Outcomes in CME/CPD - Special Collection: Effect Size Benchmarking for Internet-based Enduring CME Activities.

The volume of certified, internet enduring materials produced per year has nearly doubled in the last decade. Meta-analyses indicate that Internet-based education for clinicians is effective; however, the relevance of these studies to the nearly 50,000 such activities certified per year is questionable. Effect size is one metric by which CME providers may assess effectiveness, but caution must be used in comparing effect size data with external benchmarks such as peer-reviewed literature. This report presents a pooled standardised mean difference (Cohen's d) for 40 accredited, Internet-based enduring materials produced between 2016 and 2018. Data suggests that a Cohen's d between 0.48 and 0.75 may be a useful benchmark. Benchmarks reported in the literature for this format are notably higher. The limitations of comparison to such benchmarks are considered.

Medical simulation topic interests in a pediatric healthcare system.

INTRODUCTION: Encouraged by evidence suggesting that simulation-based educational programs can translate to improved patient care, interest and investment in medical simulation have grown considerably in the past decade. Despite such growth, simulation is still a developing field, and little is known of the perceived needs for simulation training among practicing clinicians. This study describes medical simulation interests among clinicians in a pediatric health care system. METHODS: A web-based survey addressing previous medical simulation experience, medical simulation interests, and demographics was distributed to physicians, nurses, and respiratory therapists within a pediatric healthcare system in the Delaware Valley. RESULTS: All three groups expressed the highest level of interest in simulated resuscitation events ("mock codes") and the least interest in simulations involving communication and electronic medical records. "Airway problems" was identified as the most popular medical simulation topic of interest. Although the rank order of interest in medical simulation categories was similar across groups, physicians reported the lowest levels of interest in all simulation categories. Characteristics such as previous simulation experience and group (eg, nurses and respiratory therapists) were associated with medical simulation interests. Years in practice did not impact interest. CONCLUSIONS: For adult learners, educational experiences should be targeted to the learners' perceived needs but should also address unrecognized deficits. Collectively, physicians, nurses, and respiratory therapists were most interested in participating in simulations addressing "codes" (emergency resuscitations) and airway management; these perceptions may provide a focus for designing simulation events that appeal to diverse learning styles. Prior experience with medical simulation seems to increase interest in subsequent simulation activities and offers the optimistic possibility that first-hand experience with simulation may help overcome structural and cultural barriers. Future research should seek to better understand potential obstacles for the participation of healthcare providers, especially physicians, in simulation-enhanced learning.

Education format and resource preferences among registrants of a pediatric-focused CME website.

BACKGROUND: Despite dramatic increase in Internet-based CME activities, little is known about physician Internet CME preferences. AIMS: To identify the education format and resource preferences among registrants of a pediatric-focused CME website. METHODS: Preferences of physician registrants at PedsEducation.org between July 2000-November 2007 (n = 1388) were assessed via survey. A secondary analysis of respondent demographics vs. reported preferences was conducted. RESULTS: A total of 345 physicians participated (25% response rate). The majority (73%, n = 252) identified free CME as a highly important feature of an Internet CME resource; monthly case series was identified as the least important. Seventy-five percent of respondents (n = 260) identified practice guideline updates as a highly useful practice resource; practice feedback was identified as the least useful. Respondents with < or =10 years practice experience were more likely to identify case-based CME as highly useful to their daily practice (p < 0.001); respondents who spend > or = 90% working time on patient care were more likely to identify Internet CME as a highly useful CME format (p < 0.001). CONCLUSION: Internet CME preferences of PedsEducation.org registrants differ from those typically associated with knowledge gains and behavior changes. Demographic characteristics may influence these preferences.

Measuring quality in arthritis care: the Arthritis Foundation's quality indicator set for analgesics.

OBJECTIVE: To develop systematically validated quality indicators (QIs) addressing analgesic safety. METHODS: A comprehensive literature review of existing quality measures, clinical guidelines, and evidence supporting potential QIs concerning nonselective (traditional) nonsteroidal anti-inflammatory drugs (NSAIDs) and newer cyclooxygenase 2-selective NSAIDs was undertaken. An expert panel then validated or refuted potential indicators utilizing a proven methodology. RESULTS: Eleven potential QIs were proposed. After panel review, 8 were judged to be valid; an additional 10 were proposed by the panel, of which 7 were rated as valid. Quality indicators focused upon informing patients about risk, NSAID choice and gastrointestinal prophylaxis, and side effect monitoring. CONCLUSION: The 15 validated indicators were combined, where appropriate, to yield 10 validated processes of care indicators for the safe use of NSAIDs. These indicators developed by literature review and finalized by our expert panel process can serve as a basis to compare the quality of analgesic use provided by health care providers and delivery systems.