title: An Analysis of 2.3 Million Participations in the Continuing Medical Education Program of a General Medical Journal: Suitability, User Characteristics, and Evaluation by Readers.
abstract: Physicians frequently use continuing medical education (CME) in journals. However, little is known of the evaluation of journal CME by readers and also user and participation characteristics. Deutsches Ärzteblatt, the journal of the German Medical Association, is distributed to every physician in Germany and regularly offers its readers CME articles. Therefore, it provides a unique opportunity to analyze a journal CME program directed at an entire population of physicians.
  
  
  
  The aim is to show key sociodemographic characteristics of participants, frequency and temporal distributions of participations, and to analyze whether the articles are suitable for a general medical audience, how physicians rate the CME articles, how successful they were in answering simple multiple-choice questions, and to detect distinct clusters of participants.
  
  
  
  Using obligatory online evaluation forms and multiple-choice questions, we analyzed all participations of the entire 142 CME articles published between September 2004 and February 2014. We compared demographic characteristics of participants with official figures on those characteristics as provided by the German Medical Association.
  
  
  
  A total of 128,398 physicians and therapists (male: 54.64%, 70,155/128,393; median age class 40 to 49 years) participated 2,339,802 times (mean 16,478, SD 6436 participations/article). Depending on the year, between 12.33% (44,064/357,252) and 16.15% (50,259/311,230) of all physicians in the country participated at least once. The CME program was disproportionally popular with physicians in private practice, and many participations took place in the early mornings and evenings (4544.53%, 1,041,931/2,339,802) as well as over the weekend (28.70%, 671,563/2,339,802). Participation by specialty (ranked in descending order) was internal medicine (18.25%, 23,434/128,392), general medicine (16.38%, 21,033/128,392), anesthesiology (10.00%, 12,840/128,392), and surgery (7.06%, 9059/128,392). Participants rated the CME articles as intelligible to a wider medical audience and filling clinically relevant knowledge gaps; 78.57% (1,838,358/2,339,781) of the sample gave the CME articles very good or good marks. Cluster analysis revealed three groups, one comprised of only women, with two-thirds working in private practice.
  
  
  
  The CME article series of Deutsches Ärzteblatt is used on a regular basis by a considerable proportion of all physicians in Germany; its multidisciplinary articles are suitable to a broad spectrum of medical specialties. The program seems to be particularly attractive for physicians in private practice and those who want to participate from their homes and on weekends. Although many physicians emphasize that the articles address gaps in knowledge, it remains to be investigated how this impacts professional performance and patient outcomes.
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Hildegard
authors.identifier: 0000-0003-3235-2994
authors.initials: H
authors.lastname: Christ
authors.affiliation: Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany.
authors.forename: Jeremy
authors.identifier: 0000-0003-1536-0925
authors.initials: J
authors.lastname: Franklin
authors.affiliation: Municipal Hospital Cologne-Merheim, University of Cologne, Cologne, Germany.
authors.forename: Reinhard
authors.identifier: 0000-0002-6430-0665
authors.initials: R
authors.lastname: Griebenow
authors.affiliation: Deutsches Ärzteblatt, Editorial Offices, Cologne, Germany.
authors.forename: Christopher
authors.identifier: 0000-0001-6246-3674
authors.initials: C
authors.lastname: Baethge
mesh_terms: D000328:Adult; D004502:Education, Medical, Continuing / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010506:Periodicals as Topic / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*
keywords: continuing interactive tutorial; education; journal article; medical