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January 6, 1984, Vol 251, No. 1 >
ARTICLE | January 6, 1984

A Critical Appraisal of the Efficacy of Continuing Medical Education FREE

R. Brian Haynes, MD, PhD; David A. Davis, MD; Ann McKibbon, MLS; Peter Tugwell, MD, MSc
[+] Author Affiliations

Reprint requests to Program for Educational Development, McMaster Health Sciences Center, Room 3V43, 1200 Main St W, Hamilton, Ontario, Canada L8N 3Z5 (Dr Haynes).


JAMA. 1984;251(1):61-64. doi:10.1001/jama.1984.03340250041018
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References

To determine the efficacy of continuing medical education (CME), we collected 248 original articles describing studies of CME interventions. These articles were reviewed for applicability and scientific credibility by applying preset methodological criteria. Thirteen percent of articles described randomized trials, but only 7% of all articles and 20% of randomized trials assessed the impact of CME on patient outcomes. Seven articles met all our criteria and were reviewed in detail. These studies provide convincing evidence that CME can improve physician behaviors. However, only three of these methodologically sound studies assessed patient outcomes and only one demonstrated any improvement in outcomes.

(JAMA 1984;251:61-64)

REFERENCES

1 +
Beeson PB:  Changes in medical therapy during the past half century . Medicine 1980;; 59:79-99.
2 +
Stross JK, Harlan WR:  The dissemination of new medical information . JAMA 1979;; 241:2622-2624.
3 +
The Diabetic Retinopathy Study Research Group:  Preliminary report on effects of photocoagulation therapy . Am J Ophthalmol 1976;; 81:383-396.
4 +
Berg AO:  Does continuing medical education improve the quality of medical care?: A look at the evidence . J Fam Pract 1979;;8:1171-1174.
5 +
Miller LA:  The current investment in continuing medical education , in Egdhal RH, Gertman PM (eds): Quality Health Care: The Role of Continuing Medical Education . Germantown, Md, Aspen Systems Corp, 1977;, pp 143-160.
6 +
Staff of the Department of Physician Credentials and Qualification and the Department of Continuing Medical Evaluation:  Continuing medical education . JAMA 1977;;238:2803-2808.
7 +
Scott AJ:  Continuing education: More or better? N Engl J Med 1976;;295:444.
8 +
Stein LS:  The effectiveness of continuing medical education: Eight research reports . J Med Educ 1980;;56:103-110.
9 +
Miller GE:  Continuing education for what? J Med Educ 1976;;42:320-326.
10 +
Fleisher DS:  Medical education: A clinical pathologic conference . Med Clin North Am 1970;; 54:591-602.
11 +
Meyer TC:  Toward a continuum in medical education . Bull NY Acad Med 1972;;51:719-726.
12 +
Stein TL:  Continuing medical education in America . J Fam Pract 1976;;3:297-300.
13 +
Bertram DA, Brooks-Bertram PA:  The evaluation of continuing medical education: A literature review . Health Educ Monogr 1977;; 5:330-362.
14 +
Abrahamson S:  Evaluation in continuing medical education . JAMA 1968;;206:625-628.
15 +
Greenberg AG, Bruegel RB, Peskin GW:  Surgical continuing education: Format and impact . Surgery 1977;;81:708-715.
16 +
Lloyd JS, Abrahamson S:  Effectiveness of continuing medical education, a review of the evidence . Eval Health Professions 1979;;2:251-280.
17 +
 Continuing medical education annotated bibliography . Ann R Coll Phys Surg Can 1983;; 16:85-90.
18 +
Sanazaro PJ, Worth RM:  Concurrent quality assurance in hospital care: Report of a study by private initiative in PSRO . N Engl J Med 1978;;298:1171-1177.
19 +
Linn BS:  Continuing medical education: Impact on emergency room burn care . JAMA 1980;;244:565-570.
20 +
Stross JK, Bole GG:  Evaluation of a continuing education program on rheumatoid arthritis . Arthritis Rheum 1980;;23:846-849.
21 +
Sibley JC, Sackett DL, Neufeld VR, et al:  A randomized trial of continuing medical education . N Engl J Med 1982;;306:511-515.
22 +
Putnum W, Curry L:  Patient care appraisal in the ambulatory setting: Effectiveness as a continuing medical education tool . Annu Conf Res Med Educ 1980;;207-212.
23 +
Avorn J, Soumerai SB:  Use of computer-based Medicaid drug data to analyze and correct inappropriate medication use . J Med Syst 1982;; 6:377-386.
24 +
Avorn J, Soumerai SB:  Improving drugtherapy decisions through educational outreach: A randomized controlled trial of academically based 'detailing.' N Engl J Med 1983;;308:1457-1463.
25 +
