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Effekt av etterutdanning av helsepersonell - prosjektbeskrivelse
This review updates Forsetlund L, Bjørndal A, Rashidian A, Jamtvedt G, O’Brien MA, Wolf F, Davis D, Odgaard-Jensen J, Oxman AD. Continuing education meetings and workshops : effects on professional practice and health care outcomes. The Cochrane Database of Systematic Reviews 2009, Issue 2. Art.No.: CD003030. DOI: 10.1002/14651858.CD003030.pub2.
Plain language summary
Educational meetings are one of several continuing medical educational activities that "serve 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 2006). Educational meetings include courses, seminars and workshops in various formats. The nature of educational meetings varies in terms of aims, content, the number of participants, the degree and type of interaction, length, frequency and what kind of practices are targeted. Slow diffusion and implementation of research results (Balas 2000), large variations in professional practice (Wennberg 2011; Mays 2011) and major deficiencies in patient safety (Institute of Medicine 2001) are constant challenges in the health care delivery system. In the previous version of this review we found that the median baseline adherence to recommended practices was only 40% (interquartile range 18 to 57%). To improve health care services, one of the important tasks at hand is to identify effective strategies for improving and maintaining healthcare providers' professional performance.
Based on the 81 included trials in the previous review version (Forsetlund 2009), we concluded that educational meetings alone or combined with other interventions can improve professional practice and the achievement of treatment goals by patients. The effect on professional practice tended to be small but varied between studies, and the effect on patient outcomes was generally less, as would be expected. It was not possible to explain the observed differences in effect with confidence but it appeared that higher attendance at the meetings was associated with greater effects, that mixed interactive and didactic education was more effective than either alone, and that the effects were less for more complex behaviours and less serious outcomes.
In addition to updating our searches, in this update we will consider additional factors that might explain variation in the effects of educational meetings based on overviews of reviews of continuing medical education and theories of professional behaviour change.
American Medical Association. The Physician’s Recognition Award and credit system Information for accredited providers and physicians. Revision edition. Chicago: American Medical Association, 2006.
Balas EA, Boren SA. Managing clinical knowledge for health care improvement. In: Bemmel J, McCray AT, editor(s). Yearbook of Medical Informatics: : Patient-Centered Systems.
Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington: National Academy Press, 2001.
Mays N. Reducing unwarranted variations in healthcare in the English NHS. BMJ 2011;342:d1849.
Wennberg JE, Thomson PY. Time to tackle unwarranted variations in practice. BMJ 2011;342:d1513.
Davis D, O'Brien MAT, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A. Impact of formal continuing medical education. Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA 1999;282:867-874. [DOI: ]
Forsetlund L, Bjørndal A, Rashidian A, Jamtvedt G, O'Brien MA, Wolf F, Davis D, Odgaard-Jensen J, Oxman AD. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2009, Issue Issue 2. Art. No.: CD003030. DOI: 10.1002/14651858.CD003030.pub2.
O'Brien Thomson MA, Freemantle N, Oxman AD, Wolf F, Davis DA, Herrin J. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2001, Issue 1. Art. No.: CD003030. Art. No.: CD003030. DOI: 10.1002/14651858.CD003030.