Increasing Mammography Screening: An Application of General Principles of CME Methodology

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Abstract
The purpose of the study was to test whether a systematic approach to continuing medical education (CME) design and evaluation is practical in the ambulatory care setting. A systematic approach to practice-based CME was derived after a review of the evaluation literature. The approach comprises 3 types of principles that are frequently violated in practice: research design that either is based on the use of control groups and the collection of follow-up data or is based on a time-series analysis; educational processes that include needs assessment, clear goals, audience participation, and evaluation of behavioral change; and program evaluation that uses objective measures of change. A CME session was offered to the staff of a family medicine residency program to bring them up to date on current information about breast cancer detection. Data on referral rates for mammography were collected for 8 months before and 6 months after the CME. Referral rates were significantly higher for the CME group than for a comparison group, and significantly higher rates were maintained for at least 6 months post-CME. The authors conclude that the systematic approach to practice-based CME is practical and suitable for application by program planners in various ambulatory care settings.

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