Date of Award

2015

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Education

Abstract

Context: Limited and conflicting data exist examining the relationship between continuingEducation (CE) on actual clinician knowledge. A quantitative examination of the literature is warranted to better understand how CE influences actual clinician knowledge. Objective: To determine if continuingEducation improves actual clinician knowledge. Data Sources: We searched the following databases between March and June 2014 for the relevant articles: Academic Search Premier, Biomedical Reference, CINHAL, EBSCOhost, Google Scholar, Health Business FullTEXT, Health Source, Medline, and Sports Discuss. No date range was specified and searches were conducted to include all possible years of publication in each respective database. Key terms searched included continuing medicalEducation, continuingEducation, outcomes of continuingEducation, effectiveness of continuingEducation, physicians, athletic trainers, physical therapists, occupational therapists, physician assistants, and nursing. We used single and combined key terms. Study Selection: Studies must of met four inclusion criteria: (1) reported outcomes related to actual knowledge of clinicians; (2) examined one or more of the following professions: athletic training, nursing, occupational therapy, physician, physician assisting or physical therapy (3) utilized a pre/post research design; and(4) reported include sample size and either means and standard deviation or interferential statistics. Data Extraction: Data were extracted from text, tables and figures. ImageJ was used to extract data from figures. Funnel plots were completed to check for publication bias at the outcome level. A fail-safe N was calculated for both overall analyses and sub-analyses to assess the number of unpublished works needed to nullify the statistical significance of the analysis. After data extraction, the data was examined by two trained investigators (E.M. and K.G.) to ensure all data is entered accurately. Data then were placed into a custom spreadsheet database. A weighted, random-effects meta-analysis using the Hedges' g metric was completed for CE effect on actual knowledge. All statistical analyses were performed with Comprehensive Meta-Analysis. Statistical significance was set a priori at &agr; ≤ 0.05 for all analyses. Data Synthesis: We found 18 potential articles. Further examination yielded 9 studies meeting the inclusion criteria. CE was shown to positively affect actual clinician knowledge (Hedges' g =0.73; 95% CI = 0.60-0.85). It appears from the funnel plot analysis that there is a publication bias towards dissemination of works that CE is effective. Conclusions: CE improves actual clinician knowledge. After analyzing the literature, articles measuring the relationship between CE and actual clinician knowledge only exists in the field of physicians. Future research needs to be completed examining CE across the health professions.

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