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One of our core strengths at BMJ is being able to successfully deliver large scale training and clinical improvement programmes.  Two doctors leading clinics through the pandemic shared with us how BMJ’s resources help them to treat patients effectively and teach students to improve their knowledge.

  • CPD knowledge scores are sustained into the long-term with BMJ

  • Average post-test scores rose from 51% to 89%

  • Successful training of 18,210 doctors across 1,000 institutions

A guide to implementation

Improvement in quality of care relies on building a healthcare workforce that is trained in evidence-based medicine and updated with the latest medical knowledge and educational resources. We worked with governments and local stakeholders to advocate for and advise on developing fit-for-purpose professional development systems.

BMJ has developed a guide to implementation for continuing professional development (CPD) at a national level. This guide identifies four key stages for CME/CPD systems and how to move through each stage, including the stakeholders that need to be involved, potential pitfalls, and how to put the principles into practice.

Request your guide to implementation

 

Providing the best care throughout the pandemic with BMJ resources

Dr Meiram Shakenov is the Head of the Clinical Rehabilitation division at the National Center for Children Rehabilitation in Nur-Sultan, Kazakhstan. Each of his six clinical departments provides rehabilitation services for children with cerebral palsy, brain and spinal trauma, central nervous system (CNS) abnormalities, stroke, neuromuscular diseases and other conditions.

In 2020, his clinics treated more than 13,000 patients with covid-19 in Kazakhstan.

Dr Shakenov said, “We saw the first patient on 13 March 2020, after which the Ministry of Health and Government quickly mobilised all our medical services.

All hospitals and outpatient clinics used protocols to treat new infections, and the peak of that initial wave soon passed. Today, the rate is less than 5 %, yet most of the Kazakhstan population remains isolated as per government restrictions. 

In our medical centre, we have strict rules and resources in place to prevent any new infections with COVID-19 emerging. We do this by relying on the information we get from BMJ’s covid-19 resources. These help us to prevent and treat any new infections.”

“I use the clinical decision support tool, BMJ Best Practice, up to five times every week. It helps me check my approach to treating patients and prepares me with new information so that I can educate residents and children’s parents. ”

“Having used BMJ Learning resources several times, I have also completed courses about the epidemiology of covid-19 and neurology. [BMJ Learning] courses are straightforward, short and very useful for my colleagues and me. The courses are a good opportunity to become informed about the latest news in my specialty or any actual medical problem. 

The resources help me with diagnosis, examination and recommendations for patients. For example, in acute head injuries, we used to use X-rays. Now I always recommend a computed tomography (CT) scan, based on the information I received from BMJ’s resources.

Overall, having access to BMJ’s tools really helps us to be more competent in our practice. When I take part in any consultations in our clinical departments, I open my computer, read the latest recommendations about differentials, and come to the correct diagnosis for patients. 

We have inpatient and outpatient clinics. In both environments, we have BMJ resources open on our computers in front of us so they are easily accessible. Recently, I talked with a patient with low back pain and recommended the best approach, using the resources.

BMJ presents the latest guidelines to help health professionals be confident in their practice. These guidelines reflect Evidence-Based Medicine recommendations. For example, we focused on the relevant guidelines for our patients with spina bifida.

We treated a 7-year-old, who had surgeries from a young age due to spina bifida.  We provided her rehabilitation and recommended continuing follow-ups by the orthopedist, neurologist, paediatrician and rehabilitation specialist in the regional outpatient clinic. Throughout this process, we used the recommendations outlined in BMJ’s resources.

I teach junior doctors and residents as a lecturer. Before each lesson, I collate interesting facts and other materials to prepare lectures. One example when I used BMJ resources to prepare was the information about neurologic complications of COVID-19.

My colleagues are interested in developing their knowledge, so I highly recommend that they study English and use BMJ resources within their practice.”

“BMJ has very good, adapted information on a lot of topics for patients. I use these and can see that it works for my patients.”
Dr Meiram Shakenov, Kazakhstan

Confidence facing new and unfamiliar conditions

Dr Nurpeissova Riza Gumarovna is a paediatrician at a polyclinic in Nur-Sultan and an Associate Professor at the Department of Family Medicine and the Medical University of Astana. She uses BMJ’s resources to support her in the clinic and in the classroom, and with her continuous professional development. 

“For most of the day, I see paediatric patients and recommend the correct treatment plan. I also teach junior doctors in the clinic. 

I have a particular interest in the treatment of coronavirus infections in children. I have been seeing children with covid-19; this experience helps me with the material I create to teach doctors in our clinic on this topic. 

We are faced with new and unfamiliar conditions and symptoms every day, and my medical knowledge continues to improve. BMJ Best Practice is our reference handbook and our guide to action. The resources are ‘alive’ and constantly updated. This is especially relevant during a pandemic. 

Our profession is such that we must learn every day. It is impossible to go out to study now, so it is helpful to have the opportunity to receive the latest information and certificates without leaving the clinic or home. “

In the classroom

“BMJ’s resources help me to prepare for presentations. They also provide training in advance for junior doctors and second-year GP residents. We use translated BMJ Learning modules actively by writing cases on the Openlab platform as part of Decision Problem-Based Learning (DPBL). This innovative approach both helps to update our knowledge and to develop skills in writing clinical cases.

In my experience, access to BMJ resources helps to avoid over-prescribing drugs, prevents unnecessary research, and saves time by giving clear steps on what to do. In my teaching, I encourage students to follow the guidelines and strictly follow the advised protocol to avoid overdiagnosis and overtreatment.”

Continuous professional development during a pandemic

“The covid-19 information available in the BMJ resources is comprehensive and available in English and Russian. I like BMJ Best Practice and BMJ Learning because everything on the platforms is evidence-based, with an easy-to-use interface. They increase your professional competency and improve patient safety. 

Considering the lack of time that doctors have, I like that I can study at my convenience and view information on mobile devices such as phones and iPads. I often do this when commuting on my way to and from work. The resources help to improve my knowledge and choose the right strategy for patient management.”

“An important part of my role is working closely with carers. We always discuss the best treatment options for children with the parents. We understand that parents are very worried about their children and can refuse prescription medications.

Their concerns are very much about side effects. Parents often need more reassurance and information about the medication that we recommend. 

By explaining how our decision making is guided by the best available, evidence-based international resources, we are able to gain parent trust and increase patient adherence to the treatment plan. We also find that giving reference to our understanding of international protocols from our use of BMJ resources brings about better compliance to our recommended treatment plans.”

Discovering new treatment options

“Recently, I saw a 9-year-old girl with bronchiectasis. I turned to BMJ Best Practice to see the international guidelines – noting that its treatment approach differs from our local guidelines. However, I followed the BMJ Best Practice recommendation. The patient received comprehensive care and was given a new treatment – which improved her condition considerably.”

To find out more about how BMJ can support developing national CME/CPD systems, please contact

Dr Kieran Walsh
Clinical Director