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Research Article

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

, , , , , , , & show all
Pages 153-161 | Received 24 Sep 2019, Accepted 09 Jan 2020, Published online: 22 Feb 2020

References

  • Davis D. Does CME work? An analysis of the effect of educational activities on physician performance or health care outcomes. Int J Psychiatry Med. 1998;28(1):21–39.
  • Bloom BS. Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews. Int J Technol Assess Health Care. 2005;21(3):380–385.
  • Cervero RM, Gaines JK. The impact of CME on physician performance and patient health outcomes: an updated synthesis of systematic reviews. J Contin Educ Health Prof. 2015;35(2):131–138.
  • Mazmanian PE, Davis DA, Galbraith R. Continuing medical education effect on clinical outcomes: effectiveness of continuing medical education: American college of chest physicians evidence-based educational guidelines. Chest. 2009;135(3):49s–55s.
  • Armson H, Kinzie S, Hawes D, et al. Translating learning into practice: lessons from the practice-based small group learning program. Can Family Physician. 2007;53(9):1477–1485.
  • Scheingold L. Balint work in England: lessons for American family medicine. J Fam Pract. 1988;26(3):315–320.
  • Edmunds S, Brown G. Effective small group learning. Dundee, UK: Association for Medical Education in Europe (AMEE; 2010.
  • Dowling S, Last J, Finnigan H, et al. Continuing education for general practitioners working in rural practice: a review of the literature. Educ Primary Care. 2018;29(3):151–165.
  • Armson H, Elmslie T, Roder S, et al. Is the cognitive complexity of commitment-to-change statements associated with change in clinical practice? An application of bloom’s taxonomy. J Contin Educ Health Prof. 2015;35(3):166–175.
  • Armson H, Wakefield J. Expanding the horizons of practice-based small-group learning: what are we learning? Educ Primary Care. 2013;24(3):153–155.
  • Overton GK, McCalister P, Kelly D, et al. Practice-based small group learning: how health professionals view their intention to change and the process of implementing change in practice. Med Teach. 2009;31(11):e514–20.
  • MacVicar R, Cunningham D, Cassidy J, et al. Applying evidence in practice through small group learning: a Scottish pilot of a Canadian programme. Educ Primary Care. 2006;17(5):465–472.
  • Herbert CP, Wright JM, Maclure M, et al. Better prescribing project: a randomized controlled trial of the impact of case-based educational modules and personal prescribing feedback on prescribing for hypertension in primary care. Fam Pract. 2004;21(5):575–581.
  • Lehmann U, Dieleman M, Martineau T. Staffing remote rural areas in middle- and low-income countries: A literature review of attraction and retention. BMC Health Serv Res. 2008;8:19.
  • Vanasse A, Ricketts T, Courteau J, et al. Long term regional migration patterns of physicians over the course of their active practice careers. Rural Remote Health. 2007;7(4):812.
  • Dussault G, Franceschini MC. Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce. Hum Resour Health. 2006;4(1):1.
  • Priester R, Elliott TE. Forecasting physician workforce requirements in Minnesota. Minn Med. 1995;78(10):21–28.
  • Wright JS, Jablonowski AR. The rural‐urban distribution of health professionals in Georgia. J Rural Health. 1987;3(1):53–70.
  • Rourke J. Perspectives on rural medical care in Ontario. Can Family Physician. 1991;37:1581.
  • Glazebrook R, Harrison S. Obstacles and solutions to maintenance of advanced procedural skills for rural and remote medical practitioners in Australia. Rural Remote Health. 2006;6(4):502.
  • Knowles MS. The modern practice of adult education. New York: New York Association Press; 1970.
  • Kjaer NK, Halling A, Pedersen LB. General practitioners’ preferences for future continuous professional development: evidence from a Danish discrete choice experiment. Educ Prim Care. 2015;26(1):4–10.
  • Dowling S, Last J, Finnegan H, et al. What are the current ‘top five’ perceived educational needs of Irish general practitioners? Ir J Med Sci. 2019;1971:1–8.
  • Cahir C, Bennett K, Teljeur C, et al. Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients. Br J Clin Pharmacol. 2014;77(1):201–210.
  • O’Mahony D, O’Sullivan D, Byrne S, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age Ageing. 2015;44(2):213–218.
  • Institute BR. Benzodiazepine & Z-Drug (BZRA) Deprescribing Algorithm. deprescribingorg. Ottowa, Canada: International License: Bruyere Research Institute; 2016 March. p. 2.
  • Wilson M, Mair A, Dreischulte T, et al. Prescribing to fit the needs of older people–the NHS Scotland Polypharmacy Guidance, 2nd edition. J R Coll Physicians Edinb. 2015;45(2):108–113.
  • Farrell B, Pottie K, Thompson W, et al. Deprescribing proton pump inhibitors: evidence-based clinical practice guideline. Can Fam Physician. 2017;63(5):354–364.
  • NICE. The clinical and cost effectiveness of proton pump inhibitors for the treatment of dyspepsia. NICE: National institute for health and care excellence (NICE), guidelines N; 2000 Jul 23. Report No.
  • Excellence NIfHaC. Clinical knowledge summaries. NSAIDS-prescribing issues CKS: NICE; 2013.
  • Kernick D, Chew-Graham CA, O’Flynn N. Clinical assessment and management of multimorbidity: NICE guideline. Br J Gen Pract. 2017;67(658):235–236.
  • McSherry J, Weiss R. Managing benign prostatic hyperplasia in primary care. Patient-centred approach. Can Fam Physician. 2000;46(2):383–389.
