Does continuing medical education by peer review really work?

A peer review of breast operation statistics was conducted. Standards for the proportion of biopsies positive for cancer, and for length of postoperative stay following operation for benign and malignant conditions were developed and each surgeon was informed of his performance and how it compared with that of his colleagues. The same parameters of care were reviewed one year later to study changes in performance. Low volume of clinical material, failure of two surgeons to change, and a steady general improvement in all parameters in the years prior to the presentation of the peer review, confused the demonstration of improvement in the year after the educational effort. There was a statistically significant improvement in the proportion of biopsies positive for cancer, reflecting reduction in unnecessary biopsies, but the pre-existing annual improvement in reducing postoperative stays was not accelerated. Does continuing medical education by peer review really work? Probably.