The Chicago Manual of Style Online

writing.jpg  Many will agree that The Chicago Manual of Style, now  in its 17th edition, is indeed the bible of the publishing and research community, as it is described on the Web site of The Chicago Manual of Style Online.  I just discovered this Web site, and, although it is a subscription service, you can get a free 30 day trial and there is much useful material available for free. Here are some of the resources:

Order of the Science Scouts of Exemplary Repute and Above Average Physique

00ootssoeraaap.jpg  Order of the Science Scouts of Exemplary Repute and Above Average Physique

Here is a new club For the propagation of an ideal where science communicators can meet firstly, for drinks; secondly, for communicating; and ultimately, for networking.

Based at the University of British Columbia, members are:
– not opposed to alcohol
– fond of IPCC reports (especially the pictures)
– mostly in agreement with the “truth”
– into badges
– grieving for the slow and miserable death of the Hubble Space Telescope
– possibly possessed of supernatural powers
– not in the business of total world domination
– committed to the constant and diligent presentation of science stories, be it to editors, producers, directors, educators, relatives and/or friends of various ilk, in an effort to lessen the gap that is this thing we call public scientific literacy.

Members may earn such badges as The MacGyver, I’m pretty confident around an open flame, destroyer of quackery, sexing up science, my degree inadvertantly makes me competent in fixing household appliances, I’ve touched human internal organs with my own hands … and many more.

View all the badges and join this prestigious order here.

Online CME: from Medical Teacher

medteach.jpg  These two articles were published in the November 2006 issue of Medical Teacher:

Lockyer J, Sargeant J, Curran V, Fleet L. The transition from face-to-face to online CME facilitation. Med Teach 2006; 28(7):625-630.

This study examines the experiences of nine medical teachers who transitioned from face-to-face teaching to facilitating a course in an online environment. The authors examined the reasons why the teachers agreed to facilitate an online course, the challenges they encountered and their practical solutions, and the advantages and disadvantages they perceived to this teaching environment. Thirty-minute phone interviews were conducted. An iterative process was used to develop the themes and sub-themes for coding. Teachers reported being attracted to the novelty of the new instructional format and saw online learning as an opportunity to reach different learners. They described two facets to the transition associated with the technical and facilitation aspects of online facilitation. They had to adapt their usual teaching materials and determine how they could make the ‘classroom’ user friendly. They had to determine ways to encourage interaction and facilitate learning. Lack of participation was frustrating for most. This study has implications for those intending to develop online courses. Teacher selection is important as teachers must invest time in course development and teaching and encourage participation. Teacher support is critical for course design, site navigation and mentoring to ensure teachers facilitate online discussion.

Practice points

•Online interactive continuing medical education is a new format for physician-teachers.
•Facilitators are drawn to online CME by the novelty of teaching with this new medium and the opportunity to reach new learners.
•Facilitators faced two challenges in their transition from face-to-face teaching: the technical aspects associated with the medium and the skills of facilitating in a different environment.
•Organizations beginning to develop interactive online learning programs need to pay attention to the selection of teachers who are prepared to invest the time and energy into learning and thinking about the technology and their facilitation skills.

•Facilitators recognize and appreciate instructional design support for course construction, navigation tips and facilitation guidance.

Sandars J. Twelve tips for effective online discussion in continuing medical education. Med Teach 2006; 28(7):591-593.

Abstract: Online discussions for continuing medical education are increasing but many are ineffective. Close attention needs to be paid to the requirements of the learner and the wider healthcare organizational context within which continuing medical education takes place. There is a preference for structured and facilitated online discussions by this group of doctors. The essential skills for effective online facilitation are outlined.
See also Twelve Tips: Medical Teacher series

Effectiveness of Continuing Medical Education

jh.gif  This ambitious report was prepared by the Evidence-based Practice Center at Johns Hopkins University, and just published by the Agency for Healthcare Research and Quality.  This report is Number 149 in the AHRQ’s Evidence Report/Technology Assessment series. From the report:

‘The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment. This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.’

