title: How do physicians and trainers experience outcome-based education in "Rational prescribing"?
abstract: BACKGROUND
  Continuing medical education (CME) is compulsory in Iran, but has shown limitations in terms of educational style and format. Outcome-based education (OBE) has been proposed internationally to create links to physicians' actual practices. We designed an outcome-based educational intervention for general physicians in primary care (GPs). Positive outcomes on GPs' knowledge, skills and performance in the field of rational prescribing were found and have been reported.The specific purpose of this study was to explore the perceptions of the GPs and trainers, who participated in the outcome-based education on rational prescribing.
  
  
  METHODS
  All nine trainers in the educational programme and 12 general physicians (out of 58) were invited to individual interviews four months after participation in the CME program. Semi-structured open-ended interviews were carried out. Qualitative content analysis was used to explore the text and to interpret meaning and intention.
  
  
  RESULTS
  There was a widespread agreement that the programme improved the participants' knowledge and skills to a higher extent than previously attended programmes. Trainers emphasized the effect of outcome-based education on their educational planning, teaching and assessment methods, while the general physicians' challenges were how to adapt their learning in the real work environment considering social and economical barriers. Self-described attitudes and reported practice changed towards more rational prescribing.
  
  
  CONCLUSIONS
  Outcome-based CME seems attractive and additionally useful for general physicians in Iran and could be an effective approach when creating CME programmes to improve general physicians' performance. Similar approaches could be considered in other contexts both regionally and globally.
authors.affiliation: Medical Management Centre (MMC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden. Hamideh.M.Esmaily@ki.se.
authors.forename: Hamideh M
authors.initials: HM
authors.lastname: Esmaily
authors.forename: Rezagoli
authors.initials: R
authors.lastname: Vahidi
authors.forename: Niaz Mousavian
authors.initials: NM
authors.lastname: Fathi
authors.forename: Rolf
authors.initials: R
authors.lastname: Wahlström
mesh_terms: D002983:Clinical Competence / Q000592:standards; D003162:Competency-Based Education / Q000379:methods*; D003479:Curriculum; D011307:Drug Prescriptions / Q000592:standards; D004363:Drug Utilization / Q000592:standards; D004502:Education, Medical, Continuing / Q000379:methods*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008611:Mentors; D058007:Physicians, Primary Care / Q000193:education*; D010818:Practice Patterns, Physicians' / Q000592:standards; D013997:Time Factors