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Lisa Fleet - One of the best experts on this subject based on the ideXlab platform.
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evaluation of learning outcomes in web based Continuing Medical Education
Academic Medicine, 2006Co-Authors: Vernon Curran, Jocelyn Lockyer, Joan Sargeant, Lisa FleetAbstract:AbstractBackgroundThere has been significant growth in use of Web-based Continuing Medical Education (CME) by physicians. A number of evaluation and metareview studies have examined the effectiveness of Web-based CME to varying degrees. One of the main limitations of this literature has been the lac
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a review of evaluation outcomes of web based Continuing Medical Education
Medical Education, 2005Co-Authors: Vernon Curran, Lisa FleetAbstract:INTRODUCTION The Internet and worldwide web have expanded opportunities for the provision of a flexible, convenient and interactive form of Continuing Medical Education (CME). Larger numbers of doctors are accessing and using the Internet to locate and seek Medical information. It has been suggested that a significant proportion of this usage is directly related to questions that arise from patient care. A variety of Internet technologies are being used to provide both asynchronous and synchronous forms of web-based CME. Various models for designing and facilitating web-based CME learning have also been reported. The purpose of this study was to examine the nature and characteristics of the web-based CME evaluative outcomes reported in the peer-reviewed literature. METHODS A search of Medline was undertaken and the level of evaluative outcomes reported was categorised using Kirkpatrick’s model for levels of summative evaluation. RESULTS The results of this analysis revealed that the majority of evaluative research on web-based CME is based on participant satisfaction data. There was limited research demonstrating performance change in clinical practices and there were no studies reported in the literature that demonstrated that web-based CME was effective in influencing patient or health outcomes.
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the nature of the interaction between participants and facilitators in online asynchronous Continuing Medical Education learning environments
Teaching and Learning in Medicine, 2005Co-Authors: Vernon Curran, Jocelyn Lockyer, Joan Sargeant, Lisa Fleet, Fran Kirby, Dale WrightAbstract:Background: MDcme.ca offers an online asynchronous Continuing Medical Education (CME) environment for family physicians. The nature of participation in online CME using computer-mediated conferencing (CMC) discussion systems and the characteristics of interaction between participants and facilitators is not well understood. Purpose: To examine the association between participant and facilitator participation in online asynchronous CME learning environments. Methods: We analyzed registration and participation data including participant and facilitator postings to an asynchronous CMC discussion system for CME programs offered through MDcme.ca using frequency counts. Pearson r correlation was used to assess the association between numbers of participants and participant postings, facilitator postings and participant postings, and the number of discussion items accessed and participant postings. Results: MDcme.ca offered 25 programs to 327 registrants, of whom 180 actually participated by accessing course mat...
Paul E Mazmanian - One of the best experts on this subject based on the ideXlab platform.
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Continuing Medical Education effect on practice performance effectiveness of Continuing Medical Education american college of chest physicians evidence based Educational guidelines
Chest, 2009Co-Authors: Paul E Mazmanian, David A Davis, Robert GalbraithAbstract:Background There has been sizable debate and widespread skepticism about the effect of Continuing Medical Education (CME) on the performance of physicians in the practice setting. This portion of the review was undertaken to examine that effect. Methods The guideline panel used data from a comprehensive review of the effectiveness of CME developed by The Johns Hopkins Evidence-based Practice Center, focusing on the effect of CME on clinical performance. Results The review found 105 studies, which evaluated the impact of CME on short- and long-term physician practice performance. Nearly 60% met objectives relative to changing clinical performance in prescribing; screening; counseling about smoking cessation, diet, and sexual practices; guideline adherence; and other topics. Single live and multiple media appeared to be generally positive in their effect, print media much less so. Multiple Educational techniques were more successful at changing provider performance than single techniques. The amount or frequency of exposure to CME activities appeared to have little effect on behavior change. Conclusions Overall, CME, especially using live or multiple media and multiple Educational techniques, is generally effective in changing physician performance. More research, however, is needed that focuses on the specific types of media and Educational techniques that lead to the greatest improvements in performance.
