Schoen Michael J, Tipton Edmond F, Houston Thomas K, Funkhouser Ellen, Levine Deborah A, Estrada Carlos A, Allison Jeroan J, Williams O Dale, Kiefe Catarina I
Division of Continuing Medical Education, University of Alabama at Birmingham, Birmingham, AL 35294-0019, USA.
J Contin Educ Health Prof. 2009 Fall;29(4):246-53. doi: 10.1002/chp.20043.
Physician use of the Internet for practice improvement has increased dramatically over the last decade, but research shows that many physicians choose not to participate. The current study investigated the association of specific physician characteristics with enrollment rates and intensity of participation in a specific Internet-delivered educational intervention to improve care to post-myocardial infarction (MI) patients.
Primary-care physicians were recruited for participation in a randomized controlled trial designed to compare effectiveness of an intervention Web site versus a control Web site in the management of adult chronic disease. Physicians were informed that the intervention focused on ambulatory post-myocardial infarction patients. Physician characteristics were obtained from a commercial vendor with data merged from the American Medical Association and Alabama State Licensing Board. Enrollment and Web use were tracked electronically.
Out of a sample of 1337 eligible physicians, 177 (13.2%) enrolled in the study. Enrollment was higher for physicians with more post-MI patients (> or = 20 vs < 20 patients, 15.3% vs 9.3%, P = .002) and for those practicing in rural compared to urban areas (16.3% vs 12.1%, P = .046). Intensity of use of the Internet courses after initial enrollment was not predicted by physician characteristics in the current sample.
Physicians with more post-MI patients and rural practice location were found to predict enrollment in an Internet-delivered continuing medical education (CME) intervention designed to improve care for post-MI patients. These factors predicted program interest but not program use. More research is needed to replicate these findings to investigate variables that determine physician engagement in Internet CME.
在过去十年中,医生利用互联网改善医疗实践的情况显著增加,但研究表明,许多医生选择不参与。本研究调查了特定医生特征与参与一项通过互联网提供的教育干预措施的注册率及参与强度之间的关联,该干预旨在改善对心肌梗死(MI)后患者的护理。
招募初级保健医生参与一项随机对照试验,该试验旨在比较干预网站与对照网站在成人慢性病管理中的有效性。告知医生该干预针对门诊心肌梗死后患者。医生特征数据来自一家商业供应商,数据合并了美国医学协会和阿拉巴马州执照委员会的信息。通过电子方式跟踪注册情况和网络使用情况。
在1337名符合条件的医生样本中,177名(13.2%)注册参加了研究。有更多心肌梗死后患者的医生(≥20名患者与<20名患者相比,15.3%对9.3%,P = 0.002)以及在农村地区执业的医生与城市地区执业的医生相比(16.3%对12.1%,P = 0.046)注册率更高。在当前样本中,医生特征并未预测初始注册后互联网课程的使用强度。
发现有更多心肌梗死后患者的医生和在农村地区执业的医生更有可能注册参加一项旨在改善对心肌梗死后患者护理的互联网继续医学教育(CME)干预。这些因素预示了对该项目的兴趣,但并非项目使用情况。需要更多研究来重复这些发现,以调查决定医生参与互联网CME的变量。