Beginning in 2002, physicians from around the province participated in a research project on the effectiveness of four different methods of delivering physician education related to workplace injury management. The project was led by Dr Harry Karlinsky, psychiatric consultant to WorkSafeBC and director of Continuing Medical Education and Professional Development for the UBC Department of Psychiatry, under a grant from WorkSafeBC’s Research Secretariat. The two accredited education topics offered as part of the project were “The diagnosis and management of lateral epicondylitis” (LE module) and “Is return to work good medicine?” (RTW module). Physicians selected their module of choice and one of the following delivery methods:

• Outreach—Small group, face-to-face workshops in participating physicians’ local communities.

• Videoconference—Small group workshops offered at videoconferencing suites in local hospitals, with speaker at a remote host site.

• Conference lecture—Large group lectures offered at WorkSafeBC’s annual Physicians’ Education Conference.

• Online—Internet-based instruction.

Participants were asked to complete two questionnaires before and after each education module. A knowledge questionnaire related to the educational content in the module, while a learner attitude and satisfaction questionnaire related to demography, perceived preferred learning style, and preference for different types of continuing medical education. The same two questionnaires for each module were administered before and after each session.

Research hypothesis

Technology offers opportunities to provide CME via innovative modes of delivery. The hypothesis of this research was that training modules facilitated by new technologies (online learning and videoconferencing) will be at least as effective as and sometimes preferred over traditional CME interventions (conference lectures and outreach) in their impact on physician’s knowledge.

Research findings

In all, 581 physician encounters occurred as a result of the educational presentations. The specific communities where conference lecture, outreach, and videoconference sessions were offered are shown in the Table.

The most significant finding was that educational presentations, regardless of their delivery method, significantly increased physicians’ knowledge of both lateral epicondylitis and the physician’s role in return-to-work planning. For example, the LE module pre-test identified a common misconception among physicians that lateral epicondylitis reflects an inflammatory pathophysiology. In the post-test, the misconception was cleared and the majority understood lateral epicondylitis to be a degenerative process.

Importantly, the videoconferencing and online education sessions were at least as effective as the conference lecture and instructor-led outreach sessions in their impact on physician knowledge. The research broadly implies that instructional offerings via new technologies—in this case, videoconferencing and online learning opportunities—have the potential to increase physician access to effective CME opportunities, an important precursor to change in physician behavior and to more appropriate evidence-based management of injured workers. Participants had varied attitudes about the learning method they preferred, which suggests that education providers should continue to pursue multiple methods of delivery.

For more detailed results of this study, see the original article in the Journal of Occupational Rehabilitation[1] (this abridged article is reproduced courtesy of Springer).

—Don Graham, MD, CCFP
WorkSafeBC Chief Medical Officer

Table. Community distribution of CME sessions

RTW = Is return to work good medicine?
LE = The diagnosis and management of lateral epicondylitis

References

1. Karlinsky H, Dunn C, Clifford B, et al. Workplace injury management: Using new technology to deliver and evaluate physician continuing medical education. J Occup Rehabil 2006;16:[in press].