Department of Medicine, University of Wisconsin-Madison, USA.
Adv Health Sci Educ Theory Pract. 2012 Aug;17(3):441-51. doi: 10.1007/s10459-011-9330-3. Epub 2011 Oct 7.
Skepticism exists regarding the role of continuing medical education (CME) in improving physician performance. The harshest criticism has been reserved for didactic CME. Reviews of the scientific literature on the effectiveness of CME conclude that formal or didactic modes of education have little or no impact on clinical practice. This has led some to argue that didactic CME is a highly questionable use of organizational and financial resources, and a cause of lost opportunities for physicians to engage in meaningful learning. The authors' current program of research has forced them to reconsider the received wisdom regarding the relationship between didactic modes of education and learning, and the role frank dissemination can play in bringing about practice change. The authors argued that the practice of assessing and valuing educational methods based only on their capacity to directly influence practice reflects an impoverished understanding of how change in clinical practice actually occurs. Drawing on case studies research, examples were given of the functions didactic CME served in the interest of improved practice. Reasons were then explored as to why the contribution of didactic CME is often missed or dismissed. The goal was not to advocate for a return to the status quo ante where lecture-based education is the dominant modality, but rather to acknowledge both the limits and potential of this longstanding approach to delivering continuing education.
关于继续医学教育（CME）在改善医生绩效方面的作用存在质疑。最严厉的批评是针对讲授式 CME。对 CME 有效性的科学文献综述得出的结论是，正式或讲授式的教育模式对临床实践几乎没有影响或没有影响。这导致一些人认为，讲授式 CME 是对组织和财务资源的高度质疑的使用，也是医生错失参与有意义学习机会的原因。作者目前的研究计划迫使他们重新考虑关于讲授式教育模式与学习之间的关系的既有观点，以及坦诚传播在促成实践变革方面可以发挥的作用。作者认为，仅根据其直接影响实践的能力来评估和评估教育方法的做法反映了对临床实践实际变化方式的理解不足。通过案例研究，举例说明了讲授式 CME 为改进实践所服务的功能。然后探讨了为什么讲授式 CME 的贡献经常被忽视或忽视的原因。目标不是提倡回到以讲座为基础的教育是主要模式的现状，而是承认这种长期以来提供继续教育的方法的局限性和潜力。
