Surgical CE and knowledge retention

Recommended reading from Anne Taylor-Vaisey: Knowledge retention and improved patient outcomes are pretty much the purpose of continuing education, aren't they? This study just published in the May issue of the American Journal of Surgery reports a positive outcome from a surgical CE event:

Cheifetz RE, Phang PT. Evaluating learning and knowledge retention after a continuing medical education course on total mesorectal excision for surgeons. Am J Surg 2006;191:687-690.

Abstract: The purpose of this study was to determine whether knowledge gained (as determined by a formal course test) by surgeons in a continuing education course on total mesorectal excision and rectal cancer management is retained 1 year later. A formal course test had been previously developed and validated. The test evaluated course content including pelvic anatomy, surgical techniques, imaging, pathology, adjuvant therapies, and cancer and functional outcomes. Validation was determined by the absence of change in pre- and posttest scores of the "expert" course instructors (n = 8, P = .6) and by a linear correlation in test scores with increasing level of general-surgery resident training (n = 16, P = .001). Significant learning by the 58 surgeons taking the course had been shown by improvement in test scores from before the course (mean score 19) to after the course (mean score 25.3, P = .001, out of a possible 33 total mark). At 1 year after the course, those course participants (n = 44, 76%) who had provided postcourse contact information were asked to complete the course test again. Responses were received from 18 surgeons (41% of those surveyed, 31% of the original course participants). The mean score on the test after 1 year was 23.8. Compared with the immediate posttest scores, there was no significant knowledge loss over the year (P = .09). We conclude that knowledge acquired during a continuing education course for surgeons on total mesorectal excision and rectal-cancer management is retained 1 year later.

Excerpt from Comments: Evaluation of CME programs tends to be focused, for the providers, on attendance and, for the participants, on satisfaction. Postcourse evaluation forms consist of questions rating the quality of the presentations and venue and a subjective assessment of whether or not course objectives were met. Little attention is generally paid to whether material was actually learned and even less so on whether practice is changed. Increasingly, CME programs will need to show their effectiveness in broader ways. For example, accreditation of courses by the Royal College of Physician and Surgeons of Canada currently lists assessment of learning as an optional component for course accreditation, but it is expected that fully accredited courses will have this mandated. Recommendations have already been made to the Association of American Medical Colleges promoting systems to measure learning and validate educational effectiveness of CME programs.

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