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 24 (4) Volume 24, Issue 4, Fall 2004 J Contin Educ Health Prof 2004; 24(4):237-243 ORIGINAL RESEARCH Randomized trial of problem-based versus didactic seminars for disseminating evidence-based guidelines on asthma management to primary care physicians White M Michaud G Pachev G Lirenman D Kolenc A FitzGerald JM A b s t r a c t Introduction: This randomized controlled trial (RCT) investigated the effectiveness of and satisfaction with small-group problem-based learning (PBL) versus a didactic lecture approach to guideline dissemination in asthma management controlling for confounders common in comparative educational interventions. Methods: Sites were selected as either lecture or PBL using simple randomization. All participants were exposed to similar educational resources to ensure treatment equivalency. Instruments included standardized program/speaker evaluation forms and a validated case-based questionnaire with a visual analogue scale measuring the level of confidence of responses. The latter was presented immediately pre- and post-intervention and 3 months later. The statistician was blinded to intervention groups. Results: Overall, 52 family physicians agreed to participate, 23 in PBL sessions (mean 4.6 per group) and 29 in the didactic lecture sessions (mean 7.25). There was no significant difference between the groups with respect to the knowledge gained at each test administration. Participants rated the lecturer or facilitator equally well as having established a positive learning environment. PBL participants rated the perceived educational value of the program higher than did lecture participants (4.36 vs. 3.9.; p = .04). Both groups experienced a significant increase in asthma-related knowledge post-intervention. Attrition rates for the 3-month post-test were 14% for PBL participants versus 32% for lecture-based participants. Discussion: PBL was as effective in knowledge uptake and retention as lecture-based continuing medical education (CME) programs. Further study is warranted to investigate whether the assessment of higher educational value or an increase in response rate to delayed testing is replicable in other RCT's addressing common confounders and if these factors influence future CME participation, changes in physician clinical behavior, or patient health outcomes. Lessons for Practice Problem-based learning (PBL) can be as effective as lecture-based CME programs in promoting knowledge gain and retention Researchers planning comparative educational studies can reduce potential confounders, such as time on the task, the quality and content of the presentation, and planned versus actual treatment, using systematic and transparent methods. It is important to determine whether a significant difference in response rates at 3 months suggests that PBL fosters higher instrinsic motivation and commitment to engage in further learning or is an artifact of this study. A common databank from studies investigating PBL versus other educational treatments may improve the limitations of sample size inherent with small-group studies and facilitate common methodologies to enhance systematic reviews and meta-analyses. Publication Type: Randomized Controlled Trial; Clinical Trial MeSH Terms: Asthma; Clinical Competence; Education, Medical, Continuing; Family Practice; Health Knowledge, Attitudes, Practice; Information Dissemination; Practice Guidelines; Primary Health Care; Problem-Based Learning; Program Evaluation; Questionnaires; Time Factors
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