Continuing medical education effect on practice performance: effectiveness of continuing medical education: American College of Chest Physicians Evidence-Based Educational Guidelines

Chest. 2009 Mar;135(3 Suppl):42S-48S. doi: 10.1378/chest.08-2517.


Background: There has been sizable debate and widespread skepticism about the effect of continuing medical education (CME) on the performance of physicians in the practice setting. This portion of the review was undertaken to examine that effect.

Methods: The guideline panel used data from a comprehensive review of the effectiveness of CME developed by The Johns Hopkins Evidence-based Practice Center, focusing on the effect of CME on clinical performance.

Results: The review found 105 studies, which evaluated the impact of CME on short- and long-term physician practice performance. Nearly 60% met objectives relative to changing clinical performance in prescribing; screening; counseling about smoking cessation, diet, and sexual practices; guideline adherence; and other topics. Single live and multiple media appeared to be generally positive in their effect, print media much less so. Multiple educational techniques were more successful at changing provider performance than single techniques. The amount or frequency of exposure to CME activities appeared to have little effect on behavior change.

Conclusions: Overall, CME, especially using live or multiple media and multiple educational techniques, is generally effective in changing physician performance. More research, however, is needed that focuses on the specific types of media and educational techniques that lead to the greatest improvements in performance.

Publication types

  • Review

MeSH terms

  • Attitude of Health Personnel
  • Clinical Competence
  • Education, Medical, Continuing / standards*
  • Evidence-Based Medicine / education
  • Evidence-Based Medicine / standards*
  • Humans
  • Practice Guidelines as Topic / standards*
  • Practice Patterns, Physicians' / standards*
  • Quality of Health Care
  • Thoracic Diseases / therapy
  • Treatment Outcome
  • United States