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继续医学教育对实践表现的影响:继续医学教育的有效性:美国胸科医师学会循证教育指南

Continuing medical education effect on practice performance: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines.

作者信息

Davis Dave, Galbraith Robert

机构信息

Association of American Medical Colleges, Washington, DC 20037, USA.

出版信息

Chest. 2009 Mar;135(3 Suppl):42S-48S. doi: 10.1378/chest.08-2517.

Abstract

BACKGROUND

There has been sizable debate and widespread skepticism about the effect of continuing medical education (CME) on the performance of physicians in the practice setting. This portion of the review was undertaken to examine that effect.

METHODS

The guideline panel used data from a comprehensive review of the effectiveness of CME developed by The Johns Hopkins Evidence-based Practice Center, focusing on the effect of CME on clinical performance.

RESULTS

The review found 105 studies, which evaluated the impact of CME on short- and long-term physician practice performance. Nearly 60% met objectives relative to changing clinical performance in prescribing; screening; counseling about smoking cessation, diet, and sexual practices; guideline adherence; and other topics. Single live and multiple media appeared to be generally positive in their effect, print media much less so. Multiple educational techniques were more successful at changing provider performance than single techniques. The amount or frequency of exposure to CME activities appeared to have little effect on behavior change.

CONCLUSIONS

Overall, CME, especially using live or multiple media and multiple educational techniques, is generally effective in changing physician performance. More research, however, is needed that focuses on the specific types of media and educational techniques that lead to the greatest improvements in performance.

摘要

背景

关于继续医学教育(CME)对临床环境中医师表现的影响,一直存在大量争论和广泛质疑。本综述的这一部分旨在研究该影响。

方法

指南小组使用了约翰霍普金斯循证实践中心对CME有效性进行全面综述得出的数据,重点关注CME对临床行为的影响。

结果

该综述发现了105项研究,这些研究评估了CME对医生短期和长期临床实践表现的影响。近60%的研究在改变临床行为方面达到了目标,这些行为包括处方开具、筛查、戒烟、饮食及性行为咨询、指南遵循情况以及其他主题。单次现场教学和多种媒体形式的效果总体上似乎是积极的,印刷媒体的效果则要差得多。多种教育技术在改变医疗服务提供者行为方面比单一技术更成功。接触CME活动的数量或频率似乎对行为改变影响不大。

结论

总体而言,CME,尤其是采用现场教学或多种媒体形式以及多种教育技术时,通常能有效改变医生的行为。然而,还需要更多研究聚焦于能带来最大行为改善的特定媒体类型和教育技术。

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