Kelly M H, Murray T S
Department of Postgraduate Medicine, University of Glasgow.
Br J Gen Pract. 1996 Jun;46(407):353-6.
The 1990 Contract encouraged general practitioners to participate in continuing medical education by providing a financial incentive.
The study was designed: to determine the motivation of general practitioners attending education events; and to compare motivation and reasons for attendance pre- and post-Contract at commercial and non-commercial meetings, and at the different educational categories of Disease Management (DM), Health Promotion (HP) and Service Management (SM).
Two structured questionnaires were used. The first was sent to all general practitioners in the West of Scotland and asked about motivation pre-1990 Contract and the second, post-Contract, looked at motivation and reasons for attending a course as part of post course assessment. This latter was part of a much larger study evaluating continuing medical education.
A total of 1161 practitioners responded to questionnaire I and 552 general practitioners attended 27 randomly selected postgraduate meetings. Finance was a motivator in 3.8% pre-Contract, and this increased to 33.3% post-Contract and was the most commonly stated reason for attendance in 81.3%. Financial incentive had the biggest influence on those attending HP sessions (91.5%), then SM (87.2%) and finally DM (78.6% (chi 2 = 8.68; P < or = 0.013). It was also important to 73% attending drug-company-sponsored meetings compared with 83.7% going to non-commercial ones. Interest was a good motivator both pre- and post-Contract, but more so for DM than other categories and drug company as opposed to non-commercial meetings (chi 2 = 9.4; P < 0.002). Lack of knowledge became a less-important motivator post-Contract, and doctors felt least knowledgeable in SM (62.2%), as opposed to DM (57.9%) and HP (23.6%) (chi 2 = 38.8; P < 0.001, with each differing significantly from both others). Doctors found the topics provided by the pharmaceutical companies more interesting (chi 2 = 9.4; P < 0.002) and the hospitality provided more alluring than scheme meetings (chi 2 = 28.6; P < 0.001).
Finance has a major effect on attendance at postgraduate meetings but may not be a good incentive for learning. Planning for education must take into account the different motivational factors for the different categories. Reasons for attending commercial meetings differ from non-commercial ones and these events should be closely monitored.
1990年的合同通过提供经济激励措施鼓励全科医生参与继续医学教育。
本研究旨在：确定参加教育活动的全科医生的动机；比较在合同签订前后，在商业和非商业会议以及疾病管理（DM）、健康促进（HP）和服务管理（SM）等不同教育类别中参加会议的动机和原因。
使用了两份结构化问卷。第一份问卷发送给苏格兰西部的所有全科医生，询问他们1990年合同签订前的动机，第二份问卷在合同签订后，作为课程后评估的一部分，询问参加课程的动机和原因。后者是一项评估继续医学教育的更大规模研究的一部分。
共有1161名从业者回复了问卷I，552名全科医生参加了27次随机选择的研究生会议。在合同签订前，经济因素是3.8%的人的动机，而在合同签订后这一比例增至33.3%，并且是81.3%的人最常提及的参会原因。经济激励对参加HP课程的人影响最大（91.5%），其次是SM（87.2%），最后是DM（78.6%）（卡方=8.68；P≤0.013）。对于73%参加制药公司赞助会议的人来说经济激励也很重要，而参加非商业会议的人中这一比例为83.7%。在合同签订前后，兴趣都是一个很好的动机，但对于DM来说比其他类别更明显，并且在制药公司赞助的会议与非商业会议之间也是如此（卡方=9.4；P<0.002）。合同签订后，知识匮乏成为一个不太重要的动机，医生们在SM方面感觉知识最匮乏（62.2%），而DM方面为57.9%，HP方面为23.6%（卡方=38.8；P<0.001，且每一项与其他两项均有显著差异）。医生们发现制药公司提供的主题更有趣（卡方=9.4；P<0.002），并且其提供的款待比研讨会更有吸引力（卡方=28.6；P<0.001）。
经济因素对研究生会议的参会率有重大影响，但可能不是学习的良好激励因素。教育规划必须考虑到不同类别中的不同动机因素。参加商业会议和非商业会议的原因不同，应对这些活动进行密切监测。
