Educational interventions to improve the effectiveness in clinical competence of general practitioners: problem-based versus critical reading-based learning

BMC Medical Education

Research Article

J Martin Galaviz-deAnda¹  Carlos A Prado-Aguilar²  Yolanda Segovia-Bernal²  J de Jesus Valdivia-Martinez²  Javier Gongora-Ortega³ 

[1] Hospital General de Zona No. 2, Instituto Mexicano del Seguro Social, Aguascalientes, Ags, Mexico;Depto. de Salud Publica, Universidad Autónoma de Aguascalientes, Aguascalientes, Ags, Mexico;Unidad de Investigación Epidemiológica y en Servicios de Salud, Hospital General de Zona N 1, Instituto Mexicano del Seguro Social, Aguascalientes, Ags, Mexico;Depto. de Salud Publica, Universidad Autónoma de Aguascalientes, Aguascalientes, Ags, Mexico;Unidad de Investigación en Salud, Instituto de Salud del Estado de Aguascalientes (ISEA), Aguascalientes, Ags, Mexico;Depto. de Salud Publica, Universidad Autónoma de Aguascalientes, Aguascalientes, Ags, Mexico;

关键词: Oral Glucose Tolerance Test;    Critical Reading;    Continue Medical Education;    Problem Base Learning;    Cognitive Dimension;   

DOI  :  10.1186/1472-6920-12-53

 received in 2010-12-16, accepted in 2012-06-24,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundEvidence suggests that continuing medical education improves the clinical competence of general practitioners and the quality of health care services. Thus, we evaluated the relative impact of two educational strategies, critical reading (CR) and problem based learning (PBL), on the clinical competence of general practitioners in a healthcare system characterized by excessive workload and fragmentation into small primary healthcare centers.MethodsClinical competence was evaluated in general practitioners assigned to three groups based on the educational interventions used: 1) critical reading intervention; 2) problem based learning intervention; and 3) no intervention (control group, which continued clinical practice as normal). The effect on the clinical competence of general practitioners was evaluated in three dimensions: the cognitive dimension, via a self-administered questionnaire; the habitual behavioral dimension, via information from patient’s medical records; and the affective dimension, through interviews with patients. A paired Student´s t-test was used to evaluate the changes in the mean clinical competence scores before and after the intervention, and a 3 x 2 ANOVA was used to analyze groups, times and their interaction.ResultsNine general practitioners participated in the critical reading workshop, nine in the problem-based learning workshop, and ten were assigned to the control group. The participants exhibited no significant differences in clinical competence measures at baseline, or in socio-demographic or job characteristics (p > 0.05). Significant improvements in all three dimensions (cognitive, 45.67 vs 54.89; habitual behavioral, 53.78 vs 82.33; affective, 4.16 vs 4.76) were only observed in the problem-based learning group after the intervention (p > 0.017).ConclusionsWhile no differences in post-intervention scores were observed between groups, we conclude that problem-based learning can be effective, particularly in a small-group context. Indeed, problem-based learning was the only strategy to induce a significant difference between pre– and post- intervention scores for all three CC dimensions.

【 授权许可】

Unknown   
© Gongora-Ortega et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.