title: Efficacy of an integrated continuing medical education (CME) and quality improvement (QI) program on radiation oncologist (RO) clinical practice.
abstract: OBJECTIVE
  There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program.
  
  
  METHODS
  The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program.
  
  
  RESULTS
  Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program.
  
  
  CONCLUSIONS
  An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence.
authors.affiliation: Department of Radiation Oncology, The Cancer Institute, National University Hospital, Singapore. Cheng_Nang_Leong@mail.nhg.com.sg
authors.forename: Cheng Nang
authors.initials: CN
authors.lastname: Leong
authors.forename: Thomas Philip
authors.initials: TP
authors.lastname: Shakespeare
authors.forename: Rahul K
authors.initials: RK
authors.lastname: Mukherjee
authors.forename: Michael F
authors.initials: MF
authors.lastname: Back
authors.forename: Khai Mun
authors.initials: KM
authors.lastname: Lee
authors.forename: Jiade Jay
authors.initials: JJ
authors.lastname: Lu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Wynne
authors.forename: Keith
authors.initials: K
authors.lastname: Lim
authors.forename: Johann
authors.initials: J
authors.lastname: Tang
authors.forename: Xiaojian
authors.initials: X
authors.lastname: Zhang
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004502:Education, Medical, Continuing / Q000592:standards*; D006801:Humans; D008499:Medical Records / Q000592:standards; D015397:Program Evaluation; D018787:Radiation Oncology / Q000193:education* / Q000592:standards