre-test, the percentage of those who were confident and correct on the post-test rose from 1% to 18%, demonstrating a sharp rise in confidence. However, these persisting knowledge and confidence gaps translated to practice gaps - only 40% currently report performing mutational analysis at relapse for patients with AML. Moreover, only 51% were familiar with FLT3 MRD testing and providers lacked consensus regarding first- and subsequent-line treatment for FLT3-positive patients. Forty-seven percent noted an uncertainty regarding optimal combinations and sequencing as the primary challenge they face when selecting treatment for these patients. While knowledge and confidence scores regarding the use of PROs were high, only 16% always use PROs in practice, with patient non-compliance as the biggest barrier to implementation. Conclusion: Hematology/oncology providers lack knowledge and confidence regarding testing and management of patients with FLT3-positive AML, which translates to practice gaps. While the use of interactive CME led to robust gains in knowledge and confidence, further education is needed to address persisting gaps regarding testing and management of patients with FLT3-positive AML. Moreover, skills-based training and patient resources are needed to facilitate the use of PROs in clinical practice.

E-Cigarettes: Harmful or Harm-Reducing? Evaluation of a Novel Online CME Program for Health Care Providers.

Patients are asking health care providers about e-cigarettes, vaping, and other electronic nicotine delivery systems (ENDS). Provider advice on ENDS has varied greatly, suggesting a need for evidence-based continuing medical education (CME). A novel free online CME course was developed on ENDS risks and benefits, product types (e.g., vape pens, pods), and screening and counseling best practices for adults, adolescents, and different smoker profiles (e.g., daily, social). From January 2017 through June 2018, 1061 individuals accessed the course: 46% physicians, 7% physician assistants, 7% nurse practitioners, 15% nurses, 4% pharmacists, and 28% allied health/student/other; 41% were international. The course was built from observed online patient-provider interactions. Through video role-plays, expert interviews, and interactive activities, the course engaged learners in the evidence on ENDS. Completers earned 1.5 CME units. A total of 555 health care providers earned 832.5 CME units. Pre- to post-test scores significantly increased from 57 to 90%; 76% rated the course as above average (41%) or outstanding (35%); 99% indicated the course was free of commercial bias. Addressing the growing need for balanced provider education on ENDS, this interactive online CME engaged learners and increased knowledge on devices and evidence-based cessation approaches.

Interessenkonflikte in der ärztlichen Fortbildung – Untersuchungen an zertifizierten Online-Fortbildungsangeboten

ObjectivesAlthough the problem of conflict of interest in medical education is discussed intensively, few valid data have been published on how to deal with the form, content, funding, sponsorship, and the influence of economic interests in continuing medical education (CME). Against this background, we carried out an analysis of data which had been documented for the purpose of certification by a German Medical Association. A central aim of the study was to obtain evidence of possible influences of economic interests on continuing medical education. Furthermore, strategies for quality assurance of CME contents and their implementation were to be examined. MethodsWe analyzed all registration data for courses certified in the category D (“structured interactive CME via print media, online media and audiovisual media”) by the Bavarian Chamber of Physicians in 2012. To measure the effects of conflict of interest, relationships between topics of training and variables relating to the alleged self-interest of the organizer/sponsor (for example, drug sales in a group of physicians) were statistically verified. These data were taken from the Bavarian Medical Statistics 2012 and the GKV-Arzneimittelschnellinformation. ResultsIn 2012, a total of 734 CME course offerings have been submitted for 51 medical specialties by 30 course suppliers in the Bavarian Medical Association. To ensure the neutrality of interests of the CME courses the course suppliers signed a cooperation treaty ensuring their compliance with defined behavior towards the Bavarian Medical Association concerning sponsorship. The correlation between course topics and drug data suggests that course suppliers tend to submit topics that are economically attractive to them. There was a significant correlation between the number of CME courses in a specific field and the sales from drug prescriptions issued by physicians in the respective field. ConclusionsThe results show that neutrality of interests regarding continuing medical education is difficult to achieve under the current framework for the organization, certification, and especially the funding of CME events in Germany. The cooperation agreement between the Bavarian Medical Association and training applicants is taken as an example of how legal certainty can be ensured. Based on the findings described below, suggestions and strategies to strengthen assessment expertise of course participants have been developed and elaborated.

