Academic Medicine, Vol. 89, No. 6 / June 2014 920 Research Report Continuing professional development (CPD) encompasses a broad range of lifelong learning, skill development, and/or educational activities aimed at maintaining and improving physicians’ practice, professional behaviors, clinical skills and knowledge, and ultimately, care provided to patients. Physician participation in CPD has long been considered a professional obligation in Canada and the United States to sustain competence, enhance performance, and demonstrate accountability to the public for the privilege of self-regulation. 1–10 The value placed on CPD in relation to physician performance is evident in policies of the Canadian specialty certification bodies. The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (Royal College) have mandated participation in CPD as a requirement for maintenance of membership and fellowship. In addition, the medical regulatory authorities of many provinces, including the College of Physicians and Surgeons of Ontario (CPSO), have recently made participation in recognized programs of CPD mandatory for all licensed physicians. Such participation is regarded to be a mechanism to ensure an ongoing high level of physician performance for the public. 11 On the national level in Canada, the official position of the Federation of Medical Regulatory Authorities of Canada is that participation in CPD is critical to ensuring that the medical profession continues to act in the public’s best interest. 12 Specialty certification bodies in the United States rely on CPD for maintenance of physicians’ competence and stress the importance of lifelong learning. The recertification programs of the American Board of Medical Specialties, in part, evaluate maintenance of competence through CPD. 10 Similarly, the Federation of State Medical Boards promotes the importance of CPD as part of the assessment of competence for maintenance of licensure. 13 The positions of these numerous American and Canadian bodies make clear the importance placed on CPD for sustaining effective performance throughout a physician’s career. At the same time, some scholars question the effectiveness of the CPD approach for ensuring continuing competence of physicians in practice. 14 Studies have demonstrated that certain methods of CPD are more effective (e.g., practice-based small-group learning) than others in generating a positive impact on physician performance and care. 15–21 Researchers have found, though, that the CPD approaches shown to have a lesser effect on practice behavior (e.g., didactic large-group sessions) tend to dominate educational offerings and, as such, are selected more frequently by physicians than other forms of learning. 22–25 Throughout the literature, there is a call for further research on the influence of various types of CPD on practice. This Acad Med. 2014;89:920–927. First published online April 18, 2014 doi: 10.1097/ACM.0000000000000243 Please see the end of this article for information about the authors. Abstract Purpose To investigate the relationship between physicians’ performance, as evaluated through in-practice peer assessments, and their participation in continuing professional development (CPD). Method The authors examined the predictive effects of participating in the CPD programs of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada one year before in-practice peer assessments conducted by the medical regulatory authority in Ontario, Canada, in 2008–2009. Two multivariate logistic regression models were used to determine whether physicians who reported participating in any CPD and group-based, assessment-based, and/ or self-directed CPD activities were more or less likely to receive satisfactory assessments than physicians who had not. All models were adjusted for the effects of sex, age, specialty certification, practice location, number of patient visits per week, hours worked per week, and international medical graduate status. Results A total of 617 physicians were included in the study. Analysis revealed that physicians who reported participating in any CPD activities were significantly more likely (odds ratio [OR] = 2.5; P = .021) to have satisfactory assessments than those who had not. In addition, physicians participating in group-based CPD activities were more likely to have satisfactory assessments than those who did not (OR = 2.4; P = .016). Conclusions There is encouraging evidence supporting a positive predictive association between participating in CPD and performance on in-practice peer assessments. The findings have potential implications for policies which require physicians to participate in programs of lifelong learning. Correspondence should be addressed to Dr. Wenghofer, School of Rural and Northern Health, Laurentian University, Ramsey Lake Road, Sudbury, Ontario, Canada, P3E 2C6; telephone: (705) 675-1151 ext. 3925; e-mail: ewenghofer@ laurentian.ca. The Relationship Between Physician Participation in Continuing Professional Development Programs and Physician In-Practice Peer Assessments Elizabeth F. Wenghofer, PhD, Bernard Marlow, MD, Craig Campbell, MD, Lorraine Carter, PhD, Sophia Kam, MA, William McCauley, MD, and Lori Hill, MEd