Extramural Continuing Medical Education

The experience of one Faculty of Medicine in developing programs of continuing medical education in community hospitals is presented. After mention of the importance of regular reading of the medical literature, and the problems created by its growing volume, the necessity of supplementary programs in community hospitals is pointed out. The different patterns of community hospital meetings that evolved to meet various circumstances in the Atlantic Provinces are detailed. A “course” consisting of six weekly evening meetings, followed by morning case presentations and discussions, has proved the most successful form of continuing medical education in community hospitals. Better than half the doctors in the community attend, and active participation is the rule. The importance of advance planning, the techniques of advance planning, and the expense of operating the program are listed. A projection is made that 46 such courses would be required to cover the four Atlantic Provinces adequately, with a staff equivalent to eight full-time teachers and a budget in excess of $200,000. The fact that this is only 7.5% of Canada''s medical population indicates the magnitude of the unmet needs of continuing medical education in this country.     

Continuing Medical Education: Planning and Goals Conference in Continuing Medical Education—Workshop Recommendations

Following are the recommendations drawn up by workshops held as a part of the Planning and Goals Conference in Continuing Medical Education, sponsored by the California Medical Association and directed by its Committee on Continuing Medical Education, San Diego, March 11-12, 1967. The conference was supported in part by Contract No. PH 108-67-158, Bureau of Health Manpower, Public Health Service, Department of Health, Education and Welfare.The general subject was divided among four workshops and the reports of two of them—No. 1, (a) and (b) and No. 2—are printed in this issue. The reports of the other two workshops will be published in succeeding issues.     

Planning Continuing Medical Education Activities

A review of program development literature in adult education and continuing medical education (CME) indicates the pervasive influence of a single approach to designing instructional activities. An examination of the assumptions of this model indicates several weaknesses. An alternative model is proposed that recognizes the importance and impact of the planners'' interaction with representatives of the learner group, institutional colleagues and persons in outside agencies. Results of previous research, experience in planning, observations of the planning processes of others and discussions with expert continuing medical educators show that planning is a dynamic process of suggesting and selecting from many alternatives those instructional activities with the greatest potential for effecting the desired changes in learners. Through a series of deliberations, needs are specified, instructional activities are designed, goals and objectives are stated, and evaluation techniques are selected. CME planners direct the process and constantly focus on the immediate impact on the learners and ultimately on the learners'' practice behavior.     

Continuing Medical Education in Midpassage

Mandatory continuing education for physicians and other health professionals raises numerous problems. Issues that were considered academic when continuing education was voluntary now take on major practical and political significance. There is the risk that future legislation will mandate activities and methodologies which have not been proven. Research and development in continuing education must be accelerated so that decisions can be based on proper data. Centers of research and development should be established to encourage research and provide a sound foundation for the future of continuing education.     

The Need for Continuing Medical Education

Continuing medical education is an essential feature of the practice of modern medicine since it furnishes the means to maintain the doctor''s ability to provide quality patient care.To ensure that continuing medical education is provided efficiently and in the best quality, and utilized fully, it is necessary that: (1) the medical faculty inculcate in the student the concept of lifelong learning; (2) the practitioner adopt less time-consuming patterns of practice, to free more of his time for learning; (3) community hospital-based clinical teaching be provided universally; and (4) research be conducted to determine the best of current teaching methods and develop better ones. Conflicting efforts to meet these needs by practitioners (whose primary responsibility it is) and by organized medicine, specialty societies, voluntary health agencies and others have led to inefficient use of medical faculty teachers. The key parties in continuing medical education—practitioner and teacher—can learn best in medical school-administered programs, which need be supported by all other interested organizations.     

A Taxonomy of Continuing Medical Education Endeavour

Five basic forms of continuing educational endeavour by physicians are listed in rank order. These components constitute an indivisible unit bound together by self-learning. The scholarly habit of planned daily reading and study in a home library-sanctuary as an integral part of a physician''s workday heads the list. Day-to-day informal and formal colleague-association in patient care in the community and teaching hospital, in group practice and by consultation is the present major form of continuing educational endeavour. Emphasized is the sabbatical return every three to five years for three months at least to the teaching hospital to reinforce scholarly motivation and attitudes and to acquire new skills and knowledge. Attendance at scientific sessions of learned professional societies and short courses should be accompanied by presession and post-session guided reading to be undertaken in the physician''s home library-sanctuary.     

重塑医师职业精神的继续医学教育模式探讨

社会进步和科技发展,给现代医疗实践带来前所未有的挑战。面临新的社会环境,应对医疗体制改革新形势,需要唤起医生的职业责任感、以便使各级医师更好地履行岗位职责。简述了重塑医师职业精神的背景和医师职业精神内涵,阐述了重塑医师职业精神的重要意义,探讨培养医师职业精神的继续医学教育模式,旨在不断提高继续医学教育效果,培养医师的人文素养和职业精神,进一步促进医患和谐。     

Continuing Education: A Medical School Responsibility?

A survey of medical school deans sheds some light on current attitudes and practices regarding continuing education. The role of medical schools as leaders in continuing medical education should be clarified.     

Continuing Medical Education: Some Thoughts on Sponsorship

The proper role of departments of continuing medical education in the medical faculties of universities needs to be more clearly defined. Much of the initiative for the development of extramural postgraduate instruction in this country came from organized medicine. The individual practising doctor has traditionally made his needs known most effectively through his professional organizations and should be encouraged to continue to do so. The individual doctor, professional organizations, hospitals and medical schools are all vital elements in any successful program of continuing medical education. A variety of administrative patterns may well emerge, each adapted specially to the region it serves. With a sense of urgency and the co-operation of all concerned, rapid progress in this important field is clearly possible.