Small-group CME using e-mail discussions. Can it work?

Problem Being Addressed: Traditional continuing medical education (CME) approaches do not work well in changing physicians' behaviour, but some promising strategies and technologies might help. Our program sought to meld small-group learning with an Internet e-mail approach.
Objective of Program: In 1994, the Family medicine Education and Research Network (FERN) was developed to support on-line discussion among London, Ont, and area family physicians. To support educational, moderated case discussions using e-mail, FERN Dissemination (FERN-D) was introduced to a subgroup of participants. We hoped to increase awareness and use of evidence-based research in clinical practice and to increase use of Internet-based resources for CME. The target group was family physicians in the London area.
Main Components of Program: Forty volunteers were recruited and were e-mailed one case every 2 weeks; 34 completed the study. Each case was followed by further postings and, at the end of 2 weeks, by a summary of the group's discussion. Background material for each case was researched and was evidence-based. Evaluation was conducted using preintervention and postintervention mailed surveys combined with an e-mail feedback questionnaire and a modified focus group.
Conclusion: On-line case-based discussion is a promising strategy for encouraging family physicians to access current research. More research is needed to determine whether it can be effectively used to change physicians' practice.