Original Research Electronic Continuing Education in the Health Professions: An Update on Evidence from RCTs MARGARITA LAM-ANTONIADES, MD, CCFP; SAVITHIRI RATNAPALAN, MBBS, MED, MRCP, FRCPC, FAAP; GORDON T AIT,PHD Introduction: Demonstrating the effectiveness of the rapidly expanding field of electronic continuing education (e-CE) has important implications for CE in the health professions. This study provides an update on evidence from randomized controlled trials (RCTs) assessing the effectiveness of e-CE in the health professions. Methods: A literature search of RCTs was performed in MEDLINE, EMBASE, and CINAHL from 2004 to 2007. Papers were reviewed separately by 2 of the authors and results were categorized and reviewed according to study comparisons. Results: Fifteen studies met our inclusion criteria. Six compared e-CE to no intervention or placebo. Of these 6 studies, 4 showed a statistically significant advantage of the e-CE intervention and 2 showed no significant effect. Two studies compared e-CE to a lecture. Of these, 1 showed an advantage of e-CE and 1 showed no difference. Two studies compared e-CE to a small-group interactive intervention. In both studies, the e-CE group outperformed the control. Two studies compared a multicomponent e-CE intervention to one based on flat text, and both showed the multicomponent intervention to be more effective. Two of the 15 studies demonstrated a statistically significant effect on practice patterns. Positive effects of e-CE on knowledge were shown to persist for up to 12 months and effects on practice up to 5 months. Discussion: Overall, these studies suggest that multicomponent e-CE interventions can be effective in changing health professionals’ practice patterns, and improve their knowledge. E-CE interventions based purely on flat text appear to be of limited effectiveness in changing either knowledge or practice. These results support the use of multicomponent e-CE as a method of CE delivery. Key Words: electronic continuing education, education, medical, continuing, computer-based education, Internet, CD-ROM Introduction The number of continuing education initiatives in the health professions that are offered in electronic form has grown exponentially in the past decade. E-CE a ~electronic continu- ing education! programs offer many advantages including easy access, flexible timing, the possibility of adaptation to individual learning styles, and low cost. E-CE has the po- tential to provide many of the elements that have been found to be effective in traditional continuing medical education such as interactivity, 1 multiple sequenced sessions, 1,2 and reinforcing materials. 1 Interactivity can take many forms such as e-mail, asynchronous or synchronous discussion boards, video Web-conferencing, cases with scripted interactivity, and others. Several literature reviews on electronic learning in the health professions have been published in recent years. Wu- toh et al 3 reviewed randomized controlled trials ~ RCTs! and retrospective studies of e-CE interventions published Disclosures: The authors report none. Dr. Lam-Antoniades: Lecturer, Department of Family and Community Med- icine, University of Toronto, Staff physician, St. Michael’s Hospital, To- ronto, Canada; Dr. Ratnapalan: Assistant Professor, Department of Paediatrics, Department of Public Health Sciences, University of Toronto, Staff physician, Division of Emergency Medicine, Clinical Pharmacology & Toxicology, The Hospital for Sick Children, Toronto, Canada; Dr. Tait: Assistant Professor, Toronto General Hospital, Departments of Surgery and Anesthesia, University of Toronto, Canada. Correspondence: Margarita Lam-Antoniades, 410 Sherbourne Street, Ground Floor, Toronto, Ontario, M4X 1K2; e-mail: margarita.antoniades@ utoronto.ca. © 2009 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education. • Published online in Wiley InterScience ~www.interscience.wiley.com!. DOI: 10.10020chp.20005 a E-CE is used here to indicate any form of continuing education that is delivered with the use of either ~1! the Internet, ie, Web, or e-mail, or ~2! a computer interface, ie, CD-ROM. Studies involving computer-controlled mannequins as virtual patients were not included in this review. JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, 29(1):44–51, 2009