Continuing Medical Education
- The reference was:
After a graduate leaves Harvard, his "medical
education" continues through the visits of Drug Detail Salesmen
– each touting the drugs of some drug company.
- Doctors also participate in "continuing education" seminars
which are sponsored, guess, by the drug companies. But, after all, since drugs ARE the
accepted technique of orthodox treatment, it can’t seem wrong for drug companies to
pay for the continuing education. And, what company, selling Vitamin C, for instance,
would ever waste its money putting on a seminar for doctors!
The "official" literature of the medical profession does not,
of course, list this drug company type of "continuing education." Below there
are several abstracts reproduced referring to the activities of "continuing medical
education."
It's interesting to note that in the first study shown below, the
investigators were more interested in measuring the effect of "continuing medical
education" on "doctor performance" than they were on "patient
health-care outcomes!"
Even some of the "official" reports are critical, as for
instance:
The present postgraduate education allowance structure
for general practitioners is unacceptable and inadequate on a number of counts. {see
below}
- Title
- Evidence for the effectiveness of CME. A review of 50 randomized controlled trials [see
comments]
- Author
- Davis DA; Thomson MA; Oxman AD; Haynes RB
- Address
- Department of Family Medicine, School of Occupational Therapy and Physiotherapy, Faculty
of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
- Source
- JAMA, 1992 Sep 2, 268:9, 1111-7
- Abstract
- OBJECTIVE--To assess the impact of diverse continuing medical education (CME)
interventions on physician performance and health care outcomes.
-
- DATA SOURCES--Using continuing medical education and related phrases, we performed
regular searches of the indexed literature (MEDLINE, Social Science Index, the National
Technical Information Service, and Educational Research Information Clearinghouse) from
1975 through 1991. In addition, for these years, we used manual searches, key informants,
and requests to authors to locate other indexed articles and the nonindexed literature of
adult and continuing professional education.
-
- STUDY SELECTION--From the resulting database we selected studies that met the following
criteria: randomized controlled trials; educational programs, activities, or other
interventions; studies that included 50% or more physicians; follow-up assessments of at
least 75% of study subjects; and objective assessments of either physician performance or
health care outcomes.
-
- DATA EXTRACTION--Studies were reviewed for data related to physician specialty and
setting. Continuing medical education interventions were classified by their mode(s) of
activity as being predisposing, enabling, or facilitating. Using the statistical tests
supplied by the original investigators, physician performance outcomes and patient
outcomes were classified as positive, negative, or inconclusive.
-
- DATA SYNTHESIS--We located 777 CME studies, of which 50 met all criteria. Thirty-two of
these analyzed physician performance; seven evaluated patient outcomes; 11 examined both
measures. The majority of the 43 studies of physician performance showed positive results
in some important measures of resource utilization, counseling strategies, and preventive
medicine. Of the 18 studies of health care outcomes, eight demonstrated positive changes
in patients' health care outcomes.
-
- CONCLUSION--Broadly defined CME interventions using practice-enabling or reinforcing
strategies consistently improve physician performance and, in some instances, health care
outcomes.
-
- Language of Publication
- LA=ENG
- Unique Identifier
- 92365208
- MeSH Heading (Major)
- Clinical Competence|*SN; Education, Medical, Continuing|*/ST; Treatment Outcome|*
- MeSH Heading
- Databases, Factual; MEDLINE; Quality Assurance, Health Care; Randomized Controlled
Trials; Specialties, Medical|SN; Support, Non-U.S. Gov't; United States
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0098-7484
- Country of Publication
- UNITED STATES
-
- Title
- A randomized trial of a program to reduce the use of psychoactive drugs in nursing homes
[see comments]
- Author
- Avorn J; Soumerai SB; Everitt DE; Ross-Degnan D; Beers MH; Sherman D; Salem-Schatz SR;
Fields D
- Address
- Program for the Analysis of Clinical Strategies, Harvard Medical School, Boston, MA.
- Source
- N Engl J Med, 1992 Jul 16, 327:3, 168-73
- Abstract
- BACKGROUND. Although psychoactive medications have substantial side effects in the
elderly, these drugs are used frequently in nursing homes. Few interventions have
succeeded in changing this situation, and little is known about the clinical effects of
such interventions.
-
- METHODS. We studied six matched pairs of nursing homes; at one randomly selected nursing
home in each pair, physicians, nurses, and aides participated in an educational program in
geriatric psychopharmacology. At base line we determined the type and quantity of drugs
received by all residents (n = 823), and a blinded observer performed standardized
clinical assessments of the residents who were taking psychoactive medications.
-
- After the five-month program, drug use and patient status were reassessed.
