AMEE Berlin 2002 Programme

7I5 Ensuring cost-effective CPD:
perspectives, problems and policy
Clive Belfield and Celia Brown*
Centre for Research in Medical & Dental Education, School of
Education, University of Birmingham, Edgbaston, Birmingham
B15 2TT, UK
CPD must be cost-effective if the optimal quantity is
to be funded within health care systems burdened by
resource constraints. This paper details the
requirements for ensuring effective and cost-effective
CPD established as part of an investigation into CPD
funding, provision and participation in the UK NHS.
The perspectives for ensuring cost-effective CPD are
framed within a taxonomy that describes an educational
intervention (Bullock and Thomas, 1997). Thus issues
pertinent to both provider and participant: access,
management and planning, curriculum and pedagogy,
setting, assessment and evaluation are addressed. There
are however a number of constraints that hinder the
adoption of cost-effective CPD strategies. Empirical
and primary evidence that suggests current practice
fails to meet the requirements is presented and the
implications for CPD policy in the UK are discussed.
7I6 Improving your skills in preventive
medicine: this CME workshop works!
François Goulet*, André Jacques* and Danielle Saucier
College des Médecins du Québec, 2170 René-Levesque Ouest,
Montréal QC H3H 2T8, CANADA
A 90-minute workshop offered to small groups has been
developed to help family physicians to include
evidence-based intervention to their periodic health
examination (PHE). After the workshop, participants
completed a questionnaire with opened and closed
questions. Between September 1996 and December
1997, 40 workshops were held reaching 667
participants (16.7 participants/workshop) in all regions
of the province of Quebec. The evaluations (98.5%
response rate) showed that participants have reached
the workshop objectives (2.05 on the Likert scale –3 to
+3). The most important messages retained were a
better choice of tests (34.9%) and physician’s self
involvement (27.2%). Changes anticipated in their
practice were: better screening of tests (38.9%),
enhancement of knowledge (18.9%) and to insist on
counselling (12.8%). Role playing and discussion with
peers were effective methods used to produce
anticipated changes in the practice of family physicians.
7I7 CME program in Kuwait
K Al-Jarallah and I G Premadasa*
Kuwait Institute for Medical Specialization, Behbehani Bldg, 10th
Floor, PO Box 1793, Al-Sharq, Safat 13018, KUWAIT
The Kuwait Institute for Medical Specialization is the
designated authority for implementing a unified
continuing medical education scheme. The CME
Center administers the scheme, which commenced in
September 2000. The current phase covers medical and
dental practitioners. Participation in CME activities is
optional, but includes reinforcement policies. The
program operates in 5-year cycles, with practitioners
expected to acquire a minimum of 250 credit points
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within the cycle. CME activities fall into one of two
categories. The web site of the CME Center at
www.kims.org.kw/cme provides details of the scheme,
and an online facility for participants to register, and
for CME providers to apply for accreditation of
activities. Program implementation is monitored by
reviewing random samples of organizers and
participants. Peer review by an external evaluator has
led to quality assurance. International recognition has
been received via accreditation by Royal Colleges in
North America and Europe.
7I8 The theory of perspective
transformation and its applicability
to CME
Jill Donahue*, Stephen Hotz and Réjean Laprise*
Aventis Pharma, 49 Fallingbrook Street, Whitby, Ontario L1R
1M4, CANADA
In the field of adult education, Jack Mezirow published
his theory of Perspective Transformation which has
become one of the most important contributions to the
recent adult education literature. He identified 10
phases a learner goes through before he/she
incorporates a new perspective. There are many lessons
from this theory that we can apply to our work in CME.
After interacting with the poster, the participant will
be able to:
1 identify parallels between issues faced by
practitioners in CME and contributions of the theory
of Perspective Transformation;
2 assess the application of key concepts of the theory
to needs assessment, design and evaluation
The key point of the presentation is that when designing
CME one should consider that in order to incorporate
a new perspective, a learner may go through ten phases
that begin with a disorienting dilemma.
7I9 The transtheoretical model of
behaviour change: does it apply to
clinical practices?
Réjean Laprise*, Jill Donahue and Stephen Hotz
Aventis Pharma, Department of Professional Education, 2150
St Elzear Boulevard West, Laval, Quebec H7L 4A8, CANADA
The transtheoretical model (TTM) proposes that people
go through a series of 5 different stages of readiness
when adopting new behaviours. Stage-specific
educational interventions based on this model were
shown to facilitate adoption of healthy behaviours in
patients. In this presentation, we show evidence that
the TTM may also be useful with physicians. A study
was carried out on a convenient sample of 195 general
practioners attending continuing medical education in
cardiology. Physicians were asked to stage themselves
according to their readiness to prescribe an ACE
inhibitor to a high risk cardiac patient, to rate the
importance they put on this medical practice and to
indicate their degree of confidence in overcoming
barriers associated with the performance of this clinical
behaviour. The relationship between readiness to
change behaviour on one hand, and self-confidence and
importance on the other hand, were consistent with
predictions made from the TTM.