Handing over and letting go: using online continuing medical education in teaching and assessing medical English language and communication skills to undergraduates

AbstractIn the last few decades the medical community has increasingly underlined the necessity for medical students and healthcare professionals to acquire adequate and patient-friendly medical language and communication skills. Although teachers of foreign languages for medical purposes are usually not medically trained, their learners present them with very specific content and communication needs. Medical undergraduates who have entered the clinical phase of their programme are particularly keen to remain within the boundaries of their newly acquired expertise. Teachers of English for Medical Purposes easily recognize their need to deepen and broaden their medical knowledge, and needs-responsive teaching in this context therefore often involves specific materials development. Although implementing material from continuing medical education (CME) may seem a bridge too far at first sight, careful selection of content geared to students’ medical knowledge at a particular stage in their clinical study programme avoids overstepping the mark. Well-chosen online interactive CME materials engage the students in authentic language in a context they immediately recognize as typical of their future workplace. The learners in the course described in this article are medical undergraduates in their fifth year who need to attend the course to prepare them for a clinical placement in an English-speaking environment abroad. The article describes how CME materials have become part of teaching practice and oral assessment in a two-semester course of medical English organized on behalf of the Faculty of Medicine at the University of Leuven in the Dutch-speaking part of Belgium.

The Influence of a Continuing Medical Education Campaign on New Strategies to Improve Appropriate Use of Antibiotics

Introduction. Widespread use of antibiotics has led to drug-resistant bacteria and reports of drug-resistant infections. A continuing medical education (CME) campaign was used to improve antibiotic use among primary care providers. Methods. The Office of CME and Professional Development at the University of Colorado School of Medicine produces a semiannual, week-long course for primary care providers. A 2-year multifaceted CME campaign consisted of course content on antibiotic use, a practice audit, and two surveys to measure perceptions of the problem of antibiotic overuse, potential barriers to achieving appropriate use, and strategies to overcome barriers. Results. The overall response rate in the 2nd part of the campaign was 68.4%. Sixty-six percent of respondents had implemented at least one strategy to reduce antibiotic overuse. The rate was significantly higher among those who had attended previous reviews (81.0%) compared with those who had attended neither (54%, p=0.0002). However, there was no “dose effect” on the rate of implementing a new strategy. Conclusions. Overuse of antibiotic therapy has important public health implications. Results suggest that mixed interactive and didactic CME program was effective in increasing awareness of antibiotic overuse and strategies for reducing antibiotic administration.

The Albany Two-Way Radio Conferences, 1955–1981: A Retrospective Look at a Program Providing Interactive Continuing Medical Education at a Distance

Despite early widespread recognition of the necessity of continuing medical education (CME) for practicing physicians and surgeons, medical schools and national medical organizations were slow to mobilize to address the need. One pioneering program, developed by the Albany Medical College in New York, not only provided CME, but did so in a live distance education format that allowed for interaction between the participants and the faculty presenters. The Albany Program commenced in 1955 using what was then state-of-the-art technology; it exemplified principles and practices that can be seen as the precursors for the distance education approaches used to reach physicians today. This short article describes the contributions of the Albany Two-Way Radio Conferences and places them in the context of developments in national organizations and policies in the 20th century.

Development and evaluation of a web-based breast cancer cultural competency course for primary healthcare providers.

