Continuing medical education, continuing professional development, and knowledge translation: improving care of older patients by practicing physicians.
Many community-based internists and family physicians lack familiarity with geriatrics knowledge and best practices, but they face overwhelming fiscal and time barriers to expanding their skills and improving their behavior in the care of older people. Traditional lecture-and-slide-show continuing medical education (CME) programs have been shown to be relatively ineffective in changing this target group's practice. The challenge for geriatrics educators, then, is to devise CME programs that are highly accessible to practicing physicians, that will have an immediate and significant effect on practitioners' behavior, and that are financially viable. Studies of CME have shown that the most effective programs for knowledge translation in these circumstances involve what is known as active-mode learning, which relies on interactive, targeted, and multifaceted techniques. A systematic literature review, supplemented by structured interviews, was performed to inventory active-mode learning techniques for geriatrics knowledge and skills in the United States. Thirteen published articles met the criteria, and leaders of 28 active-mode CME programs were interviewed. This systematic review indicates that there is a substantial experience in geriatrics training for community-based physicians, much of which is unpublished and incompletely evaluated. It appears that the most effective methods to change behaviors involved multiple educational efforts such as written materials or toolkits combined with feedback and strong communication channels between instructors and learners.
Thomas
David C
DC
Department of Medicine and Rehabilitation Medicine, Outpatient Services, Division of General Internal Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. David.Thomas@mountsinai.org
Johnston
Bree
B
Dunn
Kathel
K
Sullivan
Gail M
GM
Brett
Belle
B
Matzko
Marilyn
M
Levine
Sharon A
SA
D003154:Community Medicine / Q000193:education*; D004502:Education, Medical, Continuing / Q000706:statistics & numerical data*; D005853:Geriatrics / Q000193:education*; D006801:Humans; D018794:Problem-Based Learning