A standardized-patient assessment of a continuing medical education program to improve physicians' cancer-control clinical skills

Patricia (Patty) Carney, A. J. Dietrich, D. H. Freeman, L. A. Mott

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

BACKGROUND. Although continuing medical education (CME) has long been used to inform physicians and teach specific skills, its efficacy in many areas is not well established. This randomized controlled trial assessed the effects of differing educational techniques on the cancer-control skills of 57 physicians. METHOD. The CME program was part of the Cancer Prevention in Community Practice Project in Hanover, New Hampshire, and was implemented in 1988. The program used several methods in its presentation, including interactive small-group discussion, role playing, videotaped clinical encounters, lecture presentations, and trigger tapes. Measurements included cross-sectional observations made by unannounced standardized patients (SPs) who, one year after the CME program, assessed 25 physicians who had participated in the program and 32 physicians who had not. To measure consistency in the SPs' performances and accuracy in assessing the physicians' performances, most interactions were audiotaped using a hidden microphone. Pearson chi-square, Fisher exact two-tailed test, and kappa coefficients were used for analysis. RESULTS. Significantly higher ratings were found for the CME physicians in two areas: breast cancer risk-factor determination (determined maternal history: 80% versus 52%, p =.03; determined age at first period: 16% versus 0%, p =.02), and smoking cessation counseling (providing written material: 32% versus 9%, p =.03). The CME physicians were rated higher on all 19 study variables in the target areas of early detection of breast cancer and smoking cessation. The results show that the physicians' performance were better in those areas where the CME program had used performance-based learning, such as role playing or viewing and discussing a videotaped role-play encounter. CONCLUSION. The educational techniques that rehearsed or portrayed clinical applications seem to have increased the physicians' performances of cancer-control clinical activities. The standardized-patient instrument seems to be particularly useful in evaluating interventions that address specific skills training.

Original languageEnglish (US)
Pages (from-to)52-58
Number of pages7
JournalAcademic Medicine
Volume70
Issue number1
StatePublished - 1995
Externally publishedYes

Fingerprint

Continuing Medical Education
Clinical Competence
cancer
physician
Physicians
Neoplasms
education
Role Playing
performance
Smoking Cessation
smoking
Teaching
Breast Neoplasms
role play
Early Detection of Cancer
group discussion
small group
Counseling
counseling
Randomized Controlled Trials

Keywords

  • Adult
  • Breast neoplasms (prevention & control)
  • Clinical competence
  • Comparative study
  • Education, medical, continuing (methods)
  • Education, medical, continuing (organization & administration)
  • Female
  • Human
  • Medical oncology (education)
  • Middle age
  • New hampshire
  • Patient simulation
  • Pilot projects
  • Program development
  • Smoking (prevention & control)
  • Smoking cessation
  • Support, U.S. gov't, p.h.s
  • Task performance and analysis

ASJC Scopus subject areas

  • Medicine(all)
  • Education
  • Public Health, Environmental and Occupational Health
  • Nursing(all)

Cite this

A standardized-patient assessment of a continuing medical education program to improve physicians' cancer-control clinical skills. / Carney, Patricia (Patty); Dietrich, A. J.; Freeman, D. H.; Mott, L. A.

In: Academic Medicine, Vol. 70, No. 1, 1995, p. 52-58.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND. Although continuing medical education (CME) has long been used to inform physicians and teach specific skills, its efficacy in many areas is not well established. This randomized controlled trial assessed the effects of differing educational techniques on the cancer-control skills of 57 physicians. METHOD. The CME program was part of the Cancer Prevention in Community Practice Project in Hanover, New Hampshire, and was implemented in 1988. The program used several methods in its presentation, including interactive small-group discussion, role playing, videotaped clinical encounters, lecture presentations, and trigger tapes. Measurements included cross-sectional observations made by unannounced standardized patients (SPs) who, one year after the CME program, assessed 25 physicians who had participated in the program and 32 physicians who had not. To measure consistency in the SPs' performances and accuracy in assessing the physicians' performances, most interactions were audiotaped using a hidden microphone. Pearson chi-square, Fisher exact two-tailed test, and kappa coefficients were used for analysis. RESULTS. Significantly higher ratings were found for the CME physicians in two areas: breast cancer risk-factor determination (determined maternal history: 80{\%} versus 52{\%}, p =.03; determined age at first period: 16{\%} versus 0{\%}, p =.02), and smoking cessation counseling (providing written material: 32{\%} versus 9{\%}, p =.03). The CME physicians were rated higher on all 19 study variables in the target areas of early detection of breast cancer and smoking cessation. The results show that the physicians' performance were better in those areas where the CME program had used performance-based learning, such as role playing or viewing and discussing a videotaped role-play encounter. CONCLUSION. The educational techniques that rehearsed or portrayed clinical applications seem to have increased the physicians' performances of cancer-control clinical activities. The standardized-patient instrument seems to be particularly useful in evaluating interventions that address specific skills training.",
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AU - Dietrich, A. J.