  • O’Kelly MTC, O’Kelly F, Ni Shuilleabhain A, et al. Structure of general practice in Ireland 1982–2015. 2015. p. 1–43. Dublin, Ireland: Trinity College Dublin.
  • Constructing Grounded KC. Theory. A practical guide through qualitative analysis. 1st ed. London: SAGE; 2006.
  • Morse JM. The significance of saturation. Qual Health Res. 1995;5(2):147–149.
  • Welsh E. Dealing with data: using NVivo in the qualitative data analysis process. 2002. 2002;3:2.
  • Allen M, Sargeant J, Mann K, et al. Videoconferencing for practice-based small-group continuing medical education: feasibility, acceptability, effectiveness, and cost. J Contin Educ Health Prof. 2003;23(1):38–47.
  • Murrihy RC, Byrne MK, Gonsalvez CJ. Testing an empirically derived mental health training model featuring small groups, distributed practice and patient discussion. Med Educ. 2009;43(2):140–145.
  • Eliasson G, Mattsson B. From teaching to learning: experiences of small CME group work in general practice in Sweden. Scand J Prim Health Care. 1999;17(4):196–200.
  • Sommers LS, Morgan L, Johnson L, et al. Practice inquiry: clinical uncertainty as a focus for small-group learning and practice improvement. J Gen Intern Med. 2007;22(2):246–252.
  • Larsen DP, Butler AC, Roediger III HL. Test-enhanced learning in medical education. Med Educ. 2008;42(10):959–966.
  • McCoubrie P. Improving the fairness of multiple-choice questions: a literature review. Med Teach. 2004;26(8):709–712.
  • Schuwirth LW, van der Vleuten CP Different written assessment methods: what can be said about their strengths and weaknesses? Med Educ. 2004;38(9):974–979.
  • Moattari M, Yadgari D, Hoseini SJ. The evaluation of a composed program of continuing medical education for general practitioners. J Adv Med Educ Prof. 2014;2(3):120–125.
  • Glazebrook R, Manahan D, Chater AB. Evaluation of an ultrasound program (intermediate obstetric and emergency medicine) for Australian rural and remote doctors. Aust J Rural Health. 2005;13(5):295–299.
  • Tchorz KM, Thomas N, Jesudassan S, et al. Teaching trauma care in India: an educational pilot study from Bangalore. J Surg Res. 2007;142(2):373–377.
  • Beyer M, Gerlach F, Flies U. et al. The development of quality circles/peer review groups as a method of quality improvement in Europe: results of a survey in 26 European countries. Fam Pract. 2003;20(4):443–451.
  • Ter Brugge BPH, Bartelink M-LE-L, Damoiseaux RAMJ, et al. The use of evidence during group meetings of Dutch general practitioners. Educ Primary Care. 2017;28(6):307–312.
  • Grant J. Learning needs assessment: assessing the need. BMJ. 2002;324(7330):156–159.
  • Williamson MK, Pirkis J, Pfaff JJ, et al. Recruiting and retaining GPs and patients in intervention studies: the DEPS-GP project as a case study. BMC Med Res Methodol. 2007;7:42.
  • Sirdifield C, Anthierens S, Creupelandt H, et al. General practitioners’ experiences and perceptions of benzodiazepine prescribing: systematic review and meta-synthesis. BMC Fam Pract. 2013;14(1):191.
  • Clyne B, Fitzgerald C, Quinlan A, et al. Interventions to address potentially inappropriate prescribing in community‐dwelling older adults: a systematic review of randomized controlled trials. J Am Geriatr Soc. 2016;64(6):1210–1222.
  • Britt HC, Harrison CM, Miller GC, et al. Prevalence and patterns of multimorbidity in Australia. Med J Aust. 2008;189(2):72–77.
  • Bourke J, Roper S. In with the new: the determinants of prescribing innovation by general practitioners in Ireland. Eur J Health Econ. 2012;13(4):393–407.
  • Gabhainn SN, Murphy AW, Kelleher C. A national general practice census: characteristics of rural general practices. Fam Pract. 2001;18(6):622–626.
  • Dowling S, Last J, Finnegan H, et al. Does locally delivered small group continuing medical education (CME) meet the learning needs of rural general practitioners? Educ Primary Care. 2019 May;30(3):145–151.
  • Lott DR. Obstacles to self‐paced learning for rural physicians. J Contin Educ Health Prof. 1995;15(4):203–208.
  • Curran V, Hatcher L, Kirby F. CME needs of rural physicians: how do we compare to our urban colleagues? Can J Rural Med. 2000;5(3):131.
  • Alexander C, Fraser JD. Education, training and support needs of Australian trained doctors and international medical graduates in rural Australia: a case of special needs? Rural Remote Health. 2007;7(2):681.
  • White CD, Willett K, Mitchell C, et al. Making a difference: education and training retains and supports rural and remote doctors in Queensland. Rural Remote Health. 2007 Apr–Jun;7(2):700.
  • Organisation WH. Increasing access to health workers in remote and rural areas through improved retention. Geneva: World Health Organisation; 2010.
  • Wetzel MS. Developing the role of the tutor/facilitator. Postgrad Med J. 1996;72(850):474–477.
  • Chew-Graham CA, May CR, Perry MS. Qualitative research and the problem of judgement: lessons from interviewing fellow professionals. Fam Pract. 2002;19(3):285–289.
  • Barry CA, Britten N, Barber N, et al. Using reflexivity to optimize teamwork in qualitative research. Qual Health Res. 1999;9(1):26–44.
  • Dowling S, Last J, Finnegan H, et al. Impact of participation in continuing medical education small group learning (CME-SGL) on the stress, morale, and professional isolation of rurally-based GPs: a qualitative study in Ireland. BJGP open. 2019.

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