title: Electronic continuing education in the health professions: an update on evidence from RCTs.
abstract: BACKGROUND
  Demonstrating the effectiveness of the rapidly expanding field of electronic continuing education (e-CE) has important implications for CE in the health professions. This study provides an update on evidence from randomized controlled trials (RCTs) assessing the effectiveness of e-CE in the health professions.
  
  
  METHODS
  A literature search of RCTs was performed in MEDLINE, EMBASE, and CINAHL from 2004 to 2007. Papers were reviewed separately by 2 of the authors and results were categorized and reviewed according to study comparisons.
  
  
  RESULTS
  Fifteen studies met our inclusion criteria. Six compared e-CE to no intervention or placebo. Of these 6 studies, 4 showed a statistically significant advantage of the e-CE intervention and 2 showed no significant effect. Two studies compared e-CE to a lecture. Of these, 1 showed an advantage of e-CE and 1 showed no difference. Two studies compared e-CE to a small-group interactive intervention. In both studies, the e-CE group outperformed the control. Two studies compared a multicomponent e-CE intervention to one based on flat text, and both showed the multicomponent intervention to be more effective. Two of the 15 studies demonstrated a statistically significant effect on practice patterns. Positive effects of e-CE on knowledge were shown to persist for up to 12 months and effects on practice up to 5 months.
  
  
  CONCLUSIONS
  Overall, these studies suggest that multicomponent e-CE interventions can be effective in changing health professionals' practice patterns, and improve their knowledge. E-CE interventions based purely on flat text appear to be of limited effectiveness in changing either knowledge or practice. These results support the use of multicomponent e-CE as a method of CE delivery.
authors.affiliation: Department of Family and Community Medicine, University of Toronto, Staff physician, St. Michael's Hospital, Toronto, Canada. margarita.antoniades@utoronto.ca
authors.forename: Margarita
authors.initials: M
authors.lastname: Lam-Antoniades
authors.forename: Savithiri
authors.initials: S
authors.lastname: Ratnapalan
authors.forename: Gordon
authors.initials: G
authors.lastname: Tait
mesh_terms: D003194:Computer-Assisted Instruction; D004502:Education, Medical, Continuing / Q000379:methods; D006282:Health Personnel / Q000193:education*; D006801:Humans; D020407:Internet; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D014584:User-Computer Interface