BackgroundTo develop and evaluate a continuing medical education (CME) course aimed at improving healthcare provider knowledge about breast cancer health disparities and the importance of cross-cultural communication in provider-patient interactions about breast cancer screening.MethodsAn interactive web-based CME course was developed and contained information about breast cancer disparities, the role of culture in healthcare decision making, and demonstrated a model of cross-cultural communication. A single group pre-/post-test design was used to assess knowledge changes. Data on user satisfaction was also collected.ResultsIn all, 132 participants registered for the CME with 103 completing both assessments. Differences between pre-/post-test show a significant increase in knowledge (70% vs. 94%; p < .001). Ninety-five percent of participants agreed that the web based training was an appropriate tool to train healthcare providers about cultural competency and health disparities.ConclusionThere was an overall high level of satisfaction among all users. Users felt that learning objectives were met and the web-based format was appropriate and easy to use and suggests that web-based CME formats are an appropriate tool to teach cultural competency skills. However, more information is needed to understand how the CME impacted practice behaviors.

Highly Interactive Multi‐Session Programs Impact Physician Behavior on Hypertension Management: Outcomes of a New CME Model

There has been much discussion and study about the role of continuing medical education (CME) in improving patient care. The authors describe the processes used to develop and implement a series of live, half-day, highly interactive CME events that addressed knowledge, competency, and performance gaps in hypertension diagnosis and management in the primary care community and successfully changed physician behavior toward improved patient outcomes. Participation in an intensive, highly interactive, case-based didactic program was significantly associated with an increase in clinician knowledge and competency in diagnosing and managing patients with hypertension. Participation was also associated with a high likelihood for practice change and making guideline-driven and evidence-based decisions to positively impact patient care. A greater portion of participants were able to identify the appropriate blood pressure goal and select the most appropriate pharmacotherapy regimen for specific patients. Quality of education index indicated that participants were 52% more likely to practice guideline-driven and evidence-based medicine than those who did not participate in the CME activity.

Absolute Cardiovascular Disease Risk and Shared Decision Making in Primary Care: A Randomized Controlled Trial

We wanted to determine the effect of promoting the effective communication of absolute cardiovascular disease (CVD) risk and shared decision making through disseminating a simple decision aid for use in family practice consultations. The study was based on a pragmatic, cluster randomized controlled trial (phase III) with continuing medical education (CME) groups of family physicians as the unit of randomization. In the intervention arm, 44 physicians (7 CME groups) consecutively recruited 550 patients in whom cholesterol levels were measured. Forty-seven physicians in the control arm (7 CME groups) similarly included 582 patients. Four hundred sixty patients (83.6%) of the intervention arm and 466 patients (80.1%) of the control arm were seen at follow-up. Physicians attended 2 interactive CME sessions and received a booklet, a paper-based risk calculator, and individual summary sheets for each patient. Control physicians attended 1 CME-session on an alternative topic. Main outcome measures were patient satisfaction and participation after the index consultation, change in CVD risk status, and decisional regret at 6 months' follow-up. Intervention patients were significantly more satisfied with process and result (Patient Participation Scale, difference 0.80, P<.001). Decisional regret was significantly lower at follow-up (difference 3.39, P = .02). CVD risk decreased in both groups without a significant difference between study arms. A simple transactional decision aid based on calculating absolute individual CVD risk and promoting shared decision making in CVD prevention can be disseminated through CME groups and may lead to higher patient satisfaction and involvement and less decisional regret, without negatively affecting global CVD risk.

Team- and case-based learning to activate participants and enhance knowledge: An evaluation of seminars in Germany

