CoChat
Sign Up
Cited by 1,849Innovations in Medical EducationHealth Policy Implementation ScienceHealth Sciences Research and Education

Continuing education meetings and workshops: effects on professional practice and health care outcomes

Open access
Forsetlund, Louise, Bjørndal, Arild, Rashidian, Arash, Jamtvedt, Gro, O'Brien, Mary Ann, Wolf, Fredric M, Davis, Dave, Odgaard-Jensen, Jan +1 more·2009·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd003030.pub2PMC PMC7138253
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Educational meetings are widely used for continuing medical education. Previous reviews found that interactive workshops resulted in moderately large improvements in professional practice, whereas didactic sessions did not. OBJECTIVES: To assess the effects of educational meetings on professional practice and healthcare outcomes. SEARCH STRATEGY: We updated previous searches by searching the Cochrane Effective Practice and Organisation of Care Group Trials Register and pending file, from 1999 to March 2006. SELECTION CRITERIA: Randomised controlled trials of educational meetings that reported an objective measure of professional practice or healthcare outcomes. DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed study quality. Studies with a low or moderate risk of bias and that reported baseline data were included in the primary analysis. They were weighted according to the number of health professionals participating. For each comparison, we calculated the risk difference (RD) for dichotomous outcomes, adjusted for baseline compliance; and for continuous outcomes the percentage change relative to the control group average after the intervention, adjusted for baseline performance. Professional and patient outcomes were analysed separately. We considered 10 factors to explain heterogeneity of effect estimates using weighted meta-regression supplemented by visual analysis of bubble and box plots. MAIN RESULTS: In updating the review, 49 new studies were identified for inclusion. A total of 81 trials involving more than 11,000 health professionals are now included in the review. Based on 30 trials (36 comparisons), the median adjusted RD in compliance with desired practice was 6% (interquartile range 1.8 to 15.9) when any intervention in which educational meetings were a component was compared to no intervention. Educational meetings alone had similar effects (median adjusted RD 6%, interquartile range 2.9 to 15.3; based on 21 comparisons in 19 trials). For continuous outcomes the median adjusted percentage change relative to control was 10% (interquartile range 8 to 32%; 5 trials). For patient outcomes the median adjusted RD in achievement of treatment goals was 3.0 (interquartile range 0.1 to 4.0; 5 trials). Based on univariate meta-regression analyses of the 36 comparisons with dichotomous outcomes for professional practice, higher attendance at the educational meetings was associated with larger adjusted RDs (P < 0.01); mixed interactive and didactic education meetings (median adjusted RD 13.6) were more effective than either didactic meetings (RD 6.9) or interactive meetings (RD 3.0). Educational meetings did not appear to be effective for complex behaviours (adjusted RD -0.3) compared to less complex behaviours; they appeared to be less effective for less serious outcomes (RD 2.9) than for more serious outcomes. AUTHORS' CONCLUSIONS: Educational meetings alone or combined with other interventions, can improve professional practice and healthcare outcomes for the patients. The effect is most likely to be small and similar to other types of continuing medical education, such as audit and feedback, and educational outreach visits. Strategies to increase attendance at educational meetings, using mixed interactive and didactic formats, and focusing on outcomes that are likely to be perceived as serious may increase the effectiveness of educational meetings. Educational meetings alone are not likely to be effective for changing complex behaviours.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1002/14651858.cd003030.pub2

Cites

26 of 26 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Risk of bias was assessed independently by two authors, using the Cochrane Collaboration tool for randomized controlled trials and the Newcastle-Ottawa scale for observational studies.

    “As recommended by the Cochrane Collaboration, 2 authors (A.M. and A.G.) independently assessed risk of bias in the included studies.”

