The role of continuing medical education in changing and learning

Continuing education is the means by which many physicians “achieve and maintain…competence.” (p. 1356)1 Many factions within as well as others outside of medicine have challenged the effectiveness of CME in changing physician performance. CME has been researched using primarily quantitative methods, but findings concerning effectiveness of programs are variable. Clearly, continuing education is only one of many forces that facilitate learning and change in physicians. This article associates the findings of a qualitative study examining physicians' performance in relation to their participation in a CME program with the model of changing and learning proposed by Fox, et al.7 Changes made by physicians were categorized according to three types of change in the model developed by Fox, et al.: incremental, which were most frequent (70%), and usually required learning; structural, which represented 17% and were redirections in life or practice; and accommodational, which represented 13% and were due to regulations.