Research

Short Report: Satisfaction with on-line CME

Evaluation of the RuralMDcme website

Vernon Curran, PHD   Fran Kirby, MED   Ean Parsons, MD, CCFP   Jocelyn Lockyer, PHD

Dr Curran is an Assistant Professor (Medical Education Specialist), Ms Kirby is Manager of the Office of Professional Development, and Dr Parsons is Assistant Dean of CME, all in the Faculty of Medicine at Memorial University of Newfoundland in St John’s. Dr Lockyer is Director of CME in the Faculty of Medicine at the University of Calgary in Alberta.

This article has been peer reviewed. Cet article a fait l’objet d’une évaluation externe. Can Fam Physician 2004;50:271-274.

In recent years, use of the World Wide Web as a means of providing lifelong learning opportunities has increased. The main benefits of on-line continuing medical education (CME) include easy access, convenience, cost-effectiveness, reduced travel, self-paced and self-directed learning, and an interactive multimedia format.1-3 Several on-line CME studies4-6 have reported satisfaction with Internet learning and substantial acquisition of knowledge. An interesting aspect of the on-line CME literature is the diverse nature of the delivery formats that have been described. On-line CME has been delivered by real-time Internet teleconferencing, live and delayed audio and video CME Web broadcasts, and problem-based learning discussion system designs.

In spring 2002, Memorial University of Newfoundland in St John’s led a consortium of Canadian university-based CME departments in the development of RuralMDcme, a CME website that provides accredited on-line CME courses by the College of Family Physicians of Canada. The purpose of this study was to evaluate physicians’ satisfaction with an on-line CME format that used the WebCT learning management system and facilitated interaction using computer-mediated discussion.

METHODS

All participants who took on-line courses were invited to complete a questionnaire to assess their satisfaction with the on-line learning experience. Semistructured telephone interviews were also conducted with a stratified sample of participants within 2 weeks of course completion. Participants were stratified according to sex, practice experience, and comfort with computers. Information about participation and completion rates was also recorded.

RESULTS

Four on-line CME courses were offered during the period of evaluation: Management of Whiplash and Back Injuries, Introduction to Telehealth, Introduction to Assessment and Management of Dementia, and Cases in Emergency Medicine. Courses had a mean of eight participants. Thirty-seven registrants completed course evaluation questionnaires. Most respondents were family physicians or general practitioners (86%) and rural physicians (54%). They had at least 11 years of practice experience (59%); 51% were men and 49% were women.

Responses to the questionnaires suggest great satisfaction (Table 1). Almost all respondents (97%) indicated they would participate in another on-line CME course, and 89% considered the instruction appealing, interesting, and motivating. Almost all respondents (97%) reported they were able to learn at their own pace, and 92% felt they were better able to juggle learning time with work and home responsibilities.

Semistructured interviews were conducted with 15 physicians; Table 2 presents the main themes that emerged. Positive aspects of the courses included the content, design and layout, discussion and feedback, and the opportunity to experience on-line learning. Participants appreciated the opportunity to discuss the content of courses and wanted feedback on their mastery of it. Physicians wanted courses where they could receive feedback from the facilitator and have the opportunity to communicate with their peers. At the same time, there were barriers to overcome in using on-line discussion systems: inexperience, lack of success at first attempts, few participants, and discomfort with the concept of conferencing systems.

Participants were asked how they envisioned on-line courses influencing their CME. Many indicated they intended to use on-line courses again and anticipated that it would be the “wave of the future for rural doctors.” Participants believed that making courses more interactive by promoting communication between learners and facilitators or fellow learners would increase the appeal of on-line CME.

Another suggestion was that courses be divided into smaller “bite-size pieces”—short lessons or activities that could be completed in short times. They believed that being able to complete short sections at a single sitting would provide a sense of accomplishment that would increase satisfaction with the learning.

DISCUSSION

Professional isolation and limited professional development opportunities are factors that influence recruitment and retention of rural physicians in Canada. On-line CME offers rural physicians an opportunity to participate in lifelong learning regardless of geographic location. Interaction and collaboration are key principles of effective adult learning environments. Computer-mediated discussion systems can create new learning environments to support conversation and collaboration among practitioners.

The RuralMDcme website was created to provide greater access to accredited on-line CME and foster a community of practice. Most physicians in this study described on-line computer-mediated discussion activities as important for interacting with their peers and instructors. Some respondents, however, felt that a lack of interaction with the instructor and other participants detracted from the learning experience. This suggests that satisfaction with on-line CME depends greatly on the quality of learner-learner and learner-instructor interactions. The relevance and applicability of the on-line CME subject matter is important to participants; however, the opportunity to discuss the meaning and value of this content to clinical practice with colleagues and consultants is also important.

CONCLUSION

Results of this exploratory study suggest that physicians were generally satisfied with an on-line learning format that used the WebCT learning management system and facilitated interaction using computer-mediated discussions. On-line CME, by its very nature, is a communicative and collaborative learning environment. Satisfaction with the on-line CME experience depends greatly on the quality of interactions facilitated in such an environment.

Acknowledgment

Funding and support for The Electronic Rural Medicine Strategy (TERMS) was provided by Health Canada’s Office of Rural Health’s Rural and Remote Health Innovations Initiative. RuralMDcme resulted from the collaborative efforts of many individuals, partners, and sponsors. Partners include Memorial University of Newfoundland (Lead), University of Calgary, University of Ottawa, Government of Newfoundland and Labrador, Alberta Rural Physician Action Plan, Southwestern Ontario Rural Medicine, Drs Conleth O’Maonaigh and Stephen D’Arcy, Newfoundland and Labrador Medical Association, Federation of Canadian Municipalities, and the Newfoundland and Labrador Federation of Municipalities. Special thanks go to the facilitators of the RuralMDcme courses.

Contributors

Dr Curran led the evaluation study, analyzed the data, and wrote the article. Drs Parsons and Lockyer, and Ms Kirby critically reviewed drafts of the article.

Competing interests

The RuralMDcme project was funded through a grant from Health Canada’s Office of Rural Health and Remote Health Innovations Initiative.

Correspondence to: Dr Vernon Curran, Assistant Professor (Medical Education), Centre for Collaborative Health Professional Education, Faculty of Medicine, Memorial University of Newfoundland, St John’s, NL A1B 3V6; telephone (709) 777-7542; fax (709) 777-6576; e-mail vcurran@mun.ca

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