There is a strong need for high-quality continuing medical education (CME) in Germany. To maintain a medical license, physicians are required to participate in regular training. Although evidence suggests that compared to lectures interactive methods can impart sustainable knowledge and a high degree of satisfaction, few interactive CME courses are offered. We designed an interactive, team-based CME concept and launched it in a series of seminars on internal medicine. The group work was designed using team-based learning. Pre- and postcourse knowledge tests with an electronic voting system and paper questionnaires (Likert scale 1-6) were used to evaluate knowledge, motivation, and expectations of the participants (n = 159). Participants rated the interactivity and team-based discussion (mean: 4.57, SD: 1.41) of the CME seminars as highly important reasons to participate and stated that the CME course was very instructional (mean: 5.16, SD: 0.84) and the case discussions enhanced their learning (mean: 5.46, SD: 0.75). The majority of participants stated that their expectations were met. The participants enhanced their outcome from a mean of 47.2% right answers prior to the course to 70.3% in the postcourse test ( p < 0.001). An interactive, case-based design of a CME course following the team-based learning concept leads to a significant gain in the participants' knowledge with an identified preknowledge level. Participants' expectations seemed fulfilled by a CME course design, which combines small group discussions in the lecture hall with didactic lectures and intensive discussion.

An E-learning Platform for Guideline Implementation

Effective knowledge translation in medicine is an essential element of a modern health care system. Evidence-based clinical practice guidelines (CPGs) are considered relevant instruments for the transfer of knowledge into clinical practice. To improve this transfer we have created Internet-based continuing medical education (CME) modules and online case-based learning objects. Building upon existing CPGs, an e-learning platform including a multi-step review process was developed to generate CME modules. These CME modules were presented through a modified content management system (CMS) that fulfils specific requirements of CME. An online questionnaire using a four-point Likert scale was designed to receive mandatory feedback from participating physicians. In the second step of development, case-based learning objects were added to the CMS. Existing clinical practice guidelines allowed a rapid development of CME modules specific to individual clinical indications. The modified CMS proved to be technically stable but also resource-intensive. 3105 physicians registered and used the platform between June 2003 and April 2005. 95% of the physicians expressed positive feedback in an evaluation questionnaire; only 35% of physicians actually used the corresponding CPGs in practice. Suggestions from the CME users led to the development of interactive medical case-based learning objects related to the main topics of the CPGs. To support the implementation of CPGs, an Internet platform for CME including case-based learning objects and examination tests was developed. An interactive online CME platform can support active learning and may establish an additional stimulus for knowledge translation into daily medical practice.

Performance analysis of interactive multimodal CME retraining on attitude toward and application of OPCAB

The transfer of tacit and codified knowledge on a surgical technique is studied in a consecutive cohort of teams participating in interactive multimodal continuing medical education (CME) retraining in off-pump coronary artery bypass (OPCAB). Fifty teams of 1.3 +/- 0.5 surgeons and 1.1 +/- 1.9 anesthetists visited 2.2 +/- 0.7 days. Variables describe the pre-visit cardiac activity and OPCAB attitude, complexity score (10 frequently cited complexity criteria), application, and conversion rate. The multimodal approach to knowledge transfer included interactive discussions (commitment; resistances; levers and process of change; methods; outcome; resource optimization), active participation in 3.8 +/- 1.3 unselected cases (anchor-stitch, enucleation techniques), low-fidelity bench model (shunt placement, anastomotic technique), and CD-ROM. Exit end points included OPCAB attitude and complexity score. Late end points (3 months) included OPCAB attitude, complexity score, and application rate. OPCAB was considered, upon exit, beneficial for all patients by 90% of the teams (versus 29 % pre-visit), but by only 62 % of the teams at 3 months. The complexity score downgraded at exit from 3.6 +/- 2 (pre-visit) to 1.2 +/- 1 (P <.001) but increased again at 3 months to 1.6 +/- 1 (P =.001 versus pre-visit and P =.001 versus exit). The 3-month OPCAB rate of the surgeons was 49% +/- 32% versus 23% +/- 28% pre-visit (P <.0001). This was influenced by the pre-visit OPCAB rate and education, as well as by the post-visit changes in complexity scores and attitude. The conversion rate toward cardiopulmonary bypass improved from 3.5% +/- 5% (pre-visit) to 1.3% +/- 3% (3 months, P =.006). The multimodal OPCAB re-training resulted in a substantial increase of the application, concomitant with a decrease in conversion. The positive impact on attitude and complexity score, at exit, was somewhat reduced in the following clinical confrontation.

