Search PubMed⌕ Search

Biomedical subjects

P R Manning

Publications and source records attributed to P R Manning.

At least 19 recordsLinked to original sources
PubMed2001

Continuing medical education: the paradigm is changing.

With the realization that lifelong learning is more than attending conferences, the potential for greatly expanding effective continuing medical education (CME) has never been more encouraging. Databases from groups and individual managed care practices and advances in information technology are providing major opportunities toward this goal by identifying specific information deficits and promoting practice-linked education. The National Committee for Quality Assurance (NCQA) standards, requiring audited Health Plan Employer Data and Information Set (HEDIS) reports, are a step forward in the development of CME linked closely to practice. The optimal educational use of practice data to improve clinical outcomes will require research to determine the best methods. HEDIS standards will probably continue to deal with common problems of omission rather than with those caused by physicians' lack of knowledge, which will require other approaches. Development of these methods will provide rich opportunities for demonstration studies. The spectacular advances in information technology, especially the almost limitless capabilities of the Internet and electronic mail, offer boundless possibilities of information sources and enhanced communication among physicians about puzzling patients. The further implementation of the electronic medical record with computerized reminders and other clinical information delivered at the point of need will trigger major advances. An appealing user-friendly, practice-linked, and self-directed CME is on the horizon, promising to help the practicing physician optimize patient care.

Curriculum↗
PubMed1995

'Seeing practice'.

Explore the source record for details and available documents.

Education, Veterinary↗
PubMed1990

Continuing education needs of health care professionals.

Formal continuing education for health professionals continues to grow around the base of courses, conferences, and general reading. These formats serve the indispensable function of keeping health professionals abreast of the state of medicine. Since most formal continuing education activities are planned for groups, they cannot address the specific information needed in the care of individual patients. Furthermore, the knowledge gained is memory-based, and it is misguided to believe that facts learned in lectures will be remembered accurately enough for patient-care applications. A recent study has demonstrated that physicians often want additional knowledge when they are caring for patients and that access to knowledge is often difficult and time consuming. Advances in computer and telecommunications technology may ultimately permit immediate short answers to specific questions that arise during medical practice. It is time to expand the activities of the National Library of Medicine and the libraries within the Regional Medical Library (RML) network that provide valuable information for health professionals by developing methods to answer specific questions on the spot while health professionals are caring for patients.

Education, Medical, Continuing↗
PubMed1987

The past, present, and future of continuing medical education. Achievements and opportunities, computers and recertification.

Changes in continuing medical education (CME) during the past three decades have been controversial and complex. A 1950s-style, small-scale, voluntary activity has evolved, in 1987, into broad-scale programs with accredited sponsors and with ties to relicensure. Within the next three decades, CME will be directed by methods chosen by specialty boards for recertification and by exploitation of computer and telecommunication technology. Written recertification examinations can waste physicians' time studying material that will not improve care of their patients. We hope improved methods of analysis of individual practices, on-the-spot access to pertinent medical information, and better communication among physicians can be incorporated into recertification procedures. Policies established now will shape CME for decades to come. We encourage a coordinated effort by medical specialty boards, medical societies, hospitals, medical schools, computer corporations, telecommunication firms, granting agencies, and the National Library of Medicine to ensure the most effective and efficient recertification and CME policies.

Accreditation↗
PubMed1987

A method of self-directed learning in continuing medical education with implications for recertification.

A method of self-directed learning for physicians that can be used to satisfy a portion of specialty board recertification requirements integrates contract learning (self-formulated learning plans), information brokering (linking physicians with consultants and community resources), and collegial networking (discussion groups). The method encourages physicians to focus on educational objectives, supplies learning resources, and promotes interactions with colleagues in study groups. Fifty-nine (53%) of the 102 learning goals update physicians' knowledge. Print sources and discussions with experts were the commonest resources used. Forty-five (49%) of 91 participants completed their learning plans. Forty-nine (74%) completed projects were judged successful in achieving their goals. Twenty-five (45%) of 56 physicians responding to a questionnaire stated that the method was superior to traditional continuing medical education. Fifty-two percent of the participants found the method as effective as traditional continuing medical education. Proof of accomplishment allows the method to be used as part of a specialty board recertification process.

