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Related Experiment Videos

When to recommend compulsory versus optional CME programs? A study to establish criteria

F Miller1, A Jacques, C Brailovsky

  • 1Centre for Evaluation in the Health Sciences, Laval University (CESSUL), Quebec, Canada. francois.miller@cessul.ulaval.ca

Academic Medicine : Journal of the Association of American Medical Colleges
|October 6, 1997
PubMed
Summary

Determining when continuing medical education (CME) should be compulsory versus optional for family physicians requires specific criteria. A study found substantial agreement among judges when evaluating physician competence using structured oral interviews (SOI).

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Area of Science:

  • Medical Education
  • Physician Competence Assessment
  • Continuing Medical Education

Background:

  • Continuing medical education (CME) plays a crucial role in maintaining and improving physician competence.
  • Establishing clear criteria for compulsory versus optional remedial CME is essential for effective physician development.
  • The College of Physicians of Quebec sought to define these criteria through a structured assessment process.

Purpose of the Study:

  • To develop and test criteria for recommending compulsory or optional remedial continuing medical education (CME) for family physicians.
  • To assess the consistency of physician-judge recommendations for remedial CME based on structured oral interview (SOI) reports.
  • To validate the decisions made by the College of Physicians of Quebec regarding physician-specific CME interventions.

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Main Methods:

  • A study involving 14 family physicians who underwent a structured oral interview (SOI).
  • SOI reports detailing ten aspects of physician competence were reviewed by 12 external physician-judges.
  • Judges linked observed competence aspects to five types of remedial CME programs, ranging from compulsory to optional.

Main Results:

  • Substantial agreement was found among judges when differentiating between compulsory and optional CME programs (kappa = 0.63, p < .05).
  • Key criteria for optional CME included overall strengths and clinical reasoning quality.
  • Compulsory CME recommendations additionally considered physicians' self-awareness of limits, referral management, and prescribing practices.

Conclusions:

  • The structured oral interview (SOI) provides unique observational data valuable for assessing physician competence.
  • Specific criteria, including self-awareness and clinical judgment, can guide decisions on the type of remedial CME required.
  • External judge assessments corroborated the College of Physicians of Quebec's CME recommendations, validating the study's approach.