Re-Visiting the Role of Lecture-Based CME: Does it Make a Difference in Physician Learning and Change?

Purpose: Lecture-based continuing medical education (CME) has been criticized for very limited impact on improving clinical practice and patient outcomes. This study assesses the impact of a 75-minute presentation for primary care physicians in the United States to enhance their communication with patient regarding the risks and benefits of hormone therapy for menopausal symptoms. Methods: Data were collected from 41 primary care physicians over 15 months through multiple telephone interviews, use of clinical vignettes, presentation observations, and a written survey. A 360-degree multisource evaluation of 8 participants was conducted to obtain data from their patients, peer physicians, and healthcare team members. Quantitative and qualitative data were analyzed to document educational outcomes. Results: Participants reported significant increases in their knowledge, skills, and confidence as related to menopausal care. At 9-14 months post-event, 85.7% (30 of 35) participants implemented one or more of their commitments to practice change. The 360-degree evaluation findings supported participants' claims of change, when 360-questions matched change statements. Meanwhile, we interviewed 6 conference attendants who did not participate in the previous evaluation phases. They reported similar practice changes to the rest of participants. Conclusions: A relatively short lecture-based, practice-oriented CME on menopausal care utilizing sound educational principles can precipitate changes in knowledge, skills and clinical practice. This study invites the CME community to re-visit the role of lecture-based CME and shift the discussion to consider under what conditions it can be expected to be more or less effective for physicians' learning and practice change.