Exploring educational needs of multiple sclerosis care providers: Results of a care-provider survey

Our objective was to survey experienced multiple sclerosis (MS) care providers, determine their ongoing professional educational needs, and develop future education programs. We asked providers across a variety of disciplines to identify the areas in which clinical consultation and continuing medical education (CME) would most improve their ability to provide care to individuals with MS; their preferred education modalities; and their confidence in providing care related to disease-modifying agents (DMAs), fatigue, depression, spasticity, and bladder management. At a national meeting of MS professionals, 152 MS care providers completed a self-report survey that was designed for this cross-sectional cohort study. Areas of greatest interest for clinical consultation and CME were identical and included cognition, fatigue, DMA use, spasticity, pain, sex, diagnosis of MS, and depression. Participants expressed a preference for live and interactive CME modalities. Confidence in providing specific disease-related care sometimes differed between Veterans Health Administration (VHA) and non-VHA providers. The results indicate that clinical consultations and CME should be targeted to the topics of greatest interest identified by providers and delivered in a live or interactive modality whenever possible.

Comparison of the Instructional Efficacy of Internet-Based CME With Live Interactive CME Workshops

Despite evidence that a variety of continuing medical education (CME) techniques can foster physician behavioral change, there have been no randomized trials comparing performance outcomes for physicians participating in Internet-based CME with physicians participating in a live CME intervention using approaches documented to be effective. To determine if Internet-based CME can produce changes comparable to those produced via live, small-group, interactive CME with respect to physician knowledge and behaviors that have an impact on patient care. Randomized controlled trial conducted from August 2001 to July 2002. Participants were 97 primary care physicians drawn from 21 practice sites in Houston, Tex, including 7 community health centers and 14 private group practices. A control group of 18 physicians from these same sites received no intervention. Physicians were randomly assigned to an Internet-based CME intervention that could be completed in multiple sessions over 2 weeks, or to a single live, small-group, interactive CME workshop. Both incorporated similar multifaceted instructional approaches demonstrated to be effective in live settings. Content was based on the National Institutes of Health National Cholesterol Education Program--Adult Treatment Panel III guidelines. Knowledge was assessed immediately before the intervention, immediately after the intervention, and 12 weeks later. The percentage of high-risk patients who had appropriate lipid panel screening and pharmacotherapeutic treatment according to guidelines was documented with chart audits conducted over a 5-month period before intervention and a 5-month period after intervention. Both interventions produced similar and significant immediate and 12-week knowledge gains, representing large increases in percentage of items correct (pretest to posttest: 31.0% [95% confidence interval {CI}, 27.0%-35.0%]; pretest to 12 weeks: 36.4% [95% CI, 32.2%-40.6%]; P<.001 for all comparisons). Chart audits revealed high baseline screening rates in all study groups (> or =93%) with no significant postintervention change. However, the Internet-based intervention was associated with a significant increase in the percentage of high-risk patients treated with pharmacotherapeutics according to guidelines (preintervention, 85.3%; postintervention, 90.3%; P = .04). Appropriately designed, evidence-based online CME can produce objectively measured changes in behavior as well as sustained gains in knowledge that are comparable or superior to those realized from effective live activities.

Interactive on-line continuing medical education: Physicians' perceptions and experiences

