Dubowitz Howard, Belanger Rose, Magder Laurence, Palinkas Lawrence A, Kim Hannah, Muralidharan Vyas
Department of Pediatrics (H Dubowitz, R Belanger, H Kim, and V Muralidharan), University of Maryland School of Medicine, Baltimore.
Department of Pediatrics (H Dubowitz, R Belanger, H Kim, and V Muralidharan), University of Maryland School of Medicine, Baltimore.
Acad Pediatr. 2025 Jan-Feb;25(1):102534. doi: 10.1016/j.acap.2024.07.001. Epub 2024 Jul 14.
To compare the impact of 2 common continuing medical education training modalities-independent online training (IND) and a Maintenance of Certification-4 (MOC) activity-on primary care professionals' (PCPs') thinking and practice behavior regarding the Safe Environment for Every Kid (SEEK) approach. This was part of an implementation science study scaling up the evidence-based practice, SEEK.
This is a longitudinal, multisite, mixed methods, cluster randomized controlled trial comparing 21 pediatric primary care practices across the United States randomized to 1 of 2 training modalities. Two hundred ten PCPs completed surveys up to 4 times over a 2-year period to assess their thinking and practice regarding SEEK; a subset was interviewed up to 3 times.
Training led to significant and sustained improvements in PCPs' thinking and behavior related to SEEK, with no significant differences between the IND and MOC groups. PCPs mostly viewed their training positively, but several described shortcomings. PCP characteristics, such as age and sex, did not moderate the impact of the training, nor did the presence of a behavioral health professional.
The lack of significant differences between the training modalities favors the simpler IND modality. This was despite the MOC training employing key principles of adult education. Of note, MOC-4 credits are required for pediatric board certification. More research is needed to optimize continuing medical education and tailor approaches for different learners.
SEEK: Dissemination and Implementation, NCT03642327: https://clinicaltrials.gov/ct2/show/NCT03642327.
比较两种常见的继续医学教育培训方式——独立在线培训（IND）和认证维持-4（MOC）活动——对初级保健专业人员（PCP）在“为每个孩子创造安全环境”（SEEK）方法方面的思维和实践行为的影响。这是一项实施科学研究的一部分，该研究旨在扩大基于证据的实践SEEK的应用。
这是一项纵向、多地点、混合方法、整群随机对照试验，比较了美国21家儿科初级保健机构，这些机构被随机分配到两种培训方式中的一种。210名初级保健专业人员在两年内完成了多达4次的调查，以评估他们对SEEK的思维和实践；其中一部分人接受了多达3次的访谈。
培训使初级保健专业人员在与SEEK相关的思维和行为方面有显著且持续的改善，IND组和MOC组之间没有显著差异。初级保健专业人员大多对他们的培训给予积极评价，但也有一些人描述了不足之处。年龄和性别等初级保健专业人员的特征以及行为健康专业人员的存在并没有调节培训的影响。
培训方式之间缺乏显著差异有利于更简单的IND方式。尽管MOC培训采用了成人教育的关键原则，但情况依然如此。值得注意的是，儿科委员会认证需要MOC-4学分。需要更多的研究来优化继续医学教育，并为不同的学习者量身定制方法。
SEEK：传播与实施，NCT03642327：https://clinicaltrials.gov/ct2/show/NCT03642327 。
