Articles of interest from the Journal of Continuing Education in the Health Professions

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Recommended reading from Anne Taylor-Vaisey:

Journal of Continuing Education in the Health Professions

December 2005; 25 (4) [Epub ahead of print]


Maisonneuve H. Medical education and the physician workforce of France. J Contin Educ Health Prof 2005; 25(4):289.

PubMed


Hinchman J, Beno L, Dennison D, Trowbridge F. Evaluation of a training to improve management of pediatric overweight. J Contin Educ Health Prof 2005; 25(4):259-267.


Introduction: Despite widespread concern about pediatric obesity, health care professionals report low proficiency for identifying and treating this condition. This paper reports on the evaluation of pediatric overweight assessment and management training for clinicians and staff in ! a managed care system. The training was evaluated for its impact on assessment practices and utilization of management tools.

Methods: A delayed-control design was utilized to measure the effects of two 60-minute interactive Continuing Medical education (CME) trainings for the pediatric health care teams. Chart abstraction was conducted at 0-, 3- and 6-months after training, recording the proportion of charts containing the recommended assessment methods and management tools.Results: The training was associated with a significant increase in the utilization of some tools and practices, including charting BMI-for-age percentile (p<0.001) and using a nutrition and activity self-history form (p<0.001). Overall, from baseline to 3-months post training, charting BMI-for-age percentiles increased from zero to 25.2% and utilization of the self-history form increased from zero to 35.3%. These increases were sustained at 6-months post training. Other tools guiding clinician co! unseling were less widely utilized, although a behavioral prescription pad was used with 20% of overweight patients.

Discussion: A modest investment in clinician and staff training designed to be feasible in a clinical setting was associated with substantial increases in the use of appropriate tools and practices for the assessment and management of pediatric overweight. Such training may help to augment and improve the processes of pediatric health care delivery for addressing overweight. The training provides a viable model for future CME efforts in other health care settings.

PubMed


Price DW, Xu S, McClure D. Effect of CME on primary care and OB/GYN treatment of breast masses. J Contin Educ Health Prof 2005; 25(4):240-247.

Abstract: Introduction: CME program planners are being asked to move beyond assessments of knowledge to assessing the impact of CME on practice and patient outcomes.

Methods: We conducted a pre-post analysis of administrative data from 107 physicians, nurse practitioners (NPs), or physician's assistants (PAs) who attended one or two continuing medical education (CME) programs (an in-person, mainly didactic session on breast complaints in women, or an individual mentorship with general surgeons) between August ! 2002 and March 2003. We examined associations between the number of trainings and attempted breast mass aspirations or general surgery referrals for breast masses; individual training and breast mass aspiration attempts or general surgery referrals; and provider type and attempted breast mass aspirations. Generalized linear mixed models were used to model dichotomous outcomes.

Results: Clinicians who participated in individual trainings performed more breast mass aspirations after training (odds ratio (OR) 3.07, [95% confidence interval 1.10-8.54]). Participants who completed two trainings performed more breast mass aspirations after training (OR 2.33, [1.19-4.57]), while those who completed just one did not (OR 1.34, [0.39, 4.58]) but the effect started after the first training and did not strengthen after the second training. NPs and PAs attempted more aspirations after training (OR 6.1, [1.54, 24.1]), whereas physicians did not (OR 0.89 [0.36, 2.22]). Training was not a! ssociated with a change in referrals to general surgery. Referral appropriateness, pre-training readiness to change, and previous training in breast mass aspiration were not assessed.

Discussion: Attempts to aspirate breast masses may increase after CME training. Individual training may be more effective than group training in increasing the likelihood of attempted aspirations.

PubMed


Olson CA, Tooman TR, Leist JC. Contents of a core library in continuing medical education: A Delphi study. J Contin Educ Health Prof 2005; 25(4):278-288.


Introduction: In developing their professional competence, those who are interested in the practice of continuing medical education (CME) should recognize the knowledge base that defines their field. This study systematically identifies and organizes a list of books and journals comprising a core library (100 books/15 journals) for CME professionals.

Methods: The Delphi method was applied to elicit and combine the judgments of a fifty member panel considered knowledgeable about the CME field. The panelists participated in three iterations of the survey to first identify and then rank order nominated works. Separate ranked lists were created for books and journals.Results: Forty-four participants completed the study (88% response rate). 268 books and 34 journals were identified. Mean ratings ranged from 4.78 (high) to 1.50 (low).

Discussion: The results of the study reflect the panel's judgment. The list is not definitive; instead, it describes what a select group of individuals knowledgeable about the CME field considered important. The list should therefore be seen as a general guide and a resource to facilitate decision-making, not as a prescription for creating a library.

PubMed

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