Does hands-on CME in gynaecologic procedures alter clinical practice?

摘要

BACKGROUND: Despite evidence favouring initial medical treatment for benign uterine conditions, hysterectomy rates in Ontario, Canada, in the 1990s were variable, and relatively high. Best methods for translating this or any evidence into practice are, however, elusive. AIM: This study evaluates whether an interactive skill development program had an impact on family practice participants' subsequent ability to manage benign uterine conditions medically. METHODS: Effectiveness of 50 experiential 3 h skill transfer workshops with peers teaching IUD insertion, endometrial sampling and pessary fitting (offered 2005-2007) was assessed by measuring changes in actual practice. Family physicians billing the Ontario Health Insurance Plan over 5 years (2003-2007 inclusive) formed the control group with whom 138 FP workshop participants (cases) were compared. RESULTS: Rates of all procedures increased amongst 138 family physician attendees following participation, but remained unchanged amongst controls. Number of physicians offering the target interventions also increased among cases, but not controls. CONCLUSION: Evidence-based information, delivered by peers, and associated with the opportunity to practice new skills appear to be the components of continuing medical education (CME) that translate into improved clinical care.