Effectiveness of continuing medical education.
Effectiveness of continuing medical education.
复制标题
继续医学教育的有效性。
DOI：
--
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
E. Bass
中科院分区：
文献类型：
--
作者：
S. Marinopoulos;T. Dorman;N. Ratanawongsa;L. Wilson;B. Ashar;J. Magaziner;Redonda G. Miller;P. Thomas;G. Prokopowicz;R. Qayyum;E. Bass
目标
OBJECTIVES
Despite the broad range of continuing medical education (CME) offerings aimed at educating practicing physicians through the provision of up-to-date clinical information, physicians commonly overuse, under-use, and misuse therapeutic and diagnostic interventions. It has been suggested that the ineffective nature of CME either accounts for the discrepancy between evidence and practice or at a minimum contributes to this gap. Understanding what CME tools and techniques are most effective in disseminating and retaining medical knowledge is critical to improving CME and thus diminishing the gap between evidence and practice. The purpose of this review was to comprehensively and systematically synthesize evidence regarding the effectiveness of CME and differing instructional designs in terms of knowledge, attitudes, skills, practice behavior, and clinical practice outcomes.
REVIEW METHODS
We formulated specific questions with input from external experts and representatives of the Agency for Healthcare Research and Quality (AHRQ) and the American College of Chest Physicians (ACCP) which nominated this topic. We systematically searched the literature using specific eligibility criteria, hand searching of selected journals, and electronic databases including: MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, The Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Abstracts of Reviews of Effects (DARE), PsycINFO, and the Educational Resource Information Center (ERIC). Two independent reviewers conducted title scans, abstract reviews, and then full article reviews to identify eligible articles. Each eligible article underwent double review for data abstraction and assessment of study quality.
RESULTS
Of the 68,000 citations identified by literature searching, 136 articles and 9 systematic reviews ultimately met our eligibility criteria. The overall quality of the literature was low and consequently firm conclusions were not possible. Despite this, the literature overall supported the concept that CME was effective, at least to some degree, in achieving and maintaining the objectives studied, including knowledge (22 of 28 studies), attitudes (22 of 26), skills (12 of 15), practice behavior (61 of 105), and clinical practice outcomes (14 of 33). Common themes included that live media was more effective than print, multimedia was more effective than single media interventions, and multiple exposures were more effective than a single exposure. The number of articles that addressed internal and/or external characteristics of CME activities was too small and the studies too heterogeneous to determine if any of these are crucial for CME success. Evidence was limited on the reliability and validity of the tools that have been used to assess CME effectiveness. Based on previous reviews, the evidence indicates that simulation methods in medical education are effective in the dissemination of psychomotor and procedural skills.
CONCLUSIONS
Despite the low quality of the evidence, CME appears to be effective at the acquisition and retention of knowledge, attitudes, skills, behaviors and clinical outcomes. More research is needed to determine with any degree of certainty which types of media, techniques, and exposure volumes as well as what internal and external audience characteristics are associated with improvements in outcomes.
登录
查看更多内容
产科护理人员酒精咨询录像培训：一项随机对照试验。
影响因子：
7.2
作者：
Handmaker,NS;Hester,RK;Delaney,HD
通讯作者：
Delaney,HD
影响因子：
120.7
作者：
Wells, KB;Sherbourne, C;Rubenstein, LV
通讯作者：
Rubenstein, LV
基于社区的教学实践中信息寻求行为的变化。
DOI：
--
发表时间：
2004
期刊：
Journal of the Medical Library Association : JMLA.
影响因子：
--
作者：
Byrnes,JenniferA;Kulick,TracyA;Schwartz,DianeG
通讯作者：
Schwartz,DianeG
DOI：
--
发表时间：
1988
期刊：
JAMA
影响因子：
--
作者：
Wilson,DM;Taylor,DW;Gilbert,JR;Best,JA;Lindsay,EA;Willms,DG;Singer,J
通讯作者：
Singer,J
基于互联网的教程在提高初级保健医生的皮肤癌分类技能方面的有效性。
DOI：
10.1080/08858190209528784
发表时间：
2002
期刊：
Journal of cancer education : the official journal of the American Association for Cancer Education.
影响因子：
--
作者：
Gerbert,Barbara;Bronstone,Amy;Maurer,Toby;Berger,Timothy;McPhee,StephenJ;Caspers,Nona
通讯作者：
Caspers,Nona