Journal of Continuing Education in the Health Professions



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CURRENT ISSUE BACK ISSUES SUBSCRIBE ADVERTISE ABOUT JCEHP FOR AUTHORS JCEHP AWARD SEARCH (Members only) FULL-TEXT		Volume 22 (4) Volume 22, Issue 4, Fall 2002 J Contin Educ Health Prof 2002; 22(4):214-221 ORIGINAL ARTICLES Randomized controlled trials of continuing medical education: what makes them most effective? Cauffman JG Forsyth RA Clark VA Foster JP Martin KJ Lapsys FX Davis DA A b s t r a c t INTRODUCTION: It is essential that professional standards of excellence are demonstrated in the continuing medical education (CME) curriculum and research. METHODS: This review examines 20 randomized controlled trial (RCT) studies in CME and their effect on physician performance and/or patient health care outcomes. A systematic evaluation of the 20 RCT articles was performed. The investigators of the trials were interviewed using a standardized interview schedule. Citations from science and social science publications were compiled to obtain an unobtrusive measure of the influence of the trials. RESULTS: Investigators were most often motivated to build on earlier research of others, their own earlier research, or a combination of others' earlier research and their own. The most effective educational strategies used multiple interventions, two-way communications, printed and graphic materials in person, and locally respected health personnel as educators. Statistically significant findings more often related to physician performance than to patient health care outcomes. The most effective studies were the ones in which the educational methods were cost effective, findings could be generalized to other physician groups, the studies were implemented elsewhere in multisite health care and health-related programs and had the most citations. Investigators interviewed about their RCTs provided advice for future directions of CME curriculum development and research. DISCUSSION: CME program directors should determine what physicians need to learn, should reach out to nonparticipating physicians, and should focus on relevant problem areas. These problem areas should be ones in which it is possible to make changes, particularly in patient health care outcomes. Lessons for Practice Medical educators must take advantage of multiple communication tools such as the Internet, special programs available on compact discs or DVDs, two-way communications in small groups, and use of locally respected health professionals. Medical education researchers should use both qualitative and quantitative indicators to study outcomes. New insights may be gained from structured interviews with investigators who conduct randomized controlled trials, and this topic of research should be continued. MeSH Terms: Curriculum; Education, Medical, Continuing; Family Practice; Physician's Practice Patterns; Program Evaluation; Randomized Controlled Trials; Support, Non-U.S. Gov't Publication Type: Review
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