How does small group continuing medical education (CME) impact on practice for rural GPs and their patients, a mixed-methods study

ABSTRACT

Studies which report outcomes of continuing medical education (CME) interventions for rural general practitioners (GPs) are limited. This mixed methods study recruited GPs from four CME small group learning (SGL) tutor groups based in different rural locations in the Republic of Ireland. A two-hour teaching module on deprescribing in older patients was devised and implemented. Assessment of educational outcomes was via questionnaires, prescribing audits and qualitative focus groups. All GPs (n = 43) in these CME-SGL groups agreed to participate, 27 of whom (63%) self-identified as being in rural practice. Rural GPs were more likely to be male (56%), in practice for longer (19 years), and attending CME for longer (13 years). The questionnaires indicated learning outcomes were achieved knowledge increased immediately after the education, and was maintained 6 months later. Twenty-four GPs completed audits involving 191 patients. Of these, 152 (79.6%) were de-prescribed medication. In the qualitative focus groups, GPs reported sharing experiences with their peers during CME-SGL helped them to improve patient care and ensured that clinical practice is more consistent across the group. For rural GPs, CME-SGL involving discussion of cases and the practical implementation of guidelines, associated with audit, can lead to changes in patient care.

KEYWORDS:

• Continuing medical education
• rural general practice
• post graduate education

Acknowledgments

The authors would like to thank all the GPs who participated in focus groups and the CME tutors who made this study possible. The authors thank patients who participated in the audit assessments. Thanks also to the national director of ICGP CME, Dr Finola Minehan, and assistant national director, Dr Claire McNicholas, for their continued help, support and advice. The authors would like to acknowledge and thank Dr Andrew Leary.

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethical approval

Ethical approval was granted by the Research Ethics Committee of the Irish College of General Practitioners

Supplementary material

The supplemental data for this article can be accessed here.

Additional information

Funding

This study was supported by an Irish College of General Practitioners (ICGP) Career Support Grant awarded to Dr Dowling.