de Villiers Marietjie, Bresick Graham, Mash Bob
School of Public and Primary Health Sciences, Faculty of Health Sciences, Stellenbosch University, Tygerberg, South Africa.
Med Educ. 2003 Sep;37(9):815-21. doi: 10.1046/j.1365-2923.2003.01595.x.
A 'competence' model of CPD using facilitated small groups covering a range of clinical topics is an alternative model to lecture-based CPD. The aim of this study was to evaluate a new small group CPD programme and to determine whether the anticipated improvements in the quality of learning were realised.
A nominal group technique (NGT) was used to compile two questionnaires for participants and facilitators, respectively, seeking quantitative and qualitative information. The NGT is an effective tool and particularly useful in developing questionnaires to evaluate an educational intervention.
The results of the participants' survey indicated broad agreement with the NGT responses. For small group participants personal time constraints was the main reason given for not attending. 91% of the respondents indicated that the small group programme improved their knowledge, 73% indicated improvement in their patient care and 61% that their clinical skills had improved. Learning practical skills and the ability to identify and focus on specific learning needs of participants were strengths of the small groups. Participants valued the ability to deal with one theme in-depth over a number of weeks rather than many topics superficially in didactic lectures.
The introduction of the small group CPD enabled an important shift from an update to a competence model of CPD, which has been shown to be more likely to lead to useful change in clinical practice. This approach to CPD should be encouraged. The main challenge for future research in this area is to assess the impact on clinical practice and health outcomes.
使用小组讨论涵盖一系列临床主题的继续职业发展（CPD）“能力”模型是基于讲座的CPD的替代模型。本研究的目的是评估一个新的小组CPD计划，并确定是否实现了预期的学习质量提升。
采用名义小组技术（NGT）分别为参与者和 facilitators 编制两份问卷，以获取定量和定性信息。NGT 是一种有效的工具，在编制用于评估教育干预的问卷时特别有用。
参与者调查结果表明与 NGT 回复广泛一致。对于小组参与者，个人时间限制是未参加的主要原因。91%的受访者表示小组计划提高了他们的知识，73%表示改善了患者护理，61%表示临床技能有所提高。学习实践技能以及识别和关注参与者特定学习需求的能力是小组的优势。参与者重视在数周内深入处理一个主题的能力，而不是在讲授式讲座中肤浅地涉及多个主题。
引入小组CPD实现了从更新模式到能力模式的重要转变，已证明这种模式更有可能在临床实践中带来有益的改变。应鼓励这种CPD方法。该领域未来研究的主要挑战是评估对临床实践和健康结果的影响。
