Thirty-nine clinical studies were included in the review (number of participants unclear). Twenty-eight studies had a control group.
Study quality overall was graded as low.
Fourteen studies found that continuing medical education intervention was associated with the desired effect on long-term clinical outcomes. Six studies reported direct measures of health status: arthritis pain and disability; depression; general health and function; emotional distress; and lost work due to back pain. Eight studies reported health behaviours or attitudes: percentage of patients taking medication; patient adherence with antibiotics; patients satisfaction with care; frequency of physician visits; hospitalisations; hospital length of stay; and smoking cessation rates. One study reported mixed results for the outcome quality of practice; 23 studies deduced no effect. There was no conclusive evidence regarding short-term effects of continuing medical education on clinical outcomes (four studies).
A print intervention was associated with improved adherence with beta-blocker use in one study that evaluated short-term effects of continuing medical education media methods on clinical outcomes.
Of the studies that evaluated long-term effects of continuing medical education media methods on clinical outcomes, one used an Internet-based continuing medical education achieved its objective. Twenty-two studies compared multiple media continuing medical education to control; four achieved their objective. Seven studies compared multiple media continuing medical education with single media continuing medical education; six achieved their stated aim, and they all found that multiple media continuing medical education was more effective than single media continuing medical education in improving clinical outcomes. Two studies that used print media did not achieve their objective.
Of the 15 studies that investigated short-term effects of continuing medical education educational techniques on clinical outcomes, one was compared with control; provision of educational readings was associated with increased use of beta blockers.
Three of five studies found that multiple simultaneous continuing medical education techniques were superior to the use of a single continuing medical education technique (reading). The authors reported that no conclusions could be drawn regarding the comparative effectiveness of single continuing medical education educational techniques or the differential effectiveness of specific educational techniques on long-term outcomes.
The authors reported that no conclusions could be drawn about the differential effectiveness of amount of continuing medical education exposure on short-term outcomes (one study) and that insufficient data were available to assess whether multiple continuing medical education exposures produced better clinical outcomes in the long-term than single exposure continuing medical education (seven studies).
Further results were available regarding key questions that did not address the clinical effectiveness outcomes of the continuing medical education intervention.