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Dissemination of Evidence From Systematic Reviews Through Academic CME Providers: A Feasibility Study
Michael Fordis1, Jason E King, Francesca Bonaduce de Nigris
1Dr. Fordis: Director, Center for Collaborative and Interactive Technologies, Senior Associative Dean of Continuing Medical Education, Baylor College of Medicine, Houston, TX. Dr. King: Associate Director, Center for Collaborative and Interactive Technologies, Baylor College of Medicine, Houston, TX. Dr. Bonaduce de Nigris: Research Associate, Center for Collaborative and Interactive Technologies, Baylor College of Medicine, Houston, TX. Dr. Morrow: Associate Clinical Professor, Department of Family and Social Medicine, Montefiore Medical Center, Bronx, NY. Dr. Baron: Professor of Medicine, Department of Medicine, University of California, San Francisco, CA. Dr. Kues: Professor Emeritus of Family and Community Medicine, Center for Continuous Professional Development, University of Cincinnati College of Medicine, Cincinnati, OH. Dr. Norton: Director, Center for Interprofessional Health Education, and Professor of Psychiatry, College of Medicine, University of Kentucky, Lexington, KY. Dr. Kessler: Professor, Departments of Medicine and Immunology/Microbiology, Rush University Medical Center, Chicago, IL. Dr. Mazmanian: Associate Dean, Office of Assessment and Evaluation Studies, Department of Family Medicine and Population Health, VCU School of Medicine, Richmond, VA. Dr. Colburn: Executive Director, Center for Continuing Education, University of Nebraska Medical Center, Omaha, NE.
Introduction:
Although systematic reviews represent a source of best evidence to support clinical decision-making, reviews are underutilized by clinicians. Barriers include lack of awareness, familiarity, and access. Efforts to promote utilization have focused on reaching practicing clinicians, leaving unexplored the roles of continuing medical education (CME) directors and faculty in promoting systematic review use. This study explored the feasibility of working with CME directors and faculty for that purpose.
Methods:
A convenience sample of five academic CME directors and faculty agreed to participate in a feasibility study exploring use in CME courses of systematic reviews from the Agency for Healthcare Research and Quality (AHRQ-SRs). AHRQ-SR topics addressed the comparative effectiveness of health care options. Participants received access to AHRQ-SR reports, associated summary products, and instructional resources. The feasibility study used mixed methods to assess 1) implementation of courses incorporating SR evidence, 2) identification of facilitators and barriers to integration, and 3) acceptability to CME directors, faculty, and learners.
Results:
Faculty implemented 14 CME courses of varying formats serving 1700 learners in urban, suburban, and rural settings. Facilitators included credibility, conciseness of messages, and availability of supporting materials; potential barriers included faculty unfamiliarity with SRs, challenges in maintaining review currency, and review scope. SR evidence and summary products proved acceptable to CME directors, course faculty, and learners by multiple measures.
Discussion:
This study demonstrates the feasibility of approaches to use AHRQ-SRs in CME courses/programming. Further research is needed to demonstrate generalizability to other types of CME providers and other systemic reviews.
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