Brennan Gerard P, Fritz Julie M, Hunter Stephen J
Rehabilitation Agency, Intermountain Health Care, Salt Lake City, Utah 84108, USA.
Phys Ther. 2006 Sep;86(9):1251-62. doi: 10.2522/ptj.20050382.
Physical therapists frequently attend continuing education courses with the goal of providing better care, yet the effectiveness of continuing education for improving outcomes has not been examined.
Data were obtained for all eligible patients (n=1,365; mean age=42.1 years, SD=14.0 years; 69.9% female) with a chief complaint of neck pain who were treated in 13 physical therapy clinics over a 24-month period. Disability data (Neck Disability Index scores) from the initial and final therapy sessions were recorded from clinical databases.
Thirty-four of 57 physical therapists employed within the 13 clinics attended a 2-day continuing education course. Eleven of the 34 attendees also participated in an ongoing clinical improvement project for patients with neck pain. Clinical outcomes were compared in the pre- and post-course periods for therapists attending or not attending the course, and for therapists participating or not participating in the ongoing project.
There were no differences in clinical outcomes based on attendance at the continuing education course. There was an interaction between time and participation in the ongoing project, such that participants achieved greater change in disability after the course. The percentage of patients achieving at least the minimum detectable amount of change in disability with treatment increased significantly for participants after the course.
Attendance at a 2-day continuing education course was not associated with improvement in clinical outcomes, but participation in an ongoing improvement project did result in greater clinical improvement for patients with neck pain. Further investigation of educational methods to improve clinical outcomes is needed. These results suggest that traditional continuing education formats may not be effective for improving patient care.
物理治疗师经常参加继续教育课程,目的是提供更好的护理,但继续教育对改善治疗效果的有效性尚未得到检验。
收集了在24个月内于13家物理治疗诊所接受治疗的所有符合条件的患者(n = 1365;平均年龄 = 42.1岁,标准差 = 14.0岁;69.9%为女性)的数据,这些患者的主要诉求为颈部疼痛。从临床数据库中记录了初始和最终治疗 session 的残疾数据(颈部残疾指数评分)。
13家诊所雇佣的57名物理治疗师中有34人参加了为期2天的继续教育课程。34名参与者中有11人还参与了一项针对颈部疼痛患者的持续临床改善项目。比较了参加或未参加课程的治疗师以及参与或未参与该持续项目的治疗师在课程前后的临床结果。
基于参加继续教育课程与否,临床结果没有差异。时间与参与持续项目之间存在交互作用,因此参与者在课程结束后残疾状况有更大变化。课程结束后,参与者中达到至少最小可检测残疾变化量的患者百分比显著增加。
参加为期2天的继续教育课程与临床结果的改善无关,但参与持续改善项目确实为颈部疼痛患者带来了更大的临床改善。需要进一步研究改善临床结果的教育方法。这些结果表明,传统的继续教育形式可能对改善患者护理无效。