Doctors' performance needs to be discussed.
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Canada↗
Biomedical subjects
William Hogg
Publications and source records attributed to William Hogg.
Why do doctors attend traditional CME events if they don't change what they do in their surgeries? Evaluation of doctors' reasons for attending a traditional CME programme.
OBJECTIVE: This study aimed to discover what the family doctors who attended an annual refresher course wished to obtain from participating in the event and what their response was to evidence that doctor behaviour is not changed by such programmes. DESIGN: The study used the qualitative method of in-depth interviews. SETTING: Ottawa, Ontario, Canada and the surrounding area. PARTICIPANTS: The informants for the study were a sample of 6 family doctors who attended the 50th Annual Refresher Course for Family Physicians, held in April 2001 in Ottawa, Ontario, Canada. METHOD: In-depth interviews with the participants were conducted before and after they attended the annual refresher course. The doctors had pre-registered for the 3-day course. They were purposely selected to obtain diversity of gender, year of graduation from medical school and practice location. RESULTS: The doctors interviewed had 3 main reasons for attending the refresher course: to obtain information or to be updated; to be reassured that their practice behaviour was within accepted guidelines, and to hear from and interact with the specialists who gave presentations. All the participants in the study were able to name changes they had made as the result of attending a similar type of programme in the past and were sceptical of findings that practice behaviour did not change as a result of traditional continuing medical education (CME). CONCLUSIONS: Despite current support for interactive and practice-linked educational activities, the doctors in this study valued the input of the experts who lectured at the course. These doctors were not prepared to accept the currently held precept that their behaviour did not change as a result of attendance at traditional CME programmes.
Canada↗
Improved preventive care in family practices with outreach facilitation: understanding success and failure.
OBJECTIVES: To understand why some family practices with a facilitator improved preventive performance more than others. Sustainability of practice improvements one year after the intervention was also explored. METHODS: Interviews with physicians and nurses from seven practices and data gathered during the intervention were used to form case studies of three high performing and four low performing family practices. Case studies were developed using cross-case analysis with a combination of the constant-comparative method and memoing-diagramming. Two researchers independently conducted in-depth coding of transcripts and documents, individual case construction for each study site, and then cross-case analysis of the identified themes between study sites. RESULTS: Staff involvement and a positive attitude toward implementation of changes were central to high improvement in performance. A lack of computers, low staff involvement or high staff turnover were associated with low improvement in performance. Personal characteristics of the facilitator are important. Six of the seven practices still had the prevention tools in place one year after the intervention and all noted that participation had improved their understanding of preventive medicine. CONCLUSIONS: When using facilitators, one should avoid practices in turmoil, strive for continuity over time, and recognise the importance of the relationship between the facilitator and the practice.
Attitude of Health Personnel↗