title: Continuing medical education and evidence-based clinical pathways. Training emergency health workers in Latium, Italy.
abstract: BACKGROUND
  In recent decades, studies that evaluate training programmes have shown that continuing education for physicians is not very effective in improving performance and behavioural changes. One of our goals was to create a Continuing Medical Education Programme (CMEP) that would result in changing the behaviour of health professionals. In early 2005, a new CMEP was offered to emergency medical services and emergency room professionals to introduce an Emergency Critical Pathway (ECP) for the management of acute stroke patients. This paper illustrates the main characteristics of the educational model and the strategies and activities adopted to realize it.
  
  
  METHODS
  The training programme was planned and organized applying the concepts and tools of experiential learning. It was organised in three successive phases: 1) interviews with health professionals to identify their learning needs; 2) training the ECP coordinators/facilitators in a residential setting; and 3) on-site training in small groups of health professionals (6-8), led by a coordinator/facilitator.
  
  
  RESULTS
  The CME involved 324 emergency health professionals. Participants positively evaluated both the educational programme and the clinical indications of the protocols. Over six months of the ECP training, health professionals treated 657 stroke patients: 153 (23.3%) were transferred to the stroke unit where 15 (9.8%) were thrombolysed. In the same period of the previous year, the professionals treated 638 patients: 99 (15.5%) were transferred to the stroke unit and no patients were thrombolysed.
  
  
  CONCLUSIONS
  The application of the new educational methodology has contributed to improved management of stroke patients in Latium.
authors.affiliation: Public Health Agency of Latium Region, Roma, Italy. deluca@asplazio.it
authors.forename: Assunta
authors.initials: A
authors.lastname: De Luca
authors.forename: Andrea
authors.initials: A
authors.lastname: Caprara
authors.forename: Mirca
authors.initials: M
authors.lastname: Barbolini
authors.forename: Carlo
authors.initials: C
authors.lastname: Francia
authors.forename: Marica
authors.initials: M
authors.lastname: Ferri
authors.forename: Silvia
authors.initials: S
authors.lastname: Mamede
authors.forename: Piero
authors.initials: P
authors.lastname: Borgia
authors.forename: Gabriella
authors.initials: G
authors.lastname: Guasticchi
mesh_terms: D003162:Competency-Based Education / Q000379:methods; D004502:Education, Medical, Continuing / Q000379:methods*; D004635:Emergency Medicine / Q000193:education*; D055416:Evidence-Based Emergency Medicine / Q000193:education*; D006801:Humans; D007558:Italy; D017145:Models, Educational; D020521:Stroke / Q000628:therapy