AU - Freeman, D. H.

AU - Mott, L. A.

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N2 - BACKGROUND. Although continuing medical education (CME) has long been used to inform physicians and teach specific skills, its efficacy in many areas is not well established. This randomized controlled trial assessed the effects of differing educational techniques on the cancer-control skills of 57 physicians. METHOD. The CME program was part of the Cancer Prevention in Community Practice Project in Hanover, New Hampshire, and was implemented in 1988. The program used several methods in its presentation, including interactive small-group discussion, role playing, videotaped clinical encounters, lecture presentations, and trigger tapes. Measurements included cross-sectional observations made by unannounced standardized patients (SPs) who, one year after the CME program, assessed 25 physicians who had participated in the program and 32 physicians who had not. To measure consistency in the SPs' performances and accuracy in assessing the physicians' performances, most interactions were audiotaped using a hidden microphone. Pearson chi-square, Fisher exact two-tailed test, and kappa coefficients were used for analysis. RESULTS. Significantly higher ratings were found for the CME physicians in two areas: breast cancer risk-factor determination (determined maternal history: 80% versus 52%, p =.03; determined age at first period: 16% versus 0%, p =.02), and smoking cessation counseling (providing written material: 32% versus 9%, p =.03). The CME physicians were rated higher on all 19 study variables in the target areas of early detection of breast cancer and smoking cessation. The results show that the physicians' performance were better in those areas where the CME program had used performance-based learning, such as role playing or viewing and discussing a videotaped role-play encounter. CONCLUSION. The educational techniques that rehearsed or portrayed clinical applications seem to have increased the physicians' performances of cancer-control clinical activities. The standardized-patient instrument seems to be particularly useful in evaluating interventions that address specific skills training.

AB - BACKGROUND. Although continuing medical education (CME) has long been used to inform physicians and teach specific skills, its efficacy in many areas is not well established. This randomized controlled trial assessed the effects of differing educational techniques on the cancer-control skills of 57 physicians. METHOD. The CME program was part of the Cancer Prevention in Community Practice Project in Hanover, New Hampshire, and was implemented in 1988. The program used several methods in its presentation, including interactive small-group discussion, role playing, videotaped clinical encounters, lecture presentations, and trigger tapes. Measurements included cross-sectional observations made by unannounced standardized patients (SPs) who, one year after the CME program, assessed 25 physicians who had participated in the program and 32 physicians who had not. To measure consistency in the SPs' performances and accuracy in assessing the physicians' performances, most interactions were audiotaped using a hidden microphone. Pearson chi-square, Fisher exact two-tailed test, and kappa coefficients were used for analysis. RESULTS. Significantly higher ratings were found for the CME physicians in two areas: breast cancer risk-factor determination (determined maternal history: 80% versus 52%, p =.03; determined age at first period: 16% versus 0%, p =.02), and smoking cessation counseling (providing written material: 32% versus 9%, p =.03). The CME physicians were rated higher on all 19 study variables in the target areas of early detection of breast cancer and smoking cessation. The results show that the physicians' performance were better in those areas where the CME program had used performance-based learning, such as role playing or viewing and discussing a videotaped role-play encounter. CONCLUSION. The educational techniques that rehearsed or portrayed clinical applications seem to have increased the physicians' performances of cancer-control clinical activities. The standardized-patient instrument seems to be particularly useful in evaluating interventions that address specific skills training.

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KW - Patient simulation

KW - Pilot projects

KW - Program development

KW - Smoking (prevention & control)

KW - Smoking cessation

KW - Support, U.S. gov't, p.h.s

KW - Task performance and analysis

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