Stross J K, Hiss R G, Watts C M, Davis W K, Macdonald R
Am Rev Respir Dis. 1983 Jun;127(6):739-46. doi: 10.1164/arrd.1983.127.6.739.
A continuing medical education program was implemented and evaluated in 16 community hospitals. It was targeted at primary-care physicians and used physicians identified by their peers as being educationally influential for the dissemination of information. Self-study materials were used, followed by an intensive 2-wk preceptorship that resulted in a significant increase in physician knowledge. Inpatient chart audits identified a series of changes in the management of chronic obstructive pulmonary disease in the intervention hospitals that were not noted in the control hospitals. These included the increased use of intravenously administered fluids, loading doses of intravenously administered bronchodilators, aerosolized and single agent bronchodilators, and respiratory therapy services. Continuing medical education, delivered through community-based educationally influential physicians, is an effective way of changing physician behavior in small communities with no prior ongoing educational programs. This approach should improve patient care and may reduce the need for participation of academic faculty in traditional continuing education programs.
在16家社区医院实施并评估了一项继续医学教育项目。该项目针对基层医疗医生，选用了被同行认为在信息传播方面具有教育影响力的医生。采用了自学材料，随后进行为期2周的强化导师指导，这使得医生的知识水平显著提高。住院病历审计发现，干预医院中慢性阻塞性肺疾病的管理出现了一系列变化，而对照医院中未观察到这些变化。这些变化包括静脉输液、静脉注射支气管扩张剂负荷剂量、雾化和单剂支气管扩张剂以及呼吸治疗服务的使用增加。通过社区中有教育影响力的医生开展继续医学教育，是在没有先前持续教育项目的小社区改变医生行为的有效方式。这种方法应能改善患者护理，并可能减少学术教员参与传统继续教育项目的需求。