    From Brief Mindfulness Practices for Healthcare Providers - A Systematic Literature Review. (2017) · cites this paper as [29]

    The Risk of bias section states that two authors independently assessed all included studies, supporting the independent-assessment part of the claim. It says they used seven EPOC criteria for RCTs; it does not support the claim that they used the Newcastle–Ottawa scale for observational studies. No page number is available in our copy. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 57

  1. Forsetlund L, Bradley P, Forsen L, Nordheim L, Jamtvedt G, Bjørndal A. Randomised controlled trial of a theoretically grounded tailored intervention to diffuse evidence-based public health practice. BMC Medical Education 2003;3:2. Garcia 2003 {published data only}
  2. Garcia P, Hughes J, Carcamo C, Holmes KK. Training pharmacy workers in recognition, management, and prevention of STDs: district-randomized controlled trial. Bulletin of the World Health Organization 2003;81:806-14.
  3. Gask 2004 {published data only} Gask L, Dowrick C, Dixon C, Sutton C, Perry R, Torgerson D, Usherwood T. A pragmatic cluster randomized controlled trial of an educational intervention for GPs in the assessment and management of depression. Psychological Medicine 2004;34:63-72.
  4. Gerrity 1999 {published data only} Gerrity MS, Cole SA, Dietrich AJ, Barrett JE. Improving recognition and management of depression: is there a role for physician education?. The Journal of Family Practice 1999;48:949-57.
  5. Gilroy K, Winch PJ, Diawara A, Swedberg E, Thiero F, Kané M, et al. Impact of IMCI training and language used by provider on quality of counseling provided to parents of sick children in Bougouni district, Mali. Patient Education and Counseling 2004;54:35-44.
  6. Goldberg 2001 {published data only} Goldberg HI, Deyo RA, Taylor VM, Cheadle AD, Contrad DA, Loeser JD, et al. Can evidence change the rate of back surgery? A randomized trial of community-based education. Effective Clinical Practice 2001;4:95-104.
  7. Gray 2004 {published data only} Gray R, Wykes T, Edmonds M, Leese M, Gournay K. Effect of a medication management training package for nurses on clinical outcomes for patients with schizophrenia. British Journal of Psychology 2004;185:157-62.
  8. Gülmezoglu 2006 {published data only} Gülmezoglu AM, Langer A, Piaggio G, Lumbiganon P, Villar J, Grimshaw J. Cluster randomised trial of an active, multifaceted educational intervention based on the WHO Reproductive Health Library to improve obstetric practices. BJOG 2007;114:16-23. Epub 2006 Sep 27. [PUBMED: 17010115 ]
  9. Hadiyono 1996 {published data only} Hadiyono JE, Suryawati S, Danu SS, Sunartono, Santoso B. Interactional group discussion: results of a controlled trial using a behavioral intervention to reduce the use of injections in public health facilities. Social Science & Medicine 1996;42:1177-83.
  10. Harmsen 2005 {published data only} Harmsen H, Bernsen R, Meeuwesen L, Thomas S, Dorrenboom, Pinto D, Bruijnzeels M. The effect of educational intervention on intercultural communication: results of a randomised controlled trial. The British Journal of General Practice 2005;55:343-50.
  11. Heale 1988 {published data only} Heale J, Davis D, Norman G, Woodward C, Neufeld V, Dodd P. A randomized controlled trial assessing the impact of problem- based versus didactic teaching methods in CME. Research in Medical Education 1988;27:72-7.
  12. Heller 2001 {published data only} Heller FH, D'Este C, Lim LL, O'Connell RL, Powell H. Randomised controlled trial to change the hospital management of unstable angina. The Medical Journal of Australia 2001;174:217-21.
  13. Jennett 1988 {published data only} Jennett PA, Laxdal OE, Hayton RC, Klaassen DJ, Swanson RW, Wilson TW, et al. The effects of continuing medical education on family doctor performance in office practice: a randomized control study. Medical Education 1988;22:139-45.
  14. Jones 1998 {published data only} Jones A, Carr EK, Newham DJ, Wilson-Barnett J. Positioning of stroke patients: evaluation of a teaching intervention with nurses. Stroke 1998;29:1612-7.
  15. Kasje 2004 {published data only} Kasje WN, Denig P, Stewart RE, de Graeff PA, Haaijer- Ruskamp FM. An educational programme for peer review groups to improve treatment of chronic heart failure and diabetes mellitus type 2 in general practice. Journal of Evaluation in Clinical Practice 2006;12:613-21.
  16. Kerse 1999 {published data only} Kerse NM, Flicker L, Jolley D, Arroll B, Young D. Improving the health behaviours of elderly people: randomised controlled trial of a general practice education programme. BMJ 1999;319:683-7.
  17. Kiessling 2002 {published data only} Kiessling A, Henriksson P. Efficacy of case method learning in general practice for secondary prevention in patients with coronary artery disease: randomised controlled study. BMJ 2002;325:877-80.
