Change through continuing education: an unproven strategy.

Continuing education is the strategy most favoured to ensure professional competence and maintain standards of patient care. This paper questions the effectiveness of current continuing education programs with their emphasis on the structure and process of professional practice. Problems with assessment using course participants' views and the educational content of programs are examined. The assumptions that knowledge is translated into improved performance and that continuing education improves outcomes, notably patient care, are questioned. It is essential that continuing education be evaluated in terms of outcomes. Without a demonstrable improvement in the practical application of skills such programs cannot be viewed as cost effective.