Bjerre Lise M, Paterson Nicholas R, McGowan Jessie, Hogg William, Campbell Craig M, Viner Gary, Archibald Douglas
Department of Family Medicine, University of Ottawa, Ottawa, Canada;; C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa, Canada;; Department of Epidemiology and Community Medicine, University of Ottawa, Canada;.
J Contin Educ Health Prof. 2013 Fall;33(4):224-34. doi: 10.1002/chp.21191.
Assessing physician needs to develop continuing medical education (CME) activities is an integral part of CME curriculum development. The purpose of the present study was to demonstrate the feasibility of identifying areas of perceived greatest needs for continuing medical education (CME) by using questions collected electronically at the point of care.
This study is a secondary analysis of the "Just-in-Time" (JIT) information librarian consultation service database of questions using quantitative content analysis methods. The original JIT project demonstrated the feasibility of a real-time librarian service for answering questions asked by primary care clinicians at the point of care using a Web-based platform or handheld device. Data were collected from 88 primary care practitioners in Ontario, Canada, from October 2005 to April 2006. Questions were answered in less than 15 minutes, enabling clinicians to use the answer during patient encounters.
Description of type and frequency of questions asked, including the organ system on which the questions focused, was produced using 2 classification systems, the "taxonomy of generic clinical questions" (TGCQ), and the International Classification for Primary Care version 2 (ICPC-2). Of the original 1889 questions, 1871 (99.0%) were suitable for analysis. A total of 970 (52%) of questions related to therapy; of these, 671 (69.2%) addressed questions about drug therapy, representing 36% of all questions. Questions related to diagnosis (24.8%) and epidemiology (13.5%) were also common. Organ systems questions concerning musculoskeletal, endocrine, skin, cardiac, and digestive systems were asked more than other categories.
Questions collected at the point of care provide a valuable and unique source of information on the true learning needs of practicing clinicians. The TGCQ classification allowed us to show that a majority of questions had to do with treatment, particularly drug treatment, whereas the use of the ICPC-2 classification illustrated the great variety of questions asked about the diverse conditions encountered in primary care. It is feasible to use electronically collected questions asked by primary care clinicians in clinical practice to categorize self-identified knowledge and practice needs. This could be used to inform the development of future learning activities.
评估医生开展继续医学教育（CME）活动的需求是CME课程开发的一个重要组成部分。本研究的目的是通过使用在医疗现场以电子方式收集的问题来证明确定继续医学教育（CME）中被认为需求最大领域的可行性。
本研究是对“即时”（JIT）信息馆员咨询服务问题数据库进行二次分析，采用定量内容分析方法。最初的JIT项目证明了实时馆员服务的可行性，该服务可通过基于网络的平台或手持设备回答基层医疗临床医生在医疗现场提出的问题。数据于2005年10月至2006年4月从加拿大安大略省的88名基层医疗从业者处收集。问题在不到15分钟内得到解答，使临床医生能够在患者诊疗过程中使用答案。
使用“通用临床问题分类法”（TGCQ）和《国际初级保健分类第2版》（ICPC-2）这两种分类系统对所提问题的类型和频率进行了描述，包括问题所关注的器官系统。在最初的1889个问题中，1871个（99.0%）适合进行分析。共有970个（52%）问题与治疗相关；其中，671个（69.2%）涉及药物治疗问题，占所有问题的36%。与诊断（24.8%）和流行病学（13.5%）相关的问题也很常见。关于肌肉骨骼、内分泌、皮肤、心脏和消化系统的器官系统问题比其他类别更多。
在医疗现场收集的问题为了解执业临床医生的真正学习需求提供了一个有价值且独特的信息来源。TGCQ分类使我们能够表明大多数问题与治疗有关，特别是药物治疗，而ICPC-2分类的使用则说明了在基层医疗中遇到的各种情况所提出的问题种类繁多。利用基层医疗临床医生在临床实践中以电子方式收集的问题来对自我确定的知识和实践需求进行分类是可行的。这可用于为未来学习活动的开展提供信息。