  18. Kimberlin 1993 {published data only} Kimberlin CL, Berardo DH, Pendergast JF, McKenzie LC. Effects of an education program for community pharmacists on detecting drug-related problems in elderly patients. Medical Care 1993;31:451-68. References to studies awaiting assessment Akici 2004 {published data only} Akici A, Kalaca S, Ugurlu MU, Karaalp A, Cali S, Oktay S. Impact of a short postgraduate course in rational pharmacotherapy for general practitioners. British Journal of Clinical Pharmacology 2004;57(3):310-21.
  19. Alder 2007 {published data only} Alder J, Christen R, Zemp E, Bitzer J. Communication skills training in obstetrics and gynaecology: Whom should we train? A randomized controlled trial. Archives of Gynecology and Obstetrics 2007;276(6):605-12.
  20. Almeida 2000 {published data only} Almeida Neto AC, Benrimoj SI, Kavanagh DJ, Boakes RA. Novel educational training program for community pharmacists. American Journal of Pharmaceutical Education 2000;64(3):302-307.
  21. Avlund 2007 {published data only} Avlund K, Vass M, Kvist K, Hendriksen C, Keiding N. Educational intervention toward preventive home visitors reduced functional decline in community-living older women. Journal of Clinical Epidemiology 2007;60(9):954-962.
  22. Awad 2006 {published data only} Awad AI, Eltayeb IB, Baraka OZ. Changing antibiotics prescribing practices in health centers of Khartoum State, Sudan. European Journal of Clinical Pharmacology 2006;62(2):135-142.
  23. Benrimoj 2003 {published data only} Benrimoj SI, Langford JH, Berry G, Collins D, Lauchlan R, Stewart K, Ward PR. Clinical intervention rates in community pharmacy: A randomised trial of the effect of education and Bernal-Delgado 2002 {published data only} Bernal-Delgado E, Galeote-Mayor M, Pradas-Arnal F, Moreno S. Evidence based educational outreach visits: Effects on prescriptions of non-steroidal anti-inflammatory drugs. Journal of Epidemiology and Community Health 2002;56(9):653-8.
  24. Bruce 2007 {published data only} Bruce ML, Brown EL, Raue PJ, Mlodzianowski AE, Meyers BS, Leon AC, et al. A randomized trial of depression assessment intervention in home health care. Journal of the American Geriatrics Society 2007;55(11):1793-1800.
  25. Cabana 2006 {published data only} Cabana MD, Slish KK, Evans D, Mellins RB, Brown RW, Lin X, et al. Impact of physician asthma care education on patient outcomes. Pediatrics 2006;117(6):2149-57.
  26. Chassany 2006 {published data only} Chassany O, Boureau F, Liard F, Bertin P, Serrie A, Ferran P, et al. Effects of training on general practitioners' management of pain in osteoarthritis: A randomized multicenter study. Journal of Rheumatology 2006;33(9):1827-34.
  27. Chossis 2007 {published data only} Chossis I, Lane C, Gache P, Michaud PA, Pecoud A, Rollnick S, Daeppen JB. Effect of training on primary care residents' performance in brief alcohol intervention: A randomized controlled trial. Journal of General Internal Medicine 2007;22(8):1144-9.
  28. Chuc 2002 {published data only} Chuc NTK, Larsson M, Do NT, Diwan VK, Tomson GB, Falkenberg T. Improving private pharmacy practice: A multi- intervention experiment in Hanoi, Vietnam. Journal of Clinical Epidemiology 2002;55(11):1148-55.
  29. Colon-Emeric 2007 {published data only} Colon-Emeric CS, Lyles KW, House P, Levine DA, Schenck AP, Allison J, et al. Randomized trial to improve fracture prevention in nursing home residents. American Journal of Medicine 2007;120(10):886-92.
  30. Daniels 2005 {published data only} Daniels EC, Bacon J, Denisio S, Fry YW, Murray V, Quarshie A, Rust G. Translation squared: improving asthma care for high- disparity populations through a safety net practice-based research network. Journal of Asthma 2005;42(6):499-505.
  31. Delvaux 2004 {published data only} Delvaux N, Razavi D, Marchal S, Bredart A, Farvacques C, Slachmuylder JL. Effects of a 105 hours psychological training program on attitudes, communication skills and occupational stress in oncology: A randomised study. British Journal of Cancer 2004;90(1):106-14.
  32. Dolovich 2007 {published data only} Dolovich L, Sabharwal M, Agro K, Foster G, Lee A, McCarthy L, Willan AR. The effect of pharmacist education on asthma treatment plans for simulated patients. Pharmacy World and Science 2007;29(3):228-39.
  33. Downs 2006 {published data only} Downs M, Turner S, Bryans M, Wilcock J, Keady J, Levin E, et al. Effectiveness of educational interventions in improving detection and management of dementia in primary care: Cluster randomised controlled study. BMJ 2006;332(7543):692-5.
  34. Dunkley 1997 {published data only} Dunkley J. Training midwives to help pregnant women stop smoking. Nursing Times 1997;93(5):64-6.
  35. Fordis 2005 {published data only} Fordis M, King JE, Ballantyne CM, Jones PH, Schneider KH, Spann SJ, et al. Comparison of the instructional efficacy of internet-based CME with live interactive CME workshops: A randomized controlled trial. JAMA 2005;294(9):1043-51.
  36. Foster 2007 {published data only} Foster JM, Hoskins G, Smith B, Lee AJ, Price D, Pinnock H. Practice development plans to improve the primary care management of acute asthma: randomised controlled trial. BMC Family Practice 2007;8:23.
