Improving continuing medical education by enhancing interactivity: lessons from Iran.
BACKGROUND
Continuing Medical Education (CME) has been considered as a lifelong commitment for doctors to provide the optimal care for patients. Despite a long history of creating CME programs, outcomes are far from ideal. The present qualitative study aims to clarify the barriers affecting effectiveness of the CME programs in Iran based on the experiences of general practitioners.


METHODS
Sixteen general practitioners were recruited to participate in in-depth interviews and field observations concerning experiences with CME. The study was performed using a qualitative content analysis method. The codes, categories and themes were explored through an inductive process in which the researchers moved from specific to general.


RESULTS
The participants' experiences identified a number of barriers, particularly insufficient interaction with the instructors; additional problems included the teachers' use of an undifferentiated approach; unreal and abstract CME; and ignorance of the diverse reasons to participate in CME.


CONCLUSIONS
Based on the study results, there are multiple barriers to effective implementation of CME in Iran. The key barriers include insufficient interaction between the trainees and providers, which must be considered by other stakeholders and program designers. Such interactions would facilitate improved program design, invite more specific tailoring of the education to the participants, allow for more effective educational methods and set the stage for outcome evaluation from the learners actually applying their new knowledge in practice. Replication of these findings with another sample would improve confidence in these recommendations, but these findings are broadly consistent with findings in the educational literature on improving the efficacy of CME.
Department of Medical Education, Iran University of Medical Sciences, Tehran, Iran;
Seyed Aliakbar
SA
Faghihi
Department of Health in Emergency and Disaster, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; ; Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden;
Hamid Reza
HR
Khankeh
Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
Seyed Jalil
SJ
Hosseini
Department of Medical Education, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran;
Seyed Kamran
SK
Soltani Arabshahi
Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;
Zahra
Z
Faghih
University of Toronto, University Health Network, Canadian Network for Mood and Anxiety Treatments, Toronto Western Hospital, Toronto, ON, Canada;
Sagar V
SV
Parikh
Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden; ; Research Deputy of Medical Education Department, Tehran University of Medical Sciences, Tehran, Iran.
Mandana
M
Shirazi
Continuing medical education; General practitioners; Qualitative study