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      Barriers to identifying and obtaining CME: a national survey of physicians, nurse practitioners and physician assistants

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          Abstract

          Background

          CPD educators and CME providers would benefit from further insight regarding barriers and supports in obtaining CME, including sources of information about CME. To address this gap, we sought to explore challenges that clinicians encounter as they seek CME, and time and monetary support allotted for CME.

          Methods

          In August 2018, we surveyed licensed US clinicians (physicians, nurse practitioners, and physician assistants), sampling 100 respondents each of family medicine physicians, internal medicine and hospitalist physicians, medicine specialist physicians, nurse practitioners, and physician assistants (1895 invited, 500 [26.3%] responded). The Internet-based questionnaire addressed barriers to obtaining CME, sources of CME information, and time and monetary support for CME.

          Results

          The most often-selected barriers were expense (338/500 [68%]) and travel time ( N = 286 [57%]). The source of information about CME activities most commonly selected was online search ( N = 348 [70%]). Direct email, professional associations, direct mail, and journals were also each selected by > 50% of respondents. Most respondents reported receiving 1–6 days ( N = 301 [60%]) and $1000–$5000 ( n = 263 [53%]) per year to use in CME activities. Most (> 70%) also reported no change in time or monetary support over the past 24 months. We found few significant differences in responses across clinician type or age group. In open-ended responses, respondents suggested eight ways to enhance CME: optimize location, reduce cost, publicize effectively, offer more courses and content, allow flexibility, ensure accessibility, make content clinically relevant, and encourage application.

          Conclusions

          Clinicians report that expense and travel time are the biggest barriers to CME. Time and money support is limited, and not increasing. Online search and email are the most frequently-used sources of information about CME. Those who organize and market CME should explore options that reduce barriers of time and money, and creatively use online tools to publicize new offerings.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12909-021-02595-x.

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          Most cited references24

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          Web-based learning: pros, cons and controversies

          D A Cook (2007)
          Advantages of web-based learning (WBL) in medical education include overcoming barriers of distance and time, economies of scale, and novel instructional methods, while disadvantages include social isolation, up-front costs, and technical problems. Web-based learning is purported to facilitate individualised instruction, but this is currently more vision than reality. More importantly, many WBL instructional designs fail to incorporate principles of effective learning, and WBL is often used for the wrong reasons (eg for the sake of technology). Rather than trying to decide whether WBL is superior to or equivalent to other instructional media (research addressing this question will always be confounded), we should accept it as a potentially powerful instructional tool, and focus on learning when and how to use it. Educators should recognise that high fidelity, multimedia, simulations, and even WBL itself will not always be necessary to effectively facilitate learning.
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            What is the effectiveness of printed educational materials on primary care physician knowledge, behaviour, and patient outcomes: a systematic review and meta-analyses

            Background Printed educational materials (PEMs) are commonly used simple interventions that can be used alone or with other interventions to disseminate clinical evidence. They have been shown to have a small effect on health professional behaviour. However, we do not know whether they are effective in primary care. We investigated whether PEMs improve primary care physician (PCP) knowledge, behaviour, and patient outcomes. Methods We conducted a systematic review of PEMs developed for PCPs. Electronic databases were searched for randomized controlled trials, quasi randomized controlled trials, controlled before and after studies, and interrupted time series. We combined studies using meta-analyses when possible. Statistical heterogeneity was examined, and meta-analysis was performed using a random effects model when significant statistical heterogeneity was present and a fixed effects model otherwise. The template for intervention description and replication (TIDieR) checklist was used to assess the quality of intervention description. Results Our search identified 12,439 studies and 40 studies met our inclusion criteria. We combined outcomes from 26 studies in eight meta-analyses. No significant effect was found on clinically important patient outcomes, physician behaviour, or physician cognition when PEMs were compared to usual care. In the 14 studies that could not be included in the meta-analyses, 14 of 71 outcomes were significantly improved following receipt of PEMs compared to usual care. Most studies lacked details needed to replicate the intervention. Conclusions PEMs were not effective at improving patient outcomes, knowledge, or behaviour of PCPs. Further trials should explore ways to optimize the intervention and provide detailed information on the design of the materials. Protocol registration PROSPERO, CRD42013004356 Electronic supplementary material The online version of this article (doi:10.1186/s13012-015-0347-5) contains supplementary material, which is available to authorized users.
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              What is the role of e-learning? Looking past the hype.

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                Author and article information

                Contributors
                obrienpott.maureen@mayo.edu
                blanshan.anissa@mayo.edu
                huneke.kelly@mayo.edu
                thomas.barbara@mayo.edu
                cook.david33@mayo.edu
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                19 March 2021
                19 March 2021
                2021
                : 21
                : 168
                Affiliations
                [1 ]GRID grid.66875.3a, ISNI 0000 0004 0459 167X, Planning Services, , Mayo Clinic, ; Rochester, MN USA
                [2 ]GRID grid.66875.3a, ISNI 0000 0004 0459 167X, Medical Professionals Marketing, , Mayo Clinic, ; Rochester, MN USA
                [3 ]GRID grid.66875.3a, ISNI 0000 0004 0459 167X, Mayo Clinic School of Continuous Professional Development, Mayo Clinic College of Medicine and Science, ; Rochester, MN USA
                [4 ]Office of Applied Scholarship and Education Science, Mayo Clinic College of Medicine and Science, Rochester, MN USA
                [5 ]GRID grid.66875.3a, ISNI 0000 0004 0459 167X, Division of General Internal Medicine, , Mayo Clinic, ; Rochester, MN USA
                Author information
                http://orcid.org/0000-0003-2383-4633
                Article
                2595
                10.1186/s12909-021-02595-x
                7975233
                33740962
                23e81462-34f4-4349-8faf-a0b7982b0547
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 9 July 2020
                : 5 March 2021
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Education
                education, medical, continuing,credentialing,licensure, medical,marketing,workplace learning

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