Stross JK, Hiss RG, Watts CM, et al:  Continuing education in pulmonary disease for primary care physicians . Am Rev Respir Dis 1983;;127:739-746.
26 +
Fletcher RH, Fletcher SW:  Clinical research in general medical journals: A 30 year perspective . N Engl J Med 1979;;301:180-183.
27 +
Haynes RB:  Improving patient compliance: An empirical view , in Stuart RB (ed): Adherence, Compliance and Generalization in Behavioral Medicine . New York, Brunner/Mazel Inc, 1982;, pp 28-55.
28 +
Bernier CL, Yerkey AN: Cogent Communication: Overcoming Reading Overload . Westport, Conn, Greenwood Press Inc, 1979;.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Beeson PB:  Changes in medical therapy during the past half century . Medicine 1980;; 59:79-99.
2 +
Stross JK, Harlan WR:  The dissemination of new medical information . JAMA 1979;; 241:2622-2624.
3 +
The Diabetic Retinopathy Study Research Group:  Preliminary report on effects of photocoagulation therapy . Am J Ophthalmol 1976;; 81:383-396.
4 +
Berg AO:  Does continuing medical education improve the quality of medical care?: A look at the evidence . J Fam Pract 1979;;8:1171-1174.
5 +
Miller LA:  The current investment in continuing medical education , in Egdhal RH, Gertman PM (eds): Quality Health Care: The Role of Continuing Medical Education . Germantown, Md, Aspen Systems Corp, 1977;, pp 143-160.
6 +
Staff of the Department of Physician Credentials and Qualification and the Department of Continuing Medical Evaluation:  Continuing medical education . JAMA 1977;;238:2803-2808.
7 +
Scott AJ:  Continuing education: More or better? N Engl J Med 1976;;295:444.
8 +
Stein LS:  The effectiveness of continuing medical education: Eight research reports . J Med Educ 1980;;56:103-110.
9 +
Miller GE:  Continuing education for what? J Med Educ 1976;;42:320-326.
10 +
Fleisher DS:  Medical education: A clinical pathologic conference . Med Clin North Am 1970;; 54:591-602.
11 +
Meyer TC:  Toward a continuum in medical education . Bull NY Acad Med 1972;;51:719-726.
12 +
Stein TL:  Continuing medical education in America . J Fam Pract 1976;;3:297-300.
13 +
Bertram DA, Brooks-Bertram PA:  The evaluation of continuing medical education: A literature review . Health Educ Monogr 1977;; 5:330-362.
14 +
Abrahamson S:  Evaluation in continuing medical education . JAMA 1968;;206:625-628.
15 +
Greenberg AG, Bruegel RB, Peskin GW:  Surgical continuing education: Format and impact . Surgery 1977;;81:708-715.
16 +
Lloyd JS, Abrahamson S:  Effectiveness of continuing medical education, a review of the evidence . Eval Health Professions 1979;;2:251-280.
17 +
 Continuing medical education annotated bibliography . Ann R Coll Phys Surg Can 1983;; 16:85-90.
18 +
Sanazaro PJ, Worth RM:  Concurrent quality assurance in hospital care: Report of a study by private initiative in PSRO . N Engl J Med 1978;;298:1171-1177.
19 +
Linn BS:  Continuing medical education: Impact on emergency room burn care . JAMA 1980;;244:565-570.
20 +
Stross JK, Bole GG:  Evaluation of a continuing education program on rheumatoid arthritis . Arthritis Rheum 1980;;23:846-849.
21 +
Sibley JC, Sackett DL, Neufeld VR, et al:  A randomized trial of continuing medical education . N Engl J Med 1982;;306:511-515.
22 +
Putnum W, Curry L:  Patient care appraisal in the ambulatory setting: Effectiveness as a continuing medical education tool . Annu Conf Res Med Educ 1980;;207-212.
23 +
Avorn J, Soumerai SB:  Use of computer-based Medicaid drug data to analyze and correct inappropriate medication use . J Med Syst 1982;; 6:377-386.
24 +
Avorn J, Soumerai SB:  Improving drugtherapy decisions through educational outreach: A randomized controlled trial of academically based 'detailing.' N Engl J Med 1983;;308:1457-1463.
25 +
Stross JK, Hiss RG, Watts CM, et al:  Continuing education in pulmonary disease for primary care physicians . Am Rev Respir Dis 1983;;127:739-746.
26 +
Fletcher RH, Fletcher SW:  Clinical research in general medical journals: A 30 year perspective . N Engl J Med 1979;;301:180-183.
27 +
Haynes RB:  Improving patient compliance: An empirical view , in Stuart RB (ed): Adherence, Compliance and Generalization in Behavioral Medicine . New York, Brunner/Mazel Inc, 1982;, pp 28-55.
28 +
Bernier CL, Yerkey AN: Cogent Communication: Overcoming Reading Overload . Westport, Conn, Greenwood Press Inc, 1979;.

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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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