Johns Hopkins University.Evidence-based Practice Center. Effectiveness of Continuing Medical Education. Baltimore MD: Agency for Healthcare Research and Quality, 2007.

Investigators: Spyridon S. Marinopoulos M.D., M.B.A.; Todd Dorman, M.D.; Neda Ratanawongsa, M.D.; Lisa M. Wilson, Sc.M.; Bimal H. Ashar, M.D.; Jeffrey L. Magaziner, M.D.; Redonda G. Miller, M.D., M.B.A.; Patricia A. Thomas, M.D.; Gregory P. Prokopowicz, M.D.; Rehan Qayyum, M.D.; Eric B. Bass, M.D., M.P.H.

Objective: Despite the broad range of continuing medical education (CME) offerings aimed at educating practicing physicians through the provision of up-to-date clinical information, physicians commonly overuse, under-use, and misuse therapeutic and diagnostic interventions. It has been suggested that the ineffective nature of CME either accounts for the discrepancy between evidence and practice or at a minimum contributes to this gap. Understanding what CME tools and techniques are most effective in disseminating and retaining medical knowledge is critical to improving CME and thus diminishing the gap between evidence and practice. The purpose of this review was to comprehensively and systematically synthesize evidence regarding the effectiveness of CME and differing instructional designs in terms of knowledge, attitudes, skills, practice behavior, and clinical practice outcomes.

Methods: We formulated specific questions with input from external experts and representatives of the Agency for Healthcare Research and Quality (AHRQ) and the American College of Chest Physicians (ACCP) which nominated this topic. We systematically searched the literature using specific eligibility criteria, hand searching of selected journals, and electronic databases including: MEDLINE®, EMBASE®, the Cochrane Database of Systematic Reviews, The Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Database of Abstracts of Reviews of Effects (DARE), PsycINFO, and the Educational Resource Information Center (ERIC®). Two independent reviewers conducted title scans, abstract reviews, and then full article reviews to identify eligible articles. Each eligible article underwent double review for data abstraction and assessment of study quality.

Results: Of the 68,000 citations identified by literature searching, 136 articles and 9 systematic reviews ultimately met our eligibility criteria. The overall quality of the literature was low and consequently firm conclusions were not possible. Despite this, the literature overall supported the concept that CME was effective, at least to some degree, in achieving and maintaining the objectives studied, including knowledge (22 of 28 studies), attitudes (22 of 26), skills (12 of 15), practice behavior (61 of 105), and clinical practice outcomes (14 of 33). Common themes included that live media was more effective than print, multimedia was more effective than single media interventions, and multiple exposures were more effective than a single exposure. The number of articles that addressed internal and/or external characteristics of CME activities was too small and the studies too heterogeneous to determine if any of these are crucial for CME success. Evidence was limited on the reliability and validity of the tools that have been used to assess CME effectiveness. Based on previous reviews, the evidence indicates that simulation methods in medical education are effective in the dissemination of psychomotor and procedural skills.

Conclusion: Despite the low quality of the evidence, CME appears to be effective at the acquisition and retention of knowledge, attitudes, skills, behaviors and clinical outcomes. More research is needed to determine with any degree of certainty which types of media, techniques, and exposure volumes as well as what internal and external audience characteristics are associated with improvements in outcomes.
PDF version (very large file)

Suggested Citation [from the document]:

Marinopoulos SS, Dorman T, Ratanawongsa N, Wilson LM, Ashar BH, Magaziner JL, Miller RG, Thomas PA, Prokopowicz GP, Qayyum R, Bass EB. Effectiveness of Continuing Medical Education. Evidence Report/Technology Assessment No. 149 (Prepared by the Johns Hopkins Evidence-based Practice Center, under Contract No. 290-02-0018.) AHRQ Publication No. 07-E006. Rockville, MD: Agency for Healthcare Research and Quality. January 2007.