Determining the topics and content of CME programs in five selected subjects: comparing the view points of experts and target group; a Tehran University of Medical Sciences experience

One of the most appropriate methods for needs assessment is to assess learners' needs and arrange the educational programs based on their viewpoints. The aim of this study was to determine the topics and content of Continuing Medical Education [CME] programs in five selected subjects by medical education experts and target group, based on the real needs of General Practitioners [GPs] in order to revise CME national programs. In this cross-sectional applied study, 700 GPs covered by Medical Sciences Universities in Tehran province were studied. A questionnaire consisting of two parts of demographic features and 80 scientific questions regarding their knowledge in five domains of clinical pharmacology, skin diseases, toxicology, emergencies, and forensic medicine was used. The questionnaires were delivered to physicians' offices by trained personnel using a list or by direct referral to offices and then gathered. Three topics in each subject and 15 standard educational contents in total were developed for the target group. There was almost a complete relationship between the opinion of experts and target group in forensic medicine. Some of the first five priorities of the two groups overlapped in skin diseases, forensic medicine, and emergencies. No common viewpoints were observed between experts and target group in pharmacology. In toxicology, there was no common viewpoint in the first three selections of the two groups. Real educational needs of GPs in receiving new information in order to promote their competencies and knowledge were different from those considered by experts. It is recommended to design the educational content for the target groups in the health care field based on their real deficiencies in knowledge and practice and by assessing their views and knowledge

[ one-year epidemiological study of acute poisoning among adults and adolescents admitted to Loghman Hospital, Tehran between 2005 and 2006]

There is no specific center for poison control and surveillance in our country to gather information and analyze data. The Loghman Hospital is the only tertiary teaching hospital for poisoned patient in Tehran with more than 65 years of experience which serves from the resident population of capital city, so that most poisoned patients refer to this center. The aim of this study was to investigate the epidemiological feature of hospital-referred poisonings in Loghman hospital as a representative of capital city according to International Classification of Disease [ICD10]. All adults and adolescents more than 12 years old admitted to the Emergency toxicology clinic of the Loghman hospital, from 21 March 2005 to 20 March 2006, were included in this study. We analyzed the clinical charts for etiological and demographical characteristics of the acutely poisoned patients whom were hospitalized. Variables including group of poisons, age, sex, history of mental illness and addiction, history of drug self poisoning and prognosis, were compiled and analyzed. Among 28,002 patients admitted to the Emergency toxicology clinic, there was 12,167[43.45%] poisoned cases [5,578 females and 6,545 males and 51 unknown]. Intentional poisoning was more common [83.6%] than accidental exposures [16.4%] including drug abuses. Pharmaceutical drugs, especially antidepressants and sedative hypnotics were the major causes of intoxication which codified as T42 [21.6%] and T43 [15.4%], respectively, followed by T40 [11.8%] that mainly consisted of the opiates. The overall number of poisoned patients whom were hospitalized was a bit higher in spring and summer [51.5%]. Three hundred and four patients were died due to acute poisoning or its complications. The majority of them was due to narcotics' overdosage [33.22%], followed by pesticides [12.17%] [mostly aluminum phosphide], psychotropic drugs [8.55%] and alcohols [8.55%] [mostly methanol]. Most of the deceased patients were male [73.35%] and 45.4% were below 40 years old. Although our rate of suicide is lower than western countries, the trend of deliberate self poisoning is more than population growth rate and because of substance abuse, the sex distribution of poisoning has been dramatically changed. It seems that national policy for controlling substance abuse is not efficient enough and needs urgent intervention, especially for high risk groups. To our knowledge, it seems that this unique center is the busiest clinicaltoxicology Department of the world