Although research in continuing medical education (CME) demonstrates positive outcomes of on-line CME programs, the effectiveness of and learners' satisfaction with interpersonal interaction in on-line CME are lower Defined as faculty-learner or learner-learner interpersonal interaction, this study explores physicians' perceptions of and experiences in interactive on-line CME and factors influencing these. Focus groups and interviews were undertaken by three Canadian universities. Using purposive sampling, we recruited physicians based on their experiences with interactive on-line CME. Content analysis was applied first, followed by a comparative analysis to confirm themes and findings. Physicians based their perceptions of interactive on-line CME by comparing it with what they know best, face-to-face CME. Although perceptions about access and technical competency remained important, two other themes emerged. The first was the capacity of on-line CME to meet individual learning preferences, which, in turn, was influenced by the quality of the program, the degree of self-pacing or self-direction, opportunity for reflection, and educational design. The second was the quality and quantity of interpersonal interaction, which was shaped by perceptions of social comfort, the educational value of interactions, and the role of the facilitator. Prior experience with on-line CME moderated perceptions. The extent that on-line CME programs reflected characteristics of high-quality CME and individual learning preferences appeared to shape perceptions about it. It is important to incorporate the characteristics of effective CME into the design and implementation of interactive on-line programs, considering diverse learning preferences, providing faculty development for on-line facilitators, and grounding this work in learning theory.

Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes?

Although physicians report spending a considerable amount of time in continuing medical education (CME) activities, studies have shown a sizable difference between real and ideal performance, suggesting a lack of effect of formal CME. To review, collate, and interpret the effect of formal CME interventions on physician performance and health care outcomes. Sources included searches of the complete Research and Development Resource Base in Continuing Medical Education and the Specialised Register of the Cochrane Effective Practice and Organisation of Care Group, supplemented by searches of MEDLINE from 1993 to January 1999. Studies were included in the analyses if they were randomized controlled trials of formal didactic and/or interactive CME interventions (conferences, courses, rounds, meetings, symposia, lectures, and other formats) in which at least 50% of the participants were practicing physicians. Fourteen of 64 studies identified met these criteria and were included in the analyses. Articles were reviewed independently by 3 of the authors. Determinations were made about the nature of the CME intervention (didactic, interactive, or mixed), its occurrence as a 1-time or sequenced event, and other information about its educational content and format. Two of 3 reviewers independently applied all inclusion/exclusion criteria. Data were then subjected to meta-analytic techniques. The 14 studies generated 17 interventions fitting our criteria. Nine generated positive changes in professional practice, and 3 of 4 interventions altered health care outcomes in 1 or more measures. In 7 studies, sufficient data were available for effect sizes to be calculated; overall, no significant effect of these educational methods was detected (standardized effect size, 0.34; 95% confidence interval [CI], -0.22 to 0.97). However, interactive and mixed educational sessions were associated with a significant effect on practice (standardized effect size, 0.67; 95% CI, 0.01-1.45). Our data show some evidence that interactive CME sessions that enhance participant activity and provide the opportunity to practice skills can effect change in professional practice and, on occasion, health care outcomes. Based on a small number of well-conducted trials, didactic sessions do not appear to be effective in changing physician performance.

Editor's Page

Editor's Page

Workshop versus lecture in CME: Does physician learning method preference make a difference?

Is learning enhanced when the continuing medical education (CME) intervention corresponds to the physician's preferred learning method? Eighty-eight primary care community-based physicians were involved in this study. Each physician attended one of three 2-day CME programs based on a needs assessment of community-based primary care physicians. Each program consisted of both plenary lectures and workshops. Learning method preference and demographic profile were captured by an individual electronic touch pad that allowed each physician's responses to be uniquely identified by the system. A pre- and posttest for each workshop and each lecture was carried out. Responses were noted via touch pad. Mean test score improvement occurred for each intervention and was statistically significant for 12 of 14 interventions. Mean test score improvements for workshops and for lectures were not different. Mean test score improvements were not affected by physician learning method preference. These results are not explained by gender, year of graduation, or rural/urban differences of physicians. Contrary to our hypothesis, our data suggest that physicians do not necessarily learn more when the type of CME intervention is concordant with their preferred learning methods. Further, workshops, small groups, and other interactive CME activities may not always be more effective than didactic methods such as lectures. Further study is warranted. In the meantime, it may be more efficient for CME teachers and providers to use methods with which they are comfortable or that they consider more appropriate to the content.