A systematic review of evaluation in formal continuing medical education
Article first published online: 26 MAR 2007
Copyright © The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education
Journal of Continuing Education in the Health Professions
Volume 27, Issue 1, pages 16–27, Winter 2007
How to Cite
Tian, J., Atkinson, N. L., Portnoy, B. and Gold, R. S. (2007), A systematic review of evaluation in formal continuing medical education. J. Contin. Educ. Health Prof., 27: 16–27. doi: 10.1002/chp.89
- Issue published online: 26 MAR 2007
- Article first published online: 26 MAR 2007
- literature review;
- evaluation studies;
- randomized controlled trial
Introduction: Physicians spend a considerable amount of time in Continuing Medical Education (CME) to maintain their medical licenses. CME evaluation studies vary greatly in evaluation methods, levels of evaluation, and length of follow-up. Standards for CME evaluation are needed to enable comparison among different studies and to detect factors influencing CME evaluation.
Methods: A review of the CME evaluation literature was conducted on primary research studies published from January 2000 to January 2006. Studies assessing only satisfaction with CME were excluded, as were studies where fewer than 50% of the participants were practicing physicians. Thirty-two studies were included in the analyses. Determinations were made about evaluation methods, outcome measures, and follow-up assessment.
Results: Only 2 of 32 reviewed studies addressed all evaluation levels: physician changes in knowledge and attitudes (level 2), practices (level 3), and improved patient health status (level 4). None of the studies using self-developed instruments (n = 10) provided reliability and validity information. Only 6 studies used validated scales. Twenty studies had a follow-up period of 6 months or less, and 11 had a follow-up period between 1 and 2 years.
Discussion: A gold standard for evaluating the effectiveness of CME would include assessment of all 4 levels of evaluation. A valid, reliable, and adaptable CME evaluation questionnaire addressing variables in the second level is needed to allow comparison of effectiveness across CME interventions. A minimum 1-year postintervention follow-up period may also be indicated to investigate the sustainability of intervention outcomes.