Continuing medical education to the point of care using a digital library and intimate computers

Continuing Medical Education (CME) is the continuing education a physician receives after completing formal medical school, residency, and fellowship training. The dominant paradigm of CME is the centralized lecture, which is separated in location and time from real clinical practice. CME delivered in this manner often is ineffective and inefficient. The goal of this project was to design, implement, and evaluate a new paradigm for CME, based on integrating CME directly into a physician's daily clinical practice using digital library and intimate computing technology. A workflow for the creation of on-line CME modules was defined. A portion of the content in a digital health sciences library, the Virtual Hospital, was converted into CME modules. It was made available to physicians within the state of Iowa via a testbed network and to physicians around the world via the Internet. Access was via wired and wireless workstations. Usage of the CME modules was recorded. The CME modules received modest use, over one year, by patrons outside of the testbed network. No usage of the CME modules was recorded by patrons of the testbed network. Barriers to success were clearly identified Our results confirm that to be accepted by physicians, a computing tool must offer them a compelling reason for its use, must be seamlessly integrated into their workflow, and must be easy to use. We are now working to overcome the technological, social, economic and political barriers we face. Our hope ultimately is to create a more effective and efficient paradigm for the delivery of CME.