Wutoh Rita, Boren Suzanne Austin, Balas E Andrew
Howard University College of Pharmacy, Nursing and Allied Health Sciences, Division of Allied Health Sciences, 6th and Bryant Streets, NW, Washington, DC 20059, USA.
J Contin Educ Health Prof. 2004 Winter;24(1):20-30. doi: 10.1002/chp.1340240105.
The objective was to review the effect of Internet-based continuing medical education (CME) interventions on physician performance and health care outcomes.
Data sources included searches of MEDLINE (1966 to January 2004), CINAHL (1982 to December 2003), ACP Journal Club (1991 to July/August 2003), and the Cochrane Database of Systematic Reviews (third quarter, 2003). Studies were included in the analyses if they were randomized controlled trials of Internet-based education in which participants were practicing health care professionals or health professionals in training. CME interventions were categorized according to the nature of the intervention, sample size, and other information about educational content and format.
Sixteen studies met the eligibility criteria. Six studies generated positive changes in participant knowledge over traditional formats; only three studies showed a positive change in practices. The remainder of the studies showed no difference in knowledge levels between Internet-based interventions and traditional formats for CME.
The results demonstrate that Internet-based CME programs are just as effective in imparting knowledge as traditional formats of CME. Little is known as to whether these positive changes in knowledge are translated into changes in practice. Subjective reports of change in physician behavior should be confirmed through chart review or other objective measures. Additional studies need to be performed to assess how long these new learned behaviors could be sustained. eLearning will continue to evolve as new innovations and more interactive modes are incorporated into learning.
目的是回顾基于互联网的继续医学教育(CME)干预对医生绩效和医疗保健结果的影响。
数据来源包括对MEDLINE(1966年至2004年1月)、CINAHL(1982年至2003年12月)、《美国医师协会杂志俱乐部》(1991年至2003年7/8月)以及Cochrane系统评价数据库(2003年第三季度)的检索。如果研究是基于互联网教育的随机对照试验,且参与者为执业医疗保健专业人员或正在接受培训的卫生专业人员,则纳入分析。CME干预根据干预性质、样本量以及其他有关教育内容和形式的信息进行分类。
16项研究符合纳入标准。6项研究表明,与传统形式相比,参与者知识有积极变化;只有3项研究显示实践有积极变化。其余研究表明,基于互联网的干预与传统CME形式在知识水平上没有差异。
结果表明,基于互联网的CME项目在传授知识方面与传统CME形式同样有效。对于这些知识的积极变化是否转化为实践变化,人们知之甚少。医生行为变化的主观报告应通过病历审查或其他客观措施加以证实。需要进行更多研究,以评估这些新习得行为能够持续多久。随着新的创新和更多互动模式融入学习,电子学习将继续发展。