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Volume 28 (3)
Volume 28, Issue 3, Summer 2008
J Contin Educ Health Prof 2008; 28(3):148
RESEARCH ARTICLE
Barriers to innovation in continuing medical education
Elizabeth A. Bower, Donald E. Girard, Kristen Wessel, Thomas M. Becker, Dongseok Choi
A b s t r a c t
Introduction: Criteria for maintenance of certification (MOC) emphasize the importance of competencies such as
communication, professionalism, systems-based care, and practice performance in addition to medical knowledge.
Success of this new competency paradigm is dependent on physicians’ willingness to engage in activities that
focus on less traditional competencies. We undertook this analysis to determine whether physicians’ preferences
for CME are barriers to participation in innovative programs.
Methods: A geographically stratified, random sample of 755 licensed, practicing physicians in the state of Oregon
were surveyed regarding their preferences for type of CME offering and instructional method and plans to recertify.
Results: Three hundred seventy-six of 755 surveys were returned for 65% margin of error at 95% confidence
level; 91% of respondents were board certified. Traditional types of CME offerings and instructional methods were
preferred by the majority of physicians. Academic physicians were less likely than clinical physicians to prefer
nontraditional types of CME offerings and instructional methods. Multiple regression analyses did not reveal any
significant differences based on demography, practice location, or physician practice type.
Discussion: Physicians who participate in CME select educational opportunities that appeal to them. There is little
attraction to competency-based educational activities despite their requirement for MOC. The apparent disparity
between the instructional methods a learner prefers and those that are the most effective in changing physician
behavior may represent a barrier to participating in more innovative CME offerings and instructional methods.
These findings are important for medical educators and CME program planners developing programs that integrate
studied and effective educational methods into CME programs that are attractive to physicians.
Key Words: participation, continuing medical education, survey barriers, preferences, performance in practice
Lessons for Practice
- Physicians may prefer traditional types of CME activities and traditional, passive methods of instruction.
- Evolving criteria for CME focusing on performance in practice will require nontraditional and innovative methods.
- Physician preferences for traditional CME may represent a barrier to innovation.
- Further research to improve our understanding of what makes certain forms of CME appealing to physicians would facilitate development of activities that are both effective and attractive.
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