A Questionnaire Study Of Clinicians Participating In Continuing Medical Education Programs

1 Summary:Continuing medical education was originated in the United States in the 1950s, It is defined as a lifelong education to learn the new theory, new knowledge, new skills and new methods (abbreviation for four new) after post-graduation medical education. It aims to maintain high professional ethics for the health personnel in the career, improve their professional competence and professional levels, prompt the quality of service, and to meet the development of medical science and technology and public health undertakings.With the development of modern medical theory and technology, how to conduct continuing education for health care workers becomes an urgent problem. In this regard, many successful experiences have been already accumulated in developed countries. There are two types of continuing medical education system in developed nations:One type is mandatory enforced by means of legislation systems, and main representatives of such countries are France and the United States; The other is non-mandatory continuing medical education system. Under this system, although there are some regulations and programs about continuing medical education, the study is enforced by ways of health care workers'desire, and lack of deed restrictions. The United Kingdom and Japan are the main representatives of these countries. Although there are large differences about continuing medical education among developed countries, some common points can also be existed:First, the necessity of continuing medical education can be recognized by all medical workers; Second, specific guidance institutions have been established in most countries; Third, arrangements for specific activities and guidance documents are drawn up by all countries.Compared with foreign countries, continuing medical education started late in China, and it can be mainly divided into two stages. Before the 1990s, continuing medical education in China has just begun mainly in education for academic career. At that time, a unified national regulations and relevant continuing medical education system has not been promulgated, a sound and comprehensive organization responsible for organizing continuing medical education had not been established, and continuing medical education was in a state of disorder. In 1996, a series of continuing medical education regulations were issued by the Ministry of Health, marking China's continuing medical education in full swing. After 10 years of exploration, continuing medical education encounters a rapid development, and more and more attention from all levels administrators and health workers has been evoked towards it.After a lot of manpower, material resources have been thrown in the continuing medical education, the policy makers, managers and the general health workers are urgently needed to see the effect of continuing medical education, especially its effects on teacher training, subject construction and promotion for medical levels. Forced by the pressure of the community, Assessment of the effect of continuing medical education has become a research hotspot in recent years. However, scientific and empirical research methods to study the effect of continuing medical education has been put forward rarely, and study about continuing medical education mainly remains in the evaluation of participant's satisfaction evaluation on the lower level. There is little evaluation of doctor's behavioral change, and improvement on diagnosis and treatment of disease. Studies about continuing medical education on clinical results of patients has not been reported yet.A landmark paper written by Davis DA, etc. was published in the JAMA in 1995 pointed out that traditional continuing medical education had little effects on diagnosis and treatment of patient's illness. However, a study of Grimshow's in 2003 indicated that the former conclusion was lack of evidence. There are obvious differences about two viewpoints.In this study, document analysis and survey of young clinicians participating continuing medical education activities are introduced for verification the effects of continuing medical education on clinicians.2 Objective2.1 To investigate the basic situation of continuing medical education and its influencing factors, and provide useful guidance for healthy development of continuing medical education.2.2 To describe the status of continuing medical education activities in medical universities nowadays.2.3 To probe into the problems and the countermeasures about continuing medical education.2.4 To evaluate the effect of continuing medical education on physician's activities.2.5 To promote the importance of continuing medical education and the general acceptance of health technicians, and further promote the healthy development of continuing medical education.3 Study subjects and methods 3.1 SubjectsClinicians participating in the programs of national and provincial continuing medical education programs in a certain medical university in Guangzhou in recent years were taken as study subjects.3.2 Questionnaire designA questionnaire of clinicians in continuing medical education activities focusing on research objects was formulated according to documents review and theories and methods of epidemic research. The questionnaire was tested by means of pre-test analysis, principal component analysis and factor analysis methods, and the reliability and validity of the questionnaire was improved to determine the content and format. The items were taken as units, and unified arrangements of scene investigation were taken.3.3 Survey MethodDuring 2008.10-2009.11,450 clinicians participating in 42 items of national and provincial continuing medical education in a certain key medical university were investigated according to the whole random sampling method. The items involved in 35 clinic subjects. Each answered one questionnaire,407 questionnaires were collected, and the response rate was 90.4%; 22 questionnaires was determined invalid due to the main item missing; 385 questionnaires were eligible, accounting for 94.6%. Effective actual number of investigation was 385, and the effective rate was 85.6%. Among them, male physicians numbered 157, female ones 228.3.4 data entry, sorting and StatisticsThe data of questionnaire was treated with EXCEL form, after two overall check and a sample check. SPSS 13.0 statistical software was used to process descriptive analysis of the problems about the status of continuing medical education activities, problems and its effects. 4 Results4.1 A questionnaire of clinicians in continuing medical education activities was designed.4.2 An open database was established with SPSS 13.0 statistical software.4.3 This study shows that clinicians have higher recognization and participation of CME activities, most of them consider that CME activities are necessary to carry out; The main purpose of participating in CME activities are mainly to improve their professional levels and help job.4.4 The investigation showed high evaluation of CME activity's quality from clinicians, and CME activities can meet the requirement on the whole; clinicians in different levels may widen the mentality, develop the thoughts, raises the specialized theoretical level, and raises the practice operational level through CME.4.5 The demand of CME contents differs from different clinician's level. Face to face teaching and distance learning are the main CME activities, but the pattern of CME may be more various; Clinicians participate in CME activities mainly on spare time, and the means of CME activities differs from different clinicians.4.6 There are more factors influencing participation of CME activities. Among them, lack of time, inconvenience of traffic and conflict with job account for the main factors. The time spending on CME activities is expected within 40 class hours, and thus the contradiction between work and study can be avoided to some extend.5 Conclusions5.1 Conclusion 1:The feasibility of described theory and method of epidemiological study utilizing in the study of continuing medical education was proved by our practice of research5.2 Conclusion 2:Department in charge of continuing Medical Education activities should strengthen management and improve the quality of activities. 5.3 Conclusion 3:Various continuing medical education activities should promoted according to clinical practice5.4 Conclusion 4:Continuing medical education activities can play a great role, after the medical needs were fully understand.