[A somewhat immature thought on education--medical education; an introduction to bibliography on nursing education].
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The use of an educational computer for a medical course is reviewed. It is of value for assessment, small group teaching, self-instruction, and continuing medical education. It is particularly useful for patient management problems.
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1. Continuing medical education is unquestionably a worthwhile goal. Knowledge or exposure to information, however, does not ensure competence in medical care; nevertheless, without knowledge there is no possibility of true competence. 2. Continuing medical education should not be judged by recall knowledge but should ensure exposure to current and acceptable medical knowledge. 3. Because all licensed physicians have unrestricted licenses regardless of their specialty, they all should benefit from a comprehensive type of CME. 4. An open-book examination with reference sources appended to the questions would expose the physician to current and acceptable medical knowledge. 5. Recall types of examinations have no place in practical CME.
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Although continuing education has a long tradition within the medical profession, mandated continuing medical education is of very recent origin. The conceptual framework used to justify continuing medical education is that it exposes physicians to new knowledge, changes physician behavior, and favorably alters patient outcomes. Considerable evidence exists that physician knowledge can be increased, and that behavior can be changed, but there is very little to show an effect on patient outcomes. The effectiveness of continuing medical education is further clouded by such issues as consumerism, licensure politics, and professional standards review organization legislation. Family physicians should have a role in determining the outcome of the continuing medical education debate, as participants, as policy-setters, and as informed critics.
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