Intended for healthcare professionals

Education And Debate Continuing medical education

Interprofessional working and continuing medical education

BMJ 1998; 316 doi: (Published 07 March 1998) Cite this as: BMJ 1998;316:771
  1. Linda A Headrick (, associate professor of medicinea,
  2. Peter M Wilcock, specialist in healthcare improvementb,
  3. Paul B Batalden, professor of paediatricsc
  1. a Department of Medicine, Metro Health Medical Center, Room 221, 2500 Metro Health Drive, Case Western Reserve University, Cleveland, OH 44109, USA
  2. b Bournemouth University Institute of Health and Community Studies, Bournemouth BH12 5BB,
  3. c Health Care Improvement and Leadership Development, Dartmouth Medical School, Hanover, NH 03755, USA
  1. Correspondence to: Dr Headrick

    Editorial by Toghill

    The increased focus on the results of professional practice (that is, the health outcomes of individuals and populations) creates two related tensions which will be considered in this paper. The first is the need for improved working and collaboration among different health professionals; the second is the demand for a broader vision of continuing medical education (CME).

    Almost everyone who seeks medical care interacts with more than one health professional. The number of professionals involved and the importance of their ability to work collaboratively increases with the complexity of the patient's needs. New initiatives to improve management of diseases such as asthma, diabetes, or congestive heart failure invariably point out the need for interprofessional collaboration.1 Increasingly, the “myth of the omnipotence of the independent practitioner” is being challenged as we discover the gains in quality and savings in cost when health professionals work together well.2

    At the same time, traditional approaches to delivering CME for doctors are being questioned. A recent review of randomised controlled trials of CME concluded that it was undermined by difficulties with its delivery, that it seemed unable to respond to the urgent demands of healthcare reform, and that there was little evidence for its own effectiveness and efficacy.3 The bulk of the studies focused on traditional approaches, although they identified a widening range of CME activities. Further, it was shown that even when there was change in doctors' behaviour there was “most often a small, less often a moderate, and rarely a large” effect on health outcomes.

    In its working paper Continuing Professional Development for Doctors and Dentists, the Standing Committee on Postgraduate Medical and Dental Education (SCOPME) concluded that “conventional continuing medical education is no longer adequate to meet all the education and career development needs of …

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