  37. Friedmann 2006 {published data only} Friedmann PD, Rose J, Hayaki J, Ramsey S, Charuvastra A, Dube C, et al. Training primary care clinicians in maintenance care for moderated alcohol use. Journal of General Internal Medicine 2006;21(12):1269-75.
  38. Frostholm 2005 {published data only} Frostholm L, Fink P, Oernboel E, Christensen KS, To T, Olesen F, Weinman J. The uncertain consultation and patient satisfaction: The impact of patients' illness perceptions and a randomized controlled trial on the training of physicians' communication skills. Psychosomatic Medicine 2005;67(6):897-905.
  39. Gielen 2001 {published data only} Gielen AC, Wilson ME, McDonald EM, Serwint JR, Andrews JS, Hwang WT, Wang MC. Randomized trial of enhanced anticipatory guidance for injury prevention. Archives of Pediatrics & Adolescent Medicine 2001;155:42-9.
  40. Gunn 2003 {published data only} Gunn J, Southern D, Chondros P, Thomson P, Robertson K. Guidelines for assessing postnatal problems: Introducing evidence-based guidelines in Australian general practice. Family Practice 2003;20(4):382-9.
  41. Jain 2006 {published data only} Jain MK, Heyland D, Dhaliwal R, Day AG, Drover J, Keefe L, Gelula M. Dissemination of the Canadian clinical practice guidelines for nutrition support: Results of a cluster randomized controlled trial. Critical Care Medicine 2006;34(9):2362-9.
  42. Lakkireddy 2007 {published data only} Lakkireddy DR, Basarakodu KR, Vacek JL, Kondur AK, Ramachandruni SK, Esterbrooks DJ, et al. Improving death certificate completion: A trial of two training interventions. Journal of General Internal Medicine 2007;22(4):544-8.
  43. Lo 2006 {published data only} Lo Fo Wong SH, Wester F, Mol SSL, Lagro-Janssen TLM. Increased awareness of intimate partner abuse a er training: A randomised controlled trial. The British Journal of General Practice 2006;56(525):249-57.
  44. Masika 2006 {published data only} Masika PM, Semarundu WJ, Urassa R, Mosha J, Chandramohan D, Gosling RD. Over-diagnosis of malaria is not a lost cause. Malaria Journal 2006;5:120.
  45. Merckaert 2005 {published data only} Merckaert I, Libert Y, Delvaux N, Marchal S, Boniver J, Etienne AM, et al. Factors that influence physicians' detection of distress in patients with cancer: Can a communication skills training program improve physicians' detection?. Cancer 2005;104(2):411-21.
  46. Metlay 2007 {published data only} Metlay JP, Camargo J, MacKenzie T, McCulloch C, Maselli J, Levin SK, et al. Cluster-randomized trial to improve antibiotic use for adults with acute respiratory infections treated in emergency departments. Annals of Emergency Medicine 2007;50(3):221-30.
  47. Middleton 2006 {published data only} Middleton JF, McKinley RK, Gillies CL. Effect of patient completed agenda forms and doctors' education about the agenda on the outcome of consultations: Randomised controlled trial. BMJ 2006;332(7552):1238-41.
  48. Miller 2004 {published data only} Miller WR, Yahne CE, Moyers TB, Martinez J, Pirritano M. A randomized trial of methods to help clinicians learn motivational interviewing. Journal of Consulting and Clinical Psychology 2004;72(6):1050-62.
  49. Molander A, Caplan D, Bergenholtz G, Reit C. Improved quality of root fillings provided by general dental practitioners educated in nickel-titanium rotary instrumentation. International Endodontic Journal 2007;40(4):254-60.
  50. Molina 2005 {published data only} Molina LT, Dominguez Camacho JC, Santos Lozano JM, Carbonell CA, Sanchez AJ, Paz Leon ML. Efficacy of educational sessions to modify the prescription of new drugs [Spanish]. Atencion Primaria 2005;36(7):367-72.
  51. Watson E, Clements A, Lucassen A, Yudkin P, Mackay J, Austoker J. Education improves general practitioner (GP) management of familial breast/ovarian cancer: findings from a cluster randomised controlled trial. Journal of Medical Genetics 2002;39(10):779-81.
  52. Winkelstein 2006 {published data only} Winkelstein ML, Quartey R, Pham L, Lewis-Boyer L, Lewis C, Hill K, Butz A. Asthma education for rural school nurses: resources, barriers, and outcomes. Journal of School Nursing 2006;22(3):170-7.
  53. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, et al. for the CONSORT Group. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Annals of Internal Medicine 2001;134:663-93.
  54. Beaudrey 1989 Beaudrey JS. The effectiveness of continuing medical education: a quantitative synthesis. The Journal of Continuing Education in the Health Professions 1989;9:285-307.
  55. Bloom 2005 Bloom BS. Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews. International Journal of Technology Assessment in Health Care 2005;21:380-5.
  56. Boonyasai RT, Windish DM, Chakraborti C, Feldman LS, Rubin HR, Bass EB. Effectiveness of teaching quality improvement to clinicians: a systematic review. JAMA 2007;298:1023-37.
  57. Brown CA, Belfield CR, Field SJ. Cost effectiveness of continuing professional development in health care: a critical review of the evidence. BMJ 2002;324:652-5.

