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继续教育会议与研讨会:对专业实践和医疗保健结果的影响

Continuing education meetings and workshops: effects on professional practice and health care outcomes.

作者信息

Thomson O'Brien M A, Freemantle N, Oxman A D, Wolf F, Davis D A, Herrin J

机构信息

School of Rehabilitation Science, McMaster University, Hamilton Regional Cancer Centre, Concession Street, Hamilton, Ontario, Canada, L8V 5C2. maryann.o'

出版信息

Cochrane Database Syst Rev. 2001(2):CD003030. doi: 10.1002/14651858.CD003030.

Abstract

BACKGROUND

Educational meetings and printed educational materials are the two most common types of continuing education for health professionals. An important aim of continuing education is to improve professional practice so that patients can receive improved health care.

OBJECTIVES

To assess the effects of educational meetings on professional practice and health care outcomes.

SEARCH STRATEGY

We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE (from 1966), the Research and Development Resource Base in Continuing Medical Education in January 1999 and reference lists of articles.

SELECTION CRITERIA

Randomised trials or well designed quasi-experimental studies examining the effect of continuing education meetings (including lectures, workshops, and courses) on the clinical practice of health professionals or health care outcomes.

DATA COLLECTION AND ANALYSIS

Two reviewers independently applied inclusion criteria, assessed the quality of each study, and extracted study data. We attempted to collect missing data from investigators. We conducted both qualitative and quantitative analyses.

MAIN RESULTS

Thirty-two studies were included with a total of 36 comparisons. The studies involved from 13 to 411 health professionals (total N= 2995) and were judged to be of moderate or high quality, although methods were generally poorly reported. There was substantial variation in the complexity of the targeted behaviours, baseline compliance, the characteristics of the interventions and the results. The heterogeneity of the results was best explained by differences in the interventions. For 10 comparisons of interactive workshops, there were moderate or moderately large effects in six (all of which were statistically significant) and small effects in four (one of which was statistically significant). For interventions that combined workshops and didactic presentations, there were moderate or moderately large effects in 12 comparisons (eleven of which were statistically significant) and small effects in seven comparisons (one of which was statistically significant). In seven comparisons of didactic presentations, there were no statistically significant effects, with the exception of one out of four outcome measures in one study.

REVIEWER'S CONCLUSIONS: Interactive workshops can result in moderately large changes in professional practice. Didactic sessions alone are unlikely to change professional practice.

摘要

背景

教育会议和印刷教育材料是卫生专业人员继续教育最常见的两种形式。继续教育的一个重要目标是改善专业实践,以便患者能够获得更好的医疗保健。

目的

评估教育会议对专业实践和医疗保健结果的影响。

检索策略

我们检索了Cochrane有效实践与护理组织小组专门注册库、MEDLINE(始于1966年)、1999年1月的继续医学教育研究与发展资源库以及文章的参考文献列表。

选择标准

随机试验或设计良好的准实验研究,考察继续教育会议(包括讲座、研讨会和课程)对卫生专业人员临床实践或医疗保健结果的影响。

数据收集与分析

两名评价员独立应用纳入标准,评估每项研究的质量,并提取研究数据。我们试图从研究者处收集缺失数据。我们进行了定性和定量分析。

主要结果

纳入32项研究,共36项比较。这些研究涉及13至411名卫生专业人员(总数N = 2995),尽管方法报告总体较差,但被判定为中等或高质量。目标行为的复杂性(、基线依从性、干预措施的特征和结果存在很大差异。结果的异质性最好用干预措施的差异来解释。对于10项互动研讨会的比较,6项有中等或中等偏大的效果(所有这些在统计学上均有显著意义),4项有小效果(其中1项在统计学上有显著意义)。对于结合研讨会和讲授式报告的干预措施,12项比较中有中等或中等偏大的效果(其中11项在统计学上有显著意义),7项比较中有小效果(其中1项在统计学上有显著意义)。在7项讲授式报告的比较中,除一项研究中的四项结果指标之一外,没有统计学上的显著效果。

评价员结论

互动研讨会可导致专业实践产生中等偏大的变化。仅讲授式课程不太可能改变专业实践。

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