PT  - JOURNAL ARTICLE
AU  - Hanna Sandelowsky
AU  - Ingvar Krakau
AU  - Sonja Modin
AU  - Björn Ställberg
AU  - Sven-Erik Johansson
AU  - Anna Nager
TI  - Effectiveness of traditional lectures and case methods in Swedish general practitioners’ continuing medical education about COPD: a cluster randomised controlled trial
AID  - 10.1136/bmjopen-2018-021982
DP  - 2018 Aug 01
TA  - BMJ Open
PG  - e021982
VI  - 8
IP  - 8
4099  - http://bmjopen.bmj.com/content/8/8/e021982.short
4100  - http://bmjopen.bmj.com/content/8/8/e021982.full
SO  - BMJ Open2018 Aug 01; 8
AB  - Objectives To study the effects of continuing medical education (CME) about chronic obstructive pulmonary disease (COPD) for general practitioners (GPs) by comparing two commonly used CME methods with each other and no CME (reference group).Design A pragmatic cluster randomised controlled trial with primary healthcare centres (PHCCs) as units of randomisation.Setting, participants and interventions 24 PHCCs in Stockholm County, Sweden, were randomised into two CME intervention arms: case method learning (CM) (n=12) and traditional lectures (TL) (n=12). A reference group without CME (n=11) was recruited separately. GPs (n=255) participated in the study arm to which their PHCC was allocated: CM, n=87; TL, n=93; and reference, n=75. Two 2-hour CME seminars were given in a period of 3 months.Primary outcome measures Changes in scores between baseline and 12 months on a 13-item questionnaire about evidence-based COPD management (0–2 points/question, maximum total score 26 points).Results 133 (52%) GPs completed the questionnaire both at baseline and 12 months. Both CM and TL resulted in small yet significantly higher total scores at 12 months than at baseline (CM, 10.34 vs 11.44; TL, 10.21 vs 10.91; p<0.05); there were few significant differences between these CME methods. At both baseline and 12 months, all three groups’ scores were generally high on questions about smoking cessation support and low on those that measured spirometry interpretation skills, interprofessional care and management of multimorbidity.Conclusions Neither short CM nor short TL CME sessions substantially improve GPs’ skills in managing COPD. It is justified to challenge the use of these common CME methods as a strategy for improving GPs’ level of knowledge about management of COPD and other complex chronic diseases characterised by multimorbidity.Trial registration number NCT02213809; Results.