-
- RESULTS. Scores on an index of psychoactive-drug use, measuring both the magnitude and
the probable inappropriateness of medication use, declined significantly more in the
nursing homes in which the program was carried out (experimental nursing homes) than in
the control nursing homes (decrease, 27 percent vs. 8 percent; P = 0.02). The use of
antipsychotic drugs was discontinued in more residents in the experimental nursing homes
than in the control nursing homes (32 percent vs. 14 percent); the comparable figures for
the discontinuation of long-acting benzodiazepines were 20 percent vs. 9 percent, and for
antihistamine hypnotics, 45 percent vs. 21 percent. In the experimental nursing homes
residents who were initially taking antipsychotic drugs showed less deterioration on
several measures of cognitive function than similar residents in the control facilities,
but they were more likely to report depression. Those who were initially taking
benzodiazepines or antihistamine hypnotic agents reported less anxiety than controls but
had more loss of memory. Most other measures of clinical status remained unchanged in both
groups.
-
- CONCLUSIONS. An educational program targeted to physicians, nurses, and aides can reduce
the use of psychoactive drugs in nursing homes without adversely affecting the overall
behavior and level of functioning of the residents.
- Language of Publication
- LA=ENG
- Unique Identifier
- 92301485
- MeSH Heading (Major)
- Drug Utilization|*SN/ST; Nursing Homes|*ST; Psychotropic Drugs|*AD
- MeSH Heading
- Aged; Antidepressive Agents|AD; Benzodiazepines|AD; Education, Continuing; Education,
Medical, Continuing; Education, Nursing, Continuing; Geriatric Psychiatry|ED; Homes for
the Aged|ST; Human; Hypnotics and Sedatives|AD; Massachusetts; Mental Processes|DE;
Nurses' Aides|ED; Support, Non-U.S. Gov't; Treatment Outcome
- Publication Type
- CLINICAL TRIAL JOURNAL ARTICLE RANDOMIZED CONTROLLED TRIAL
- ISSN
- 0028-4793
- Country of Publication
- UNITED STATES
- CAS Registry/EC Number
- 0 (Antidepressive Agents); 0 (Benzodiazepines); 0 (Hypnotics and Sedatives); 0
(Psychotropic Drugs)
- Title
- Improving continuing medical education and addressing the challenge of instituting
reaccreditation.
- Author
- Westcott R
- Source
- Br J Gen Pract, 1996 Jan, 46:402, 43-5
- Abstract
- The present postgraduate education allowance structure for general practitioners is
unacceptable and inadequate on a number of counts. Improvements could be made in
continuing medical education by involving learners more actively, through giving them
greater ownership of their continuing medical education aims and by integrating it with
the current moves towards reaccreditation. Current proposals for the implementation of
reaccreditation are expensive, unacceptable to many in the general practice profession,
and unconnected with present continuing medical education arrangements and the existing
education structure.
-
- It would be more sensitive to current attitudes, more practical, a better use of
existing facilities and more logical to improve continuing medical education by linking
its improvement to the evaluation of reaccreditation in as acceptable and simple a way as
possible. A framework is proposed, based on an annual educational general practitioner
assessment visit in which a personal learning plan is developed as a focus for an
individual's continuing medical education needs.
- Language of Publication
- LA=ENG
- Unique Identifier
- 96286904
- MeSH Heading (Major)
- Accreditation|*OG; Education, Medical, Continuing|*OG; Family Practice|*ED
- MeSH Heading
- Great Britain; Human
- Publication Type
- JOURNAL ARTICLE
- ISSN
- 0960-1643
- Country of Publication
- ENGLAND
- Title
- Satellite-delivered continuing medical education in Europe.
- Author
- Geraghty JG; Young HL
- Address
- General Surgical Oncology, European Institute of Oncology, Milan, Italy.
- Source
- Postgrad Med J, 1996 Apr, 72:846, 218-20
- Abstract
- There is increasing recognition of the need for continuing medical education in the
medical profession. There are now many ways of delivering medical education including
conferences, books, journals amongst others. This paper describes a novel method of
delivering medical education using satellite transmission. This medium allows live medical
education programmes to be broadcast to over 150 receiver sites in Europe. It also enables
two-way live satellite links to be made between countries during the broadcast.
EuroTransMed has an editorial board, in much the same way as a journal, which is
representative of the differing medical societies in Europe. As the barriers between the
various countries fall, EuroTransMed is an ideal medium to promote high quality, easily
accessible, continuing medical education at a pan-European level.
- Language of Publication
- LA=ENG
- Unique Identifier
- 96297249
- MeSH Heading (Major)
- Education, Medical, Continuing|*MT/TD; Satellite Communications|*OG/TD
- MeSH Heading
- Europe; Forecasting; Human
- Publication Type
- JOURNAL ARTICLE REVIEW REVIEW, TUTORIAL
- ISSN
- 0032-5473
- Country of Publication
- ENGLAND
