CMEの有効性の証拠. 50件のランダム化比較試験のレビュー
D A Davis1, M A Thomson, A D Oxman
1Department of Family Medicine, School of Occupational Therapy and Physiotherapy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
JAMA
|September 2, 1992
まとめ
継続的な医療教育 (CME) 介入は,医師の実務を支援し,パフォーマンスを大幅に改善し,患者の健康結果を向上させることができます. これらの発見は,医療における標的型教育戦略の価値を強調しています.
科学分野:
- 医学教育研究 医学教育研究
- 医療の質の向上 医療の質の向上
- 医療従事者のプロフェッショナル・デベロップメント
背景:
- 継続的な医療教育 (CME) は,医師の専門知識を維持し,強化するために不可欠です.
- 臨床実務と患者の結果に対する様々なCME介入の有効性を評価することは,医療の質にとって不可欠です.
研究 の 目的:
- 様々な継続医療教育 (CME) の介入が医師のパフォーマンスと患者の健康に与える影響を体系的に評価する.
- CMEの有効性に関するランダム化対照試験からの証拠を合成する.
主な方法:
- 複数のデータベース (MEDLINEなど) で包括的な文献検索が行われました. 1975年から1991年までの期間.
- 研究は,ランダム化比較試験,医師に焦点を当てた介入,客観的な結果評価を含む基準に基づいて選択されました.
- 医師の専門分野,環境,介入の種類,およびアウトカム (パフォーマンスと患者) に関するデータが抽出され,分類されました.
主要な成果:
- 特定された777件の研究のうち,50件が含める基準を満たした.
- 医者の業績に焦点を当てた研究の大多数は,資源利用,カウンセリング,予防ケアにプラスの効果を示した.
- 医療成果を評価した研究の有意な部分は,患者の健康状態に肯定的な変化を示した.
結論:
- 広く定義されたCME介入,特に実践を可能にするまたは強化する戦略を採用するものは,一貫して医師のパフォーマンスの向上につながります.
- これらの効果的なCME戦略は,また,特定のケースでは,患者の医療結果に肯定的な影響を与える可能性があります.
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