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the science of Continuing Medical Education terms tools and gaps effectiveness of Continuing Medical Education american college of chest physicians evidence based Educational guidelines
Chest, 2009Co-Authors: Dave Davis, Todd Dorman, Nancy L Bennett, Spyridon S Marinopoulos, Paul E Mazmanian, Georges Bordage, Lisa K Moores, Douglas C MccroryAbstract:Background By its synthesis of a selected portion of the Continuing Medical Education (CME) literature, the evidence-based practice center (EPC) review discovered several major issues in primary study design and in the systematic review process of CME studies. Through this process, the review speaks to the need for clarity in designing, reporting and synthesizing CME trials and provides an opportunity to advance the research agenda in this field. Methods The evidence-based guideline (EBG) committee reviewed the methods section of the EPC report and these guidelines in detail, commenting on the search and review process and on the nature of the primary literature and the definitions used within it, comparing these to other published standardized measures. Results Although the EBG committee noted much strength in the EPC review, limitations of the primary literature and the review methodology were identified and defined. These strengths and limitations hold implications for further research in this area. Conclusions Noting these limitations and in order to move the field forward, the EBG committee proposes a standard nomenclature of terms in common use in CME; a more rigorous process of searching, distilling, and synthesizing the primary literature in this area; and a common format on which to base the development and description of future trials of CME interventions.
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lessons for Continuing Medical Education from simulation research in undergraduate and graduate Medical Education effectiveness of Continuing Medical Education american college of chest physicians evidence based Educational guidelines
Chest, 2009Co-Authors: William C Mcgaghie, Paul E Mazmanian, Viva J Siddall, Janet N MyersAbstract:Background Simulation technology is widely used in undergraduate and graduate Medical Education as well as for personnel training and evaluation in other healthcare professions. Simulation provides safe and effective opportunities for learners at all levels to practice and acquire clinical skills needed for patient care. A growing body of research evidence documents the utility of simulation technology for educating healthcare professionals. However, simulation has not been widely endorsed or used for Continuing Medical Education (CME). Methods This article reviews and evaluates evidence from studies on simulation technology in undergraduate and graduate Medical Education and addresses its implications for CME. Results The Agency for Healthcare Research and Quality Evidence Report suggests that simulation training is effective, especially for psychomotor and communication skills, but that the strength of the evidence is low. In another review, the Best Evidence Medical Education collaboration supported the use of simulation technology, focusing on high-fidelity Medical simulations under specific conditions. Other studies enumerate best practices that include mastery learning, deliberate practice, and recognition and attention to cultural barriers within the Medical profession that present obstacles to wider use of this technology. Conclusions Simulation technology is a powerful tool for the Education of physicians and other healthcare professionals at all levels. Its Educational effectiveness depends on informed use for trainees, including providing feedback, engaging learners in deliberate practice, integrating simulation into an overall curriculum, as well as on the instruction and competence of faculty in its use. Medical simulation complements, but does not replace, Educational activities based on real patient-care experiences.
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Continuing Medical Education and the physician as a learner guide to the evidence
JAMA, 2002Co-Authors: Paul E Mazmanian, David A DavisAbstract:One faculty member in a professional school referred to Continuing Education as “shouting out of windows,” and an analysis of the programs at his institution shows the aptness of his metaphor: Faculty members who can be persuaded to do so give lectures on subjects of their own choosing to audiences they do not know, who have assembled only because they want to put in enough hours of classroom attendance so that they can meet a relicensure requirement. As a result, every profession now has members who vigorously oppose what they regard as the excessive promotion of Continuing Education. Cyril O. Houle, 1980 RESEARCHERS OF THE PAST DEcade produced systematic reviews of Continuing Medical Education (CME) and other strategies intended to change physician behavior and improve patient outcomes. The subjects of the reviews included such concepts as audit and feedback, chart-based reminders, clinical practice guidelines, and formal lectures. Defined as interventions to change the behavior of physicians, the effects of those strategies were inconsistent across practitioners, settings, and behaviors. As a result, in the midst of contemporary discussions about quality improvement and the effects of Continuing Education, there is no singularly effective method for improving physician performance. Physicians must accept responsibility for their own continuous learning: setting goals and selecting Educational activities to achieve those goals. We searched the Research and Development Resource Base in Continuing Medical Education and the Specialised Register of the Cochrane Effective Practice and Organization of Care group, supplemented by searches of MEDLINE from 1992 to February 2002 for systematic reviews and evidence of CME and its effect on both physicians and CME planners.
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Continuing Medical Education a new vision of the professional development of physicians
Academic Medicine, 2000Co-Authors: Nancy L Bennett, Dave Davis, William E Easterling, Paul E Mazmanian, Paul Friedmann, Joseph S Green, Bruce M Koeppen, Herbert S WaxmanAbstract:The authors describe their vision of what Continuing Medical Education (CME) should become in the changing health care environment. They first discuss six types of literature (e.g., concerning learning and adult development principles, problem-based/practice-based learning, and other topics) that contribute to ways of thinking about and understanding CME. They then state their view that the Association of American Medical Colleges (AAMC) has made a commitment to helping CME be more effective in the professional development of physicians. In presenting their new vision of CME, the authors describe their interpretation of the nature and values of CME (e.g., optimal CME is highly self-directed; the selection and design of the most relevant CME is based on data from each physician's responsibilities and performance; etc.). They then present seven action steps, suggestions to begin them, and the institutions and organizations they believe should carry them out, and recommend that the AAMC play a major role in supporting activities to carry out these steps. (For example, one action step is the generation and application of new knowledge about how and why physicians learn, select best practices, and change their behaviors). Six core competencies for CME educators are defined. The authors conclude by stating that collaboration among the appropriate academic groups, professional associations, and health care institutions, with leadership from the AAMC, is essential to create the best learning systems for the professional development of physicians.
Vernon Curran - One of the best experts on this subject based on the ideXlab platform.
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evaluation of learning outcomes in web based Continuing Medical Education
Academic Medicine, 2006Co-Authors: Vernon Curran, Jocelyn Lockyer, Joan Sargeant, Lisa FleetAbstract:AbstractBackgroundThere has been significant growth in use of Web-based Continuing Medical Education (CME) by physicians. A number of evaluation and metareview studies have examined the effectiveness of Web-based CME to varying degrees. One of the main limitations of this literature has been the lac
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a review of evaluation outcomes of web based Continuing Medical Education
Medical Education, 2005Co-Authors: Vernon Curran, Lisa FleetAbstract:INTRODUCTION The Internet and worldwide web have expanded opportunities for the provision of a flexible, convenient and interactive form of Continuing Medical Education (CME). Larger numbers of doctors are accessing and using the Internet to locate and seek Medical information. It has been suggested that a significant proportion of this usage is directly related to questions that arise from patient care. A variety of Internet technologies are being used to provide both asynchronous and synchronous forms of web-based CME. Various models for designing and facilitating web-based CME learning have also been reported. The purpose of this study was to examine the nature and characteristics of the web-based CME evaluative outcomes reported in the peer-reviewed literature. METHODS A search of Medline was undertaken and the level of evaluative outcomes reported was categorised using Kirkpatrick’s model for levels of summative evaluation. RESULTS The results of this analysis revealed that the majority of evaluative research on web-based CME is based on participant satisfaction data. There was limited research demonstrating performance change in clinical practices and there were no studies reported in the literature that demonstrated that web-based CME was effective in influencing patient or health outcomes.
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the nature of the interaction between participants and facilitators in online asynchronous Continuing Medical Education learning environments
Teaching and Learning in Medicine, 2005Co-Authors: Vernon Curran, Jocelyn Lockyer, Joan Sargeant, Lisa Fleet, Fran Kirby, Dale WrightAbstract:Background: MDcme.ca offers an online asynchronous Continuing Medical Education (CME) environment for family physicians. The nature of participation in online CME using computer-mediated conferencing (CMC) discussion systems and the characteristics of interaction between participants and facilitators is not well understood. Purpose: To examine the association between participant and facilitator participation in online asynchronous CME learning environments. Methods: We analyzed registration and participation data including participant and facilitator postings to an asynchronous CMC discussion system for CME programs offered through MDcme.ca using frequency counts. Pearson r correlation was used to assess the association between numbers of participants and participant postings, facilitator postings and participant postings, and the number of discussion items accessed and participant postings. Results: MDcme.ca offered 25 programs to 327 registrants, of whom 180 actually participated by accessing course mat...
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discourse analysis of computer mediated conferencing in world wide web based Continuing Medical Education
Journal of Continuing Education in The Health Professions, 2003Co-Authors: Vernon Curran, Fran Kirby, Ean Parsons, Jocelyn LockyerAbstract:Introduction: Computer-mediated conferencing (CMC) is a computer messaging system that allows users to engage in asynchronous text-based communications that are independent of time and place. It has been suggested that CMC is an effective modality for facilitating constructivist learning environments that enable adult learners to engage in a continuous, collaborative process of building and reshaping knowledge and understanding. The goals of this exploratory study were to assess the nature of the interactions and collaborative learning characteristics exhibited in World Wide Web-based Continuing Medical Education courseware programs that used CMC and to examine physicians' satisfaction with on-line CMC discussion as a planned learning activity of Web-based CME. Method: The Transcript Analysis Tool (TAT) was used to analyze the nature of the discourse that took place in four different Web-based CME courseware programs. Course evaluation surveys and interviews were also conducted with participants to evaluate their satisfaction with on-line CMC discussion. Results: The results suggest that the nature of participation in the programs consisted primarily of independent messages with a minimal amount of learner-to-learner interaction. Elements of critical reflection, interaction, and debate between participants appeared to be missing from these discussions. As such, these discussions were not characteristic of the principles of constructivist learning environments. Discussion: Interactive participation will not occur just because CMC is being used. The design of Web-based CME learning activities, participant characteristics, and facilitation are key factors that influence the effective use of CMC.
Todd Dorman - One of the best experts on this subject based on the ideXlab platform.
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society for academic Continuing Medical Education intervention guideline series guideline 4 interprofessional Education
Journal of Continuing Education in The Health Professions, 2015Co-Authors: Thomas J Van Hoof, Rachel E Grant, Joanna Sajdlowska, Mary J Bell, Craig Campbell, Lois Colburn, David Davis, Todd Dorman, Michael A Fischer, Tanya HorsleyAbstract:Abstract:The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, to standardize the terminology for a set of important Educational interventions. In the form of a guideline, this article describes one such intervention, interprofessional Education (IPE
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society for academic Continuing Medical Education intervention guideline series guideline 1 performance measurement and feedback
Journal of Continuing Education in The Health Professions, 2015Co-Authors: Thomas J Van Hoof, Rachel E Grant, Mary J Bell, Craig Campbell, Lois Colburn, David Davis, Todd Dorman, Tanya Horsley, Nicole E Miller, Virginia JacobshalseyAbstract:Abstract:The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, to standardize the terminology for a set of important Educational interventions. In the form of a guideline, this article describes one such intervention, performance measurement and feed
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society for academic Continuing Medical Education intervention guideline series guideline 2 practice facilitation
Journal of Continuing Education in The Health Professions, 2015Co-Authors: Thomas J Van Hoof, Rachel E Grant, Craig Campbell, Lois Colburn, David Davis, Todd Dorman, Michael A Fischer, Tanya Horsley, Virginia Jacobshalsey, Gabrielle KaneAbstract:: The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, standardize the terminology for a set of important Educational interventions. In the form of a guideline, this article describes one such intervention, practice facilitation, which is a common strategy in primary care to help practices develop capacity and infrastructure to support their ability to improve patient care. Based on a review of recent evidence and a facilitated discussion with US and Canadian experts, we describe practice facilitation, its terminology, and other important information about the intervention. We encourage leaders and researchers to consider and build on this guideline as they plan, implement, evaluate, and report practice facilitation efforts. Clear and consistent use of terminology is imperative, along with complete and accurate descriptions of interventions, to improve the use and study of practice facilitation.
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society for academic Continuing Medical Education intervention guideline series guideline 3 Educational meetings
Journal of Continuing Education in The Health Professions, 2015Co-Authors: Thomas J Van Hoof, Rachel E Grant, Joanna Sajdlowska, Mary J Bell, Craig Campbell, Lois Colburn, Todd Dorman, Michael A Fischer, Tanya Horsley, Constance LeblancAbstract:: The Society for Academic Continuing Medical Education commissioned a study to clarify and, if possible, to standardize the terminology for a set of important Educational interventions. In the form of a guideline, this article describes one such intervention, Educational meetings, which is a common intervention in health professions' Education. An Educational meeting is an opportunity for clinicians to assemble to discuss and apply important information relevant to patient care. Based on a review of recent evidence and a facilitated discussion with US and Canadian experts, we describe proper Educational meeting terminology and other important information about the intervention. We encourage leaders and researchers to consider and to build on this guideline as they plan, implement, evaluate, and report Educational meeting efforts. Clear and consistent use of terminology is imperative, along with complete and accurate descriptions of interventions, to improve the use and study of Educational meetings.
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the science of Continuing Medical Education terms tools and gaps effectiveness of Continuing Medical Education american college of chest physicians evidence based Educational guidelines
Chest, 2009Co-Authors: Dave Davis, Todd Dorman, Nancy L Bennett, Spyridon S Marinopoulos, Paul E Mazmanian, Georges Bordage, Lisa K Moores, Douglas C MccroryAbstract:Background By its synthesis of a selected portion of the Continuing Medical Education (CME) literature, the evidence-based practice center (EPC) review discovered several major issues in primary study design and in the systematic review process of CME studies. Through this process, the review speaks to the need for clarity in designing, reporting and synthesizing CME trials and provides an opportunity to advance the research agenda in this field. Methods The evidence-based guideline (EBG) committee reviewed the methods section of the EPC report and these guidelines in detail, commenting on the search and review process and on the nature of the primary literature and the definitions used within it, comparing these to other published standardized measures. Results Although the EBG committee noted much strength in the EPC review, limitations of the primary literature and the review methodology were identified and defined. These strengths and limitations hold implications for further research in this area. Conclusions Noting these limitations and in order to move the field forward, the EBG committee proposes a standard nomenclature of terms in common use in CME; a more rigorous process of searching, distilling, and synthesizing the primary literature in this area; and a common format on which to base the development and description of future trials of CME interventions.
Nancy L Bennett - One of the best experts on this subject based on the ideXlab platform.
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the science of Continuing Medical Education terms tools and gaps effectiveness of Continuing Medical Education american college of chest physicians evidence based Educational guidelines
Chest, 2009Co-Authors: Dave Davis, Todd Dorman, Nancy L Bennett, Spyridon S Marinopoulos, Paul E Mazmanian, Georges Bordage, Lisa K Moores, Douglas C MccroryAbstract:Background By its synthesis of a selected portion of the Continuing Medical Education (CME) literature, the evidence-based practice center (EPC) review discovered several major issues in primary study design and in the systematic review process of CME studies. Through this process, the review speaks to the need for clarity in designing, reporting and synthesizing CME trials and provides an opportunity to advance the research agenda in this field. Methods The evidence-based guideline (EBG) committee reviewed the methods section of the EPC report and these guidelines in detail, commenting on the search and review process and on the nature of the primary literature and the definitions used within it, comparing these to other published standardized measures. Results Although the EBG committee noted much strength in the EPC review, limitations of the primary literature and the review methodology were identified and defined. These strengths and limitations hold implications for further research in this area. Conclusions Noting these limitations and in order to move the field forward, the EBG committee proposes a standard nomenclature of terms in common use in CME; a more rigorous process of searching, distilling, and synthesizing the primary literature in this area; and a common format on which to base the development and description of future trials of CME interventions.
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a controlled trial of the effectiveness of internet Continuing Medical Education
BMC Medicine, 2008Co-Authors: Linda Casebeer, Nancy L Bennett, Sally Engler, Martin Irvine, Destry Sulkes, Marc Deslauriers, Sijian ZhangAbstract:Background: The internet has had a strong impact on how physicians access information and on the development of Continuing Medical Education activities. Evaluation of the effectiveness of these activities has lagged behind their development. Methods: To determine the effectiveness of a group of 48 internet Continuing Medical Education (CME) activities, case vignette surveys were administered to US physicians immediately following participation, and to a representative control group of non-participant physicians. Responses to case vignettes were analyzed based on evidence presented in the content of CME activities. An effect size for each activity was calculated using Cohen's d to determine the amount of difference between the two groups in the likelihood of making evidence-based clinical decisions, expressed as the percentage of non-overlap, between the two groups. Two formats were compared. Results: In a sample of 5621 US physicians, of the more than 100,000 physicians who participated in 48 internet CME activities, the average effect size was 0.75, an increased likelihood of 45% that participants were making choices in response to clinical case vignettes based on clinical evidence. This likelihood was higher in interactive case-based activities, 51% (effect size 0.89), than for textbased clinical updates, 40% (effect size 0.63). Effectiveness was also higher among primary care physicians than specialists. Conclusion: Physicians who participated in selected internet CME activities were more likely to make evidence-based clinical choices than non-participants in response to clinical case vignettes. Internet CME activities show promise in offering a searchable, credible, available on-demand, highimpact source of CME for physicians.
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Continuing Medical Education a new vision of the professional development of physicians
Academic Medicine, 2000Co-Authors: Nancy L Bennett, Dave Davis, William E Easterling, Paul E Mazmanian, Paul Friedmann, Joseph S Green, Bruce M Koeppen, Herbert S WaxmanAbstract:The authors describe their vision of what Continuing Medical Education (CME) should become in the changing health care environment. They first discuss six types of literature (e.g., concerning learning and adult development principles, problem-based/practice-based learning, and other topics) that contribute to ways of thinking about and understanding CME. They then state their view that the Association of American Medical Colleges (AAMC) has made a commitment to helping CME be more effective in the professional development of physicians. In presenting their new vision of CME, the authors describe their interpretation of the nature and values of CME (e.g., optimal CME is highly self-directed; the selection and design of the most relevant CME is based on data from each physician's responsibilities and performance; etc.). They then present seven action steps, suggestions to begin them, and the institutions and organizations they believe should carry them out, and recommend that the AAMC play a major role in supporting activities to carry out these steps. (For example, one action step is the generation and application of new knowledge about how and why physicians learn, select best practices, and change their behaviors). Six core competencies for CME educators are defined. The authors conclude by stating that collaboration among the appropriate academic groups, professional associations, and health care institutions, with leadership from the AAMC, is essential to create the best learning systems for the professional development of physicians.
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learning and change implications for Continuing Medical Education
BMJ, 1998Co-Authors: Robert D Fox, Nancy L BennettAbstract:Medical Education, particularly Continuing Medical Education (CME), has been greatly influenced by studies of adult learning. The observation that it is not teaching but learning that leads doctors to change their practice has resulted in a shift in perspective: rather than Education being regarded as instruction, it is regarded as facilitation of learning. This paradigm shift has been based on research into how and why doctors change their practice and into the role of learning in that process. The direction of Continuing Medical Education in North America and elsewhere has changed in response to the new perspective that has emerged from contemporary studies of learning and change. The nature of this new perspective is evident from a comparison of the common elements of CME in the 1980s with the approach that is now being used. Traditionally a CME programme was an Educational event that applied appropriate resources and methods to fulfill set instructional objectives. Such programmes were often considered to be good if the information was valuable, the lecturer skilful, and the setting comfortable. Too often, however, there was little or no actual effect on Medical practice, even though all three conditions were met. The critical difference in the 1990s is that it has increasingly been accepted that CME programmes are based—or should be—on the principle of teaching and Education as a means of facilitating learning. This new approach has been adopted in response to studies on how and why doctors change their performance in clinical practice and the role of learning in that process. This article describes some of these models and sets out the key principles that have emerged for Continuing Medical Education in the past decade. #### Summary points The purpose of Continuing Medical Education is to facilitate change in clinical practice CME should be based on the natural processes …