On the advantages and disadvantages of virtual continuing medical education: a scoping review

Authors

DOI:

https://doi.org/10.36834/cmej.75681

Abstract

Introduction: With the COVID-19 pandemic, most continuing medical education activities became virtual (VCME). The authors conducted a scoping review to synthