Study tracks learning via online CME

Online CME has a modest effect on physician knowledge over the long term. Doctors value the content quality of online CME above all else, and the more interactive the program, the more satisfied physicians are.

These are a few of the findings from the "Study of Continuing Online Physician Education," conducted by the continuing medical education department of the University of Alabama School of Medicine, Birmingham, in collaboration with CECity, a developer of online education technologies.

Touted as a milestone in CME research, the study, funded by the Merck Co. Foundation, has won the Alliance for Continuing Medical Education's 2004 William Campbell Felch/Wyeth Award for Research in CME.

"Most of our programming has been transformed from programs that require the physician to come to us. Now, we are delivering it to them," said Robert Kristofco, associate professor and director of continuing medical education at UAB.

The study looked at why physicians access specific online courses, what they learned from the course, whether case-based courses were more effective than text-based courses and if physicians make any practice changes as a result.

Some 1,800 physicians participated, with 720 completing posttests. The doctors took a pretest evaluation, a posttest review and a follow-up test four weeks later.

The trial evaluated 30 online CME courses categorized as text-based or case-based. Overall average knowledge scores increased from 58.1% at pretest to 75.6% at posttest, decreasing to 68.2% four weeks later. Case-based courses increased physician knowledge more than text-based ones.

Nearly all physicians reported making practice changes after completing the course, though not always the ones they had expected to make.

For example, Kristofco said physicians would indicate they were taking a course on diabetes care to update themselves on current treatments. Yet what they learned from the course might have been something new about the diagnosis of type 2 diabetes, which is what they ended up using in their practice instead of a new standard of care.

Content quality was the most important CME characteristic to physicians; too little interaction was the largest source of dissatisfaction.

About 55% of physicians said they had selected their course because of a need to update their knowledge in that area, 14% picked the course because they needed CME credit and 14% chose the topic because of a patient who recently had a problem in that area.