Does continuing medical education in general practice make a difference?

Continuing medical education (CME) has undergone enormous changes in recent years in terms of its theoretical base, the methodologies used, and the expectations of what it should deliver. It has become an increasingly important concern for governments and patients as well as doctors. As reaccreditation and quality assurance programmes have become more widespread, the effectiveness of continuing medical education in changing clinical behaviour has come under closer scrutiny. Davis defines continuing medical education as “any and all the ways by which doctors learn after formal completion of their training.”1 Grant and Stanton distinguish between continuing medical education and continuing professional development.2 Continuing medical education is seen as representing a more teacher based, didactic style whereas continuing professional development implies a more learner centred and self directed approach to learning. These terms are used interchangeably in the literature. For the purposes of this article we will refer to all postgraduate educational events as continuing medical education. In this review we aim to describe some forces for change in continuing medical education, to summarise the findings of systematic reviews of continuing medical education, and to examine the effectiveness of postgraduate continuing medical education in general practice in particular. Do educational interventions based on general practice change doctors' behaviour and improve patient outcomes? ### Summary points

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