Certification↗
PubMed1986

Changing prescribing practices through individual continuing education.

In a study involving 94 practicing physicians, committees of clinical pharmacologists analyzed copies of prescriptions (and additional relevant clinical data) to identify problems in prescribing ("educational needs"). Only the ten most commonly prescribed drugs were studied in the samples of 200 prescriptions from each physician; 1061 problems were identified in the prescriptions of the 94 participants. One physician group (n = 41) received feedback (instructional packets) addressing specific problems in prescribing; a second sample consisting of 200 prescriptions was then collected and analyzed. The physicians in this group changed their prescribing practices 30% of the time in accordance with recommendations, whereas those in the group that received no educational feedback changed in only 3% of the cases. When a physician stated an intention to change, an actual change resulted 50% of the time. Individualized teaching in response to real events in practice is a practical and effective method of improving physician performance.

California↗
PubMed1986

Pregnancy in sickle cell disease.

Risks associated with pregnancy for mothers with sickle cell disease and their infants have decreased markedly during the last decade. Among 79 women with sickle cell anemia (156 pregnancies), maternal death decreased from 4.1% before 1972 to 1.7% after 1972; their infants' fetal and perinatal death rates decreased from 52.7 to 22.7% (P less than .05), and from 33.3 to 27.3% among infants of women with sickle hemoglobin C disease. There has been a significant improvement in birth weight specific mortality and an increase in number of weeks' gestation from 34.7 to 37.4 (P less than .05). A higher percentage of sickle hemoglobin C disease mothers completed their pregnancies with no complications (43%) when compared with sickle cell anemia mothers (21%), thus identifying a subset of women for whom pregnancy does not represent an increased risk. These results are attributed to improvements in state-of-the-art medical, obstetric, and perinatal care.

Adult↗
PubMed1986

The computer and the future of continuing medical education.

Traditional continuing medical education-general reading, attending courses and conferences and having discussions with colleagues-helps physicians review fundamental concepts and learn new developments in medicine. This type of continuing education is well established and will not change dramatically. Beyond this, physicians learn from specific problems that arise in practice. A computer can enhance practice-related continuing medical education by providing information when a physician is developing diagnostic and therapeutic plans. Computer mail and telephone voice mail improve communication among physicians. Computers, by storing practice data, enable physicians to study their practices and profit from experience. Hospitals, specialty societies and medical schools should investigate using computers to help physicians profit maximally from experience.

Computers↗
PubMed1985

Information needs in office practice: are they being met?

We studied the self-reported information needs of 47 physicians during a half day of typical office practice. The physicians raised 269 questions about patient management. Questions related to all medical specialties and were highly specific to the individual patient's problem. Subspecialists most frequently asked questions related to other subspecialties. Only 30% of physicians' information needs were met during the patient visit, usually by another physician or other health professional. Reasons print sources were not used included the age of textbooks in the office, poor organization of journal articles, inadequate indexing of books and drug information sources, lack of knowledge of an appropriate source, and the time required to find the desired information. Better methods are needed to provide answers to questions that arise in office practice.

Adult↗
PubMed1983

Continuing medical education. The next step.

Traditional continuing medical education (CME) keeps physicians aware of the state of the art. It has limitations, however, as a quality-assurance tool: it is memory based, involves a group endeavor with diffuse goals, often unrelated to practice, is an inappropriate remedy for many problems in patient care, is hampered by poor-quality evaluation, and is governed more by market factors than educational outcomes. The self-study of practice and practice-linked CME offer rich potential for development. The physician's monitoring of his work, with appropriate improvements in performance, is valuable CME. Computers provide facts and guidance at the time and place the physician is developing diagnostic plans, diminishing reliance on memory. The next step in CME is for hospitals, societies, and medical schools to perfect methods of self-study of practice and practice-linked CME.

Computer-Assisted Instruction↗