Educational Interventions and Outcomes—A Literature Review of CME Regarding Institute of Medicine (IOM) Competencies
Background. The Institute of Medicine (IOM) has identified for healthcare practitioners 5 core competencies that are believed to improve the quality and safety of patient care. Practitioners must: provide patient-centered care (PCC), work in interdisciplinary teams (IT), employ evidence-based practice (EBP), apply quality improvement (QI) techniques, and utilize informatics. This literature review was conducted to assess the evidence that CME related to each competency translates into improved physician performance or patient outcomes.
Methods. Medline and the Research and Development Research Base in Continuing Medical Education (RDRB-CME, University of Toronto) were searched for articles published between January 1995 and August 2003 that met the following criteria: (1) educational interventions were in the form of a certified educational activity, (2) educational interventions taught a core competency as defined by the IOM,and (3) physician performance or patient/healthcare outcomes were objectively measured.
Results. Of 105 papers selected for initial review, only 13 articles met the final inclusion criteria and form the basis for this analysis: 9 PCC, 4 IT, 0 EBP, 0 QI, and 0 informatics. Of these, 12 (8 PCC and 4 IT) reported positive outcomes for physician performance or patient care. Several articles overlapped competencies.
Conclusion. Although the search has revealed a paucity of published data that discuss the impact of educational interventions in the context of the 5 core competencies, it has supported the relevance of the competencies. The results of this literature search document a need for additional research and enhanced publication regarding the outcomes of CME interventions related to each of the IOM competencies.
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