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Continuing medical education: does "no evidence" trump all?
http://www.100md.com 《英国医生杂志》
     EDITOR—Patel, a cardiology fellow at Duke Clinical Research Institute, told the BMJ that no studies have been done to show whether continuing education is working.1 This sentence reports his views, but it does not quote him directly, attach any conditional comments, or set in context. In the circumstances we should excuse Patel and the BMJ for a misleading statement.

    According to a Cochrane review, "Interactive workshops can result in moderately large changes in professional practice."2 Incidentally, the same review shows no effect from "didactic" teaching sessions—that is, lectures to large audiences.

    Thus continuing professional development is capable of changing professional practice. And workshop style programmes are commonplace in the United Kingdom (and much enjoyed by participants). It would probably be correct to say that no studies have shown a global effect of all the continuing professional development happening on all the practice and healthcare outcomes that are supposed to ensue. And that most studies of its effect are confined to localities or individual programmes.

    Would methodologically rigorous large scale studies be possible? Or worth the effort?

    Does anyone else get a little irritated by the lazy rhetorical device of crying out: "no evidence," as if that trumps all?

    Michael F Loudon, freelance general practitioner

    Newark, Nottinghamshire NG22 0AG michael@hillsidehouse.co.uk

    Competing interests: MFL is involved in a freelance project evaluating a continuing professional development programme for Mansfield and District Primary Care Trust.

    References

    Hopkins Tanne J. Requiring doctors to take part in continuing medical education doesn't improve heart attack care. BMJ 2004;328: 664. (20 March.)

    Thomson O'Brien MA, Freemantle N, Oxman AD, Wolf F, Davis DA, Herrin J. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev 2001;(2): CD003030 .