[Development and implementation of the dementia guideline of the German Society of General Practice and Family Medicine]. / Entwicklung und Implementierung der Leitlinie "Demenz" der Deutschen Gesellschaft für Allgemeinmedizin und Familienmedizin.

The evidence-based guidelines of the German Society of General Practice and Family Medicine (DEGAM) are developed according to an established ten-stage plan. The twelfth guideline addresses the health care problem of dementia. The main focus is the sensitive handling of patients and their relatives, e.g., although the goal is an early diagnosis, patients should also be protected against overdiagnosis. The treatment of Alzheimer's disease consists of three components: optimal care and supervision, the use of nondrug therapy, and a critically weighed administration of medications. The successful implementation of the guideline should be achieved by a multimodal strategy. This includes not only the direct integration of general practitioners (GPs) in developing the guideline, but also a comprehensive publication offensive, a wide use in training sessions including new media, the testing of complex implementation approaches in trials, and the use of the guideline in the context of GP contracts.

Knowledge transfer for the management of dementia: a cluster randomised trial of blended learning in general practice.

BACKGROUND: The implementation of new medical knowledge into general practice is a complex process. Blended learning may offer an effective and efficient educational intervention to reduce the knowledge-to-practice gap. The aim of this study was to compare knowledge acquisition about dementia management between a blended learning approach using online modules in addition to quality circles (QCs) and QCs alone. METHODS: In this cluster-randomised trial with QCs as clusters and general practitioners (GPs) as participants, 389 GPs from 26 QCs in the western part of Germany were invited to participate. Data on the GPs' knowledge were obtained at three points in time by means of a questionnaire survey. Primary outcome was the knowledge gain before and after the interventions. A subgroup analysis of the users of the online modules was performed. RESULTS: 166 GPs were available for analysis and filled out a knowledge test at least two times. A significant increase of knowledge was found in both groups that indicated positive learning effects of both approaches. However, there was no significant difference between the groups. A subgroup analysis of the GPs who self-reported that they had actually used the online modules showed that they had a significant increase in their knowledge scores. CONCLUSION: A blended learning approach was not superior to a QCs approach for improving knowledge about dementia management. However, a subgroup of GPs who were motivated to actually use the online modules had a gain in knowledge. TRIAL REGISTRATION: Current Controlled Trials ISRCTN36550981.

General Practitioners' preferences and use of educational media: a German perspective.

BACKGROUND: Several studies suggest that General Practitioners (GPs) prefer "traditional" media such as journals or quality circles when they are seeking out different options to meet their continuing medical education (CME) requirements. A survey was designed in order to gain a better understanding of German General Practitioners' preferences for different forms of educational media that will meet their CME needs. METHODS: Four hundred and forty nine (N = 449) German physicians were contacted to take part in this study on the occasion of one of their quality circle meetings. The participating physicians received a standardized 26-item-questionnaire that surveyed their preferences for different forms of educational media. A factor analysis was performed in order to determine whether the observed variables can be explained largely or entirely in terms of the underlying patterns. RESULTS: Two hundred and sixty-four physicians with an average age of 51.1 years participated (28.5% female, 71.5% male). We found that GPs favor learning environments such as: journals, colleagues, and quality circles. New media like the internet was used less often for their learning activities, even though the usage of the internet in general was quite high. The most important requirements for media in medical education as perceived by the participants were its relevancy for daily practice and dependability. CONCLUSION: Despite a growing use of the Internet it seems that German GPs favor "classical/traditional" settings for their learning activities. These results should be taken into consideration when planning CME or CPD programs or other learning activities. TRIAL REGISTRATION: Current Controlled Trials ISRCTN36550981.

[Primary care physicians, internet and educational media. Preferences, usages and appraisal in a 6-year comparison]. / Hausärzte, Internet und Fortbildungsmedien. Nutzung und Effizienzeinschätzung durch Allgemeinärzte und hausärztlich tätige Internisten im 6-Jahres-Vergleich.

BACKGROUND AND PURPOSE: Several studies suggest that primary care physicians prefer "traditional" media like journals or quality circles for their postgraduate medical education. This survey was designed to gain a better understanding of primary care physicians' learning media preferences. The actual results were compared with data from a survey with the same physicians conducted in 2001 to identify a change in their preferred learning media. METHODS: 57 primary care physicians (23% female, 77% male) took part in this survey. A standardized questionnaire was distributed which covered three topics: medical knowledge acquired after medical school, current use of and demands on medical education media. All participating physicians had already completed this questionnaire 6 years ago. Answers were compared on single-item level using Kendall's tau(c) correlation coefficient. Additionally, in 2007, there were a few items about internet and PDA ("personalized digital assistants") usage which were analyzed descriptively. RESULTS: For their continuing medical education primary care physicians predominantly indicated quality circles, scientific journals, and colleagues. The internet, pharmaceutical representatives, and scientific staff at research institutions were less used and less valued. The most favored attributes concerning medical education media were "reliable" and "relevant for daily practice", less favored were "interactive" and "pictorial". A high correlation between the results of the 2001 and the 2007 survey was found. CONCLUSION: The survey demonstrated the situation of medical education media from 57 primary care physicians and their learning media preferences in a 6-year comparison: their preferences remained relatively constant. Thus far, new media have still a minor role among the relevant educational media for primary care physicians despite the fact that the internet use, in general, was high. New education tools should be designed according to these preferences.

Knowledge translation on dementia: a cluster randomized trial to compare a blended learning approach with a "classical" advanced training in GP quality circles.

BACKGROUND: Thus far important findings regarding the dementia syndrome have been implemented into patients' medical care only inadequately. A professional training accounting for both, general practitioners' (GP) needs and learning preferences as well as care-relevant aspects could be a major step towards improving medical care. In the WIDA-study, entitled "Knowledge translation on dementia in general practice" two different training concepts are developed, implemented and evaluated. Both concepts are building on an evidence-based, GP-related dementia guideline and communicate the guideline's essential insights. METHODS/DESIGN: Both development and implementation emphasize a procedure that is well-accepted in practice and, thus, can achieve a high degree of external validity. This is particularly guaranteed through the preparation of training material and the fact that general practitioners' quality circles (QC) are addressed. The evaluation of the two training concepts is carried out by comparing two groups of GPs to which several quality circles have been randomly assigned. The primary outcome is the GPs' knowledge gain. Secondary outcomes are designed to indicate the training's potential effects on the GPs' practical actions. In the first training concept (study arm A) GPs participate in a structured case discussion prepared for by internet-based learning material ("blended-learning" approach). The second training concept (study arm B) relies on frontal medical training in the form of a slide presentation and follow-up discussion ("classical" approach). DISCUSSION: This paper presents the outline of a cluster-randomized trial which has been peer reviewed and support by a national funding organization--Federal Ministry of Education and Research (BMBF)--and is approved by an ethics commission. The data collection has started in August 2006 and the results will be published independently of the study's outcome. TRIAL REGISTRATION: Current Controlled Trials [ISRCTN36550981].