The Journal of continuing education in the health professions
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J Contin Educ Health Prof · Jan 2004
ReviewImplementing clinical guidelines: current evidence and future implications.
One of the most common findings from health services research is a failure to routinely translate research findings into daily practice. Previous systematic reviews of strategies to promote the uptake of research findings suffered from a range of methodologic problems that have been addressed in a more recent systematic review of guideline dissemination and implementation strategies. Changes in practitioner behavior; in the desired direction, were reported in 86% of the comparisons made. ⋯ Overall, there is an imperfect evidence base for decision makers to work from. Many studies had methodologic weaknesses, and reporting of this kind of research is generally poor, making the generalizability of study findings frequently uncertain. A better theoretical underpinning of studies would make this body of research more useful.
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J Contin Educ Health Prof · Jan 2004
ReviewInternet continuing education for health care professionals: an integrative review.
The objective was to review key articles and research studies on practices, preferences, and evaluation of on-line continuing education used by health care professionals. ⋯ Although the Internet is an effective and satisfactory educational format, barriers to use of the Internet for CE still exist. Additional studies are needed to measure the impact of Internet CE on practice performance, reduce barriers to on-line CE, and identify appropriate theoretical frameworks for on-line learning.
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J Contin Educ Health Prof · Jan 2004
The role of educational theory in continuing medical education: has it helped us?
Despite the existence of many approaches to understanding learning and change and attempts to incorporate these into continuing education research and practice, the search continues for a comprehensive understanding of how learning is engendered in professional practice and the processes by which learning and change occur. This article considers four broad questions in relation to the practice of continuing education: (1) What can be expected of theory? (2) How does theory relate to the educational practice of those in continuing education and the goals of continuing medical education ? (3) How have practice and theory mutually informed our current understandings? (4) How can theory serve the field more effectively in the future? Broad orientations to understanding learning provide a framework for examining the contributions of theory and practice. ⋯ Newer understandings also are introduced. The article concludes by considering reasons as to why theory appears not to have served us better and by offering ways in which those in continuing education can ensure greater usefulness of theory while contributing to its continued development.
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J Contin Educ Health Prof · Jan 2004
Randomized Controlled Trial Clinical TrialRandomized trial of problem-based versus didactic seminars for disseminating evidence-based guidelines on asthma management to primary care physicians.
This randomized controlled trial (RCT) investigated the effectiveness of and satisfaction with small-group problem-based learning (PBL) versus a didactic lecture approach to guideline dissemination in asthma management controlling for confounders common in comparative educational interventions. ⋯ PBL was as effective in knowledge uptake and retention as lecture-based continuing medical education (CME) programs. Further study is warranted to investigate whether the assessment of higher educational value or an increase in response rate to delayed testing is replicable in other RCTs addressing common confounders and if these factors influence future CME participation, changes in physician clinical behavior, or patient health outcomes.
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J Contin Educ Health Prof · Jan 2004
Educational interventions to improve practice of nonspecialty physicians who are identified in need by peer review.
This article reports on the peer review process of the College of Physicians and Surgeons of Ontario, the licensing and regulatory authority, and the effect of educational interventions on physicians identified to be in need. Since 1980, the college has assessed more than 175 random and targeted nonspecialist physicians each year. ⋯ A majority of physicians identified as needing improvement improved and maintained their improved performance. The simple structured interventions employed by the college demonstrate an educational intervention that produces practice improvement.