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Interactive continuing medical education (CME) and its influence on the working practices of genitourinary clinicians
  1. P A Fox,
  2. on behalf of the MSSVD HPV Special Interest Group
  1. Ealing Hospital, London, UK; paul.fox{at}eht.nhs.uk

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Didactic lectures are the traditional vehicle used by the MSSVD for updating clinicians on developments in the specialty, but there is mounting evidence that this sort of educational format is unlikely to change clinical practice, whereas a format which more actively involves participants can produce measurable changes.1 The MSSVD decided to formally assess the impact of combining the lecture format with an interactive approach at one of its national update meetings. The subject under review at this meeting was human papillomavirus (HPV) infection. Specialists attending were asked to vote electronically on a combination of knowledge base and treatment strategy questions. They were then presented with information on the correct answers to the questions, and on currently preferred treatments. Feedback questionnaires invited comparison with the usual didactic approach. Participants were also asked whether their clinical practice would change as a result of the meeting. Seventy MSSVD members signed for CME, and 43 returned feedback questionnaires at the end of the event. A small majority of 51% preferred the new format to the usual didactic format, while a minority of 21% preferred the traditional approach. Despite only a small majority preferring the interactive over the customary didactic lecture format, a clear majority of respondents, 70%, felt that the interactive format was better able to maintain their concentration and interest, and 60% felt the new format was more likely to induce reflection and stimulate change. To our surprise, 74% of respondents planned to make some change in clinical practice as a result of attending the event. Three months later attendees were balloted by post to ascertain whether a change had in fact occurred. The response rate was a disappointing 37%, but of this group 30% reported having already changed their practice, and a further 27% still planned to do so as soon as circumstances permitted. A large proportion of respondents stated explicitly what changes had been made. The major influence was on a cessation in the use of podophyllin, and an increased use of the topical wart treatments imiquimod and podophyllotoxin.

The incorporation of hand held electronic response units to facilitate audience participation in educational events requires considerably more preparation on the part of the organiser than would a conventional lecture. The data from this small study suggest that in terms of outcome the effort expended is worthwhile. A variety of factors make the interactive technology which was employed here powerful: firstly, each participant communicates directly not only with the lecturer, but also anonymously with all his peers; secondly, the event has to be formatted in such a way as to directly engage participants by requiring them answer clinically related questions; and thirdly, the organiser has to focus to a higher degree than normal on how everything that is said will be perceived.

We have been encouraged by the outcome of this event, and we believe that clinicians would benefit from increased utilisation of this interactive educational method.

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