A controlled trial of the effectiveness of Internet continuing medical education

Just published online in BMC Medicine [Open Access]:

Casebeer L, Engler S, Bennett N, Irvine M, Sulkes D, Deslauriers M, Zhang S. A controlled trial of the effectiveness of Internet continuing medical education. BMC Med 2008 Dec 4;6(1):37. [Epub ahead of print] PDF Version

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 CME activities, case vignette surveys were administered to U.S. 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 5,621 U.S. physicians, of the more than 100,000 physicians who participated in 48 internet CME activities, the average effect size was .75, an increased likelihood of 45% that participants were making choices based on clinical evidence. This likelihood was higher in interactive case-based activities 51% (effect size.89) than for text-based clinical updates, 40% (effect size .63). Effectiveness was also higher among primary care physicians than specialists. CME physician participation was associated with making diagnostic and therapeutic choices based on clinical evidence.
CONCLUSIONS: Physicians who participated in selected internet CME activities were more likely to make evidence-based clinical choices than non-participants. Internet CME activities show promise in offering a searchable, credible, available on-demand, high-impact source of CME for physicians.
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