Continuing Medical Education: AMEE Education Guide No 35

amee_newguides.jpgHere is a new AMEE guide on CME, just published in Medical Teacher:

Davis N, Davis D, Bloch R. Continuing medical education: AMEE Education Guide No 35. Medical Teacher 2008; 30(7):652–666.

Abstract: This guide is designed to provide a foundation for developing effective continuing medical education (CME) for practicing physicians. For the purposes of this work, continuing medical education is defined as any activity which serves to maintain, develop, or increase the knowledge, skills and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession (American Medical Association 2007; Accreditation Council for CME 2007). The term continuing professional development (CPD) is broader and has become more popular in many areas of the world. As defined by Stanton and Grant, CPD includes educational methods beyond the didactic, embodies concepts of self-directed learning and personal development and considers organizational and systemic factors (Stanton & Grant 1997). In fact, this guide describes many modalities that may be defined as CME or CPD. In the interest of simplicity, we will use the term continuing medical education (CME) throughout, with the understanding that the same strategies may be applied to non-clinical continuing professional education.

For those who do not work exclusively in CME, many terms and processes may be unfamiliar. This guide is intended to provide a broad overview of the discipline of CME as well as a pragmatic approach to the practice of CME. The format provides an overview of CME including history and rationale for the discipline, followed by a practical approach to developing CME activities, the management of the overall CME programme and finally, future trends. At the end of the guide you will find resources including readings, websites and professional associations to assist in the development and management of CME programmes.

Google Chrome

   Last night I heard about Google’s new browser, launched just last week. I listened to the development team’s presentation, downloaded Chrome, and now I’m sold! Here is how they describe it:

Google Chrome is a browser that combines a minimal design with sophisticated technology to make the web faster, safer, and easier.

Listen to the presentations and download the browser here.

Chrome is a tabbed browser like Firefox, but you can move a tab to create a real desktop application. There is one box to type URLs and search terms – the omnibox! The home page collects your favourite pages, so it’s like a collection of visual bookmarks. If you don’t want your computer to collect search history, you can choose an “incognito” window. The “multi-purpose architecture” is Open Source so that anyone creating a browser can copy the source code. I’m just learning about the features but I think I will try using Chrome as my main browser. Very promising!

Google is ten!


According to The Guardian and other sources, including my morning commute radio show, Google turned 10 on Sunday September 7.

A while back I wrote a post on Google history (A little Google history from the Internet Archive) and according to the Internet Archive, Google was actually up and running since May of that year. On May 18, Larry and Sergey wrote: Google has now been up for over a month with the current database and we would like to hear back from you. How do you like the search results? What do you think of the new logo and formatting? Do the new features work for you?

Check out this early issue of the Google Friends Newsletter.

If you feel like updating your Google search skills, check out my Google Primer and Google Scholar Primer.

Sometimes I get nostalgic and use AltaVista, my search engine of choice back in the 90s when we still talked about the “information highway”.  And dogpile is still around, a good choice when you want to cast a wide net. (Or see that cute little dog.)

Qualitative Research series from the BMJ

This excellent series on qualitative research (under the direction of Ayelet Kuper of the University of Toronto) was published online in the BMJ lin August 2008; subscription required.