Cited by

Sorted by citations

Authors
Forsetlund, L., Bjørndal, A., Rashidian, A., Jamtvedt, G., O'Brien, M. A., Wolf, F. M., Davis, D., Odgaard-Jensen, J., & Oxman, A. D.
Affiliations
  • Nasjonalt Kunnskapssenter for Helsetjenesten (NO)
  • Tehran University of Medical Sciences (IR)
  • University of Toronto; Department of Family and Community Medicine; 500 University Avenue Fifth Floor Toronto Ontario Canada M5G 1V7
  • University of Washington (US)
  • Association of American Medical Colleges (US)
  • Norwegian Knowledge Centre for the Health Services; PO Box 7004 St Olavs plass Oslo Norway 0130
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2009-04-15
Volume
9
Issue
2
Pages
CD003030-CD003030
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd003030.pub2
PMC
PMC7138253
OpenAlex
W2111892415
Cited by
1,849
References
26
Citations by year
2026: 13 · 2025: 56 · 2024: 72 · 2023: 79 · 2022: 88 · 2021: 121 · 2020: 89 · 2019: 108 · 2018: 97 · 2017: 114 · 2016: 107 · 2015: 127 · 2014: 131 · 2013: 137 · 2012: 91
FWCI
13.66
Type
journal article
Language
en
Update notices
new_version (2021-09-15)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
Keywords
continuing medical education, educational meetings, professional practice change, health care outcomes, knowledge translation, innovation implementation, health professionals' practices, patient outcomes, heterogeneous effects, multi-faceted intervention, patient safety, quality of care, patient satisfaction, patient-reported outcomes, patient-centered care
MeSH terms
Congresses as Topic, Education, Continuing, Humans, Professional Practice, Randomized Controlled Trials as Topic, Process Assessment, Health Care

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review