title: Short-Term Performance Improvement of a Continuing Medical Education Program in a Low-Income Country.
abstract: BACKGROUND
  The Haitian Annual Assembly for Orthopaedic Trauma (HAAOT) is a CME conference designed to help Haitian orthopaedic surgeons improve their knowledge and skills. The effectiveness of international CME conferences has not been studied. We hypothesized that HAAOT improves participants' short-term performance on knowledge-based assessments.
  
  
  METHODS
  Data were prospectively collected from 57 Haitian and 21 foreign orthopaedic surgeons and residents who attended HAAOT using pre- and post-presentation questions. An audience response system was used to capture responses to 40 questions. Five additional demographic questions were used to train participants and to record unique audience member responses. Questions were projected in English and in French. Two-sided paired t tests were used to compare pre- and post-test scores. ANOVA with post-hoc unpaired t tests was used to compare among demographic groups.
  
  
  RESULTS
  Response rate Median response rate was 77.4 % per day (Range: 76.5-85.9 % per day). Pre-test scores Pre-test scores averaged 21 % for Haitians and 39 % for foreigners (p < 0.0001), and were similar among Haitian attendings and residents. Pre-post differences Scores improved by 8 % for Haitians (p < 0.0001) and 10 % for foreigners (p < 0.01) after didactic presentations. Among sub-groups, Haitian attendings improved on average by 18 % compared to 6 % for residents (p < 0.0001). Haitian attending improvement trended toward significance when compared to foreign attendings (p < 0.08).
  
  
  CONCLUSIONS
  Our study is the first to show improved short-term knowledge performance using an audience response system during a CME conference in a low-income country. CME conferences in low-income countries can be an effective tool to increase surgeon knowledge, and audience response systems can help engage participants and track outcomes.
authors.affiliation: Program in Global Surgery and Social Change, Department of Plastic & Oral Surgery, Boston Children's Hospital, Enders-118 300 Longwood Avenue, Boston, MA, 02115, USA, jackyfils@post.harvard.edu.
authors.forename: Jacky
authors.initials: J
authors.lastname: Fils
authors.forename: Abhiram R
authors.initials: AR
authors.lastname: Bhashyam
authors.forename: Jacques B
authors.initials: JB
authors.lastname: Pierre Pierre
authors.forename: John G
authors.initials: JG
authors.lastname: Meara
authors.forename: George S M
authors.initials: GS
authors.lastname: Dyer
mesh_terms: D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods / Q000592:standards*; D004521:Educational Measurement / Q000379:methods; D005260:Female; D006205:Haiti; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000193:education*; D011203:Poverty; D011446:Prospective Studies