  • Kuper A, Reeves S, Levinson W. An introduction to reading and appraising qualitative research. BMJ 2008; 337:a288
    This article explores the difference between qualitative and quantitative research and the need for doctors to be able to interpret and appraise qualitative research.
  • Reeves S, Albert M, Kuper A, Hodges BD. Why use theories in qualitative research? BMJ 2008; 337:a949.
    Theories such as interactionism, phenomenology, and critical theory can be used to help design a research question, guide the selection of relevant data, interpret the data, and propose explanations of causes or influences.
  • Hodges BD, Kuper A, Reeves S. Discourse analysis. BMJ 2008; 337:a879.
    This articles explores how discourse analysis is useful for a wide range of research questions in health care and the health professions.
  • Kuper A, Lingard L, Levinson W. Critically appraising qualitative research. BMJ 2008; 337:a1035..
    Summary points:
    – Appraising qualitative research is different from appraising quantitative research
    – Qualitative research papers should show appropriate sampling, data collection, and data analysis
    – Transferability of qualitative research depends on context and may be enhanced by using theory
    – Ethics in qualitative research goes beyond review boards’ requirements to involve complex issues of confidentiality, reflexivity, and power
  • Reeves S, Kuper A, Hodges BD. Qualitative research methodologies: ethnography. BMJ 2008; 337:a1020.
    Key features of ethnographic research:
    – A strong emphasis on exploring the nature of a particular social phenomenon, rather than setting out to test hypotheses about it
    – A tendency to work primarily with “unstructured data” -that is, data that have not been coded at the point of data collection as a closed set of analytical categories
    – Investigation of a small number of cases (perhaps even just one case) in detail
    – Analysis of data that involves explicit interpretation of the meanings and functions of human actions; the product of this analysis primarily takes the form of verbal descriptions and explanations
  • Lingard L, Albert M, Levinson W. Grounded theory, mixed methods, and action research. BMJ 2008; 337:a567.
    These commonly used methods are appropriate for particular research questions and contexts.

How can chiropractic become a respected mainstream profession? The example of podiatry

The debate continues. Here is a new article from the Open Access journal Chiropractic & Osteopathy:

Murphy DR, Schneider MJ, Seaman DR, Perle SM, Nelson CF. How can chiropractic become a respected mainstream profession? The example of podiatry. Chiropr Osteopat 2008 Aug 29;16(1):10. [Epub ahead of print]  HTML version

BACKGROUND: The chiropractic profession has succeeded to remain in existence for over 110 years despite the fact that many other professions which had their start at around the same time as chiropractic have disappeared. Despite chiropractic’s longevity, the profession has not succeeded in establishing cultural authority and respect within mainstream society, and its market share is dwindling. In the meantime, the podiatric medical profession, during approximately the same time period, has been far more successful in developing itself into a respected profession that is well integrated into mainstream health care and society.

OBJECTIVE: To present a perspective on the current state of the chiropractic profession and to make recommendations as to how the profession can look to the podiatric medical profession as a model for how a non-allopathic healthcare profession can establish mainstream integration and cultural authority.

DISCUSSION: There are several key areas in which the podiatric medical profession has succeeded and in which the chiropractic profession has not. The authors contend that it is in these key areas that changes must be made in order for our profession to overcome its shrinking market share and its present low status amongst healthcare professions. These areas include public health, education, identity and professionalism.

CONCLUSION: The chiropractic profession has great promise in terms of its potential contribution to society and the potential for its members to realize the benefits that come from being involved in a mainstream, respected and highly utilized professional group. However, there are several changes that must be made within the profession if it is going to fulfill this promise. Several lessons can be learned from the podiatric medical profession in this effort.

e-Learning in medical education: AMEE Guide 32

This excellent two-part guide was published recently in Medical Teacher [available by subscription]:

Ellaway R, Masters K. AMEE Guide 32: e-Learning in medical education Part 1: Learning, teaching and assessment. Med Teach 2008; 30(5):455-473.

Masters K, Ellaway R. e-Learning in medical education Guide 32 Part 2: Technology, management and design. Med Teach 2008; 30(5):474-489.

For those involved in e-learning much of this guide’s content will offer a review. But its value lies in the thoroughness of the overview of concepts and technology, and the wealth of references to Web sites and published work. For those just entering the world of e-learning, this is an excellent starting point (in my humble opinion).

From the abstract for Part 1:
This Guide is presented both as an introduction to the novice, and as a resource to more experienced practitioners. It covers a wide range of topics, some in broad outline, and others in more detail. Each section is concluded with a brief ‘Take Home Message’ which serves as a short summary of the section. The Guide is divided into two parts. The first part introduces the basic concepts of e-learning, e-teaching, and e-assessment, and then focuses on the day-to-day issues of e-learning, looking both at theoretical concepts and practical implementation issues. The second part examines technical, management, social, design and other broader issues in e-learning, and it ends with a review of emerging forms and directions in e-learning in medical education.

See also Advancing Medical Education: the new series of AMEE guides in medical education