Study objectives: Continuing medical education
(CME) is meant to bridge the gap between new scientific observations
and clinical practice. However, traditional CME has not been effective
at altering the behaviors of physicians. One reason for this failure of
traditional CME programs may be their inflexibility. In traditional
CME, the clinician does not choose the topic, the pace of the program,
or the place of learning, and the CME material cannot be easily
delivered to the point of care where the clinician needs the
information. Computers and computer networks have the potential to
accomplish these goals. CME has begun to appear on the Internet;
however, there have been few evaluations of its usefulness,
acceptance, and effectiveness. Over the last 18 months, we have
developed three on-line pulmonary CME programs, and we have delivered
them on the Virtual Hospital, the University of Iowa’s digital health
sciences library on the Internet. We report our initial experience with
this CME material.
Design: We measured the frequency
with which the Internet-delivered CME is accessed by monitoring
page accessions and by using a log file analysis program (Analog 1.2.3;
University of Cambridge Statistical Laboratory; Cambridge, UK). In
addition, we collected all completed CME examinations and evaluation
forms submitted by registered users.
results: We have found that the frequency with which the
Internet-delivered CME is accessed has continued to increase
with time (2.3-fold increase over 18 months), that evaluations of
technical and content issues are strongly favorable, and that some
clinicians have been willing to pay to receive CME through the medium
of the Internet.
Conclusions: We feel that with
adequate peer review and quality control, physicians will use the
Internet-delivered CME. However, several obstacles to wide use remain.
These obstacles include issues regarding training in using the Internet
for physicians, reluctance of physicians to participate in on-line
commerce, and the current unavailability of CME to be delivered in
small-grained quantities to the point of care. As these issues
are addressed, we feel that on-line CME will represent an increasingly
important CME medium for clinicians.
Abbreviations: ACCME = Accreditation Council for
Continuing Medical Education; AMA = American Medical Association;
CGI = common gateway interface; CME = continuing medical education;
IP = Internet protocol