Does continuing medical education in general practice make a difference?

British Medical Journal, May 8, 1999 by Peter Cantillon, Roger Jones

The way forward

Educators of doctors should take account of the literature on effectiveness of educational interventions as described above. Guides to the planning and evaluation of educational events are available.[42 43]

General practice educational activity should be based on the work that doctors do. Standard (and significant event) audits have been shown to be effective strategies for behaviour change if they include targeted feedback. This review has highlighted the importance of building reinforcement strategies into educational planning. Group and peer review type interventions have also been shown to be feasible and effective.

There are several very positive trends in continuing medical education in primary care, which seem to incorporate both adult learning principles and the findings of the "what is effective in continuing medical education" literature. Caiman, for example, has proposed that the present financially driven credit based system in the United Kingdom be replaced by a new approach in which continuing education, audit, research, and clinical effectiveness are aligned in a unified educational strategy.[44] The educational programme as envisaged will be self directed, practice based, and multiprofessional. There are similarities between this proposed system and the quality assurance and continuing education programme in Australia.[45] Much, however, of the adult learning theory underlying these and other innovations has not been adequately evaluated.[2] These ground breaking programmes will be all the more valuable therefore if their coordinating bodies establish rigorous and continuing evaluation.

We thank Professor Janet Grant for sharing unpublished data from a review of continuing professional development with us, and Dr Jo Freeman for her helpful comments during the drafting of the paper.

Competing interests: None declared.

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