Biomaterial Database

[Does continuing medical education improve the way physicians conduct their practice?]. 1999

P Durieux, and P Ravaud, and C Chaix, and I Durand-Zaleski

Hôpital Cochin, Service de santé publique et IEPS, UFR Broussais-Hôtel Dieu, Paris. pierre.durieux@cch.ap-hop-paris.fr

OBJECTIVE Physicians practicing in France are required to participate in continuing education programs in accordance with the code of deontology and the official decree on controlling medical expenditures. We reviewed the literature to analyze the efficacy of such training on the way physicians conduct their practice. METHODS We examined the following educational methodologies: diffusion of educational documents or guidelines, conferences and presentations, interventions by opinion leaders, direct visits at the physician's office. The analysis was based solely on publications issuing from work considered to be valid in accordance with the Cochrane collaboration: intervention trials, chronological series, before-after studies with control group. RESULTS The diffusion of educational material or more formal continuing education programs do not appear to have an effect on the way physicians conduct their practice. Interventions by opinion leaders have a demonstrated impact but are rarely judged clinically significant. Visits to the physician's office by specially trained health care workers have an effect but this mode of education is costly. CONCLUSIONS The conventional strategies, such as simple information diffusion and continuing education programs, developed to promote an evolution of clinical practices appear to be the least effective methodologies.

UI	MeSH Term	Description	Entries
D010818	Practice Patterns, Physicians'	Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.	Clinical Practice Patterns,Physician's Practice Patterns,Clinical Practice Pattern,Pattern, Clinical Practice,Patterns, Clinical Practice,Practice Pattern, Clinical,Practice Patterns, Clinical,Practice Patterns, Physician's,Prescribing Patterns, Physician,Physician Practice Patterns,Physician Prescribing Pattern,Physician Prescribing Patterns,Physician's Practice Pattern,Physicians' Practice Pattern,Physicians' Practice Patterns,Practice Pattern, Physician's,Practice Pattern, Physicians',Practice Patterns, Physician,Prescribing Pattern, Physician
D011785	Quality Assurance, Health Care	Activities and programs intended to assure or improve the quality of care in either a defined medical setting or a program. The concept includes the assessment or evaluation of the quality of care; identification of problems or shortcomings in the delivery of care; designing activities to overcome these deficiencies; and follow-up monitoring to ensure effectiveness of corrective steps.	Quality Assessment, Health Care,Health Care Quality Assessment,Health Care Quality Assurance,Healthcare Quality Assessment,Healthcare Quality Assurance,Quality Assessment, Healthcare,Quality Assurance, Healthcare,Assessment, Healthcare Quality,Assessments, Healthcare Quality,Assurance, Healthcare Quality,Assurances, Healthcare Quality,Healthcare Quality Assessments,Healthcare Quality Assurances,Quality Assessments, Healthcare,Quality Assurances, Healthcare
D011787	Quality of Health Care	The levels of excellence which characterize the health service or health care provided based on accepted standards of quality.	Pharmacy Audit,Quality of Care,Quality of Healthcare,Audit, Pharmacy,Care Quality,Health Care Quality,Healthcare Quality,Pharmacy Audits
D004502	Education, Medical, Continuing	Educational programs designed to inform physicians of recent advances in their field.	Medical Education, Continuing,Continuing Medical Education,Education, Continuing Medical
D005602	France	A country in western Europe bordered by the Atlantic Ocean, the English Channel, the Mediterranean Sea, and the countries of Belgium, Germany, Italy, Spain, Switzerland, the principalities of Andorra and Monaco, and by the duchy of Luxembourg. Its capital is Paris.	Corsica,Saint Pierre and Miquelon,Miquelon and Saint Pierre,Miquelon and St. Pierre,St. Pierre and Miquelon
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man