Moore Donald E, Cervero Ronald M, Fox Robert
Division of Continuing Medical Education, Vanderbilt University School of Medicine, 320 Light Hall, 2215 Garland Avenue, Nashville, TN 37232, USA.
J Contin Educ Health Prof. 2007 Fall;27 Suppl 1:S40-54. doi: 10.1002/chp.134.
The gap between best practices and actual practice in depression care--the difference between "what should be" and "what is"--is wider for ethnic and racial minorities than for the general population. Education alone is not reducing the gap or improving outcomes. Interventions such as the chronic care model have demonstrated improvements in physician performance and patient health status, both in the general population and among ethnic and racial minorities. Recent reviews of continuing medical education (CME) have shown that it is effective when the planned activities include (1) needs assessment and a focus on higher-level outcomes, (2) multiple ongoing activities that are sequenced for learning, (3) planning that considers the context in which the learned principles will be applied, (4) interactivity, and (5) active learning. The authors describe an approach to planning CME reflecting these five factors and suggest that CME planned in this way be combined with the chronic care model to enhance outcomes further.
在抑郁症护理方面，最佳实践与实际操作之间的差距——即“应该是怎样”与“实际是怎样”之间的差异——在少数族裔和种族群体中比在普通人群中更大。仅靠教育并不能缩小这一差距或改善治疗效果。诸如慢性病护理模式等干预措施已证明，在普通人群以及少数族裔和种族群体中，医生的表现和患者的健康状况都有所改善。最近对继续医学教育（CME）的综述表明，当计划开展的活动包括以下内容时，CME是有效的：（1）需求评估并关注更高层次的结果；（2）多个按顺序进行学习的持续活动；（3）考虑所学原则应用背景的规划；（4）互动性；（5）主动学习。作者描述了一种反映这五个因素的CME规划方法，并建议以这种方式规划的CME与慢性病护理模式相结合，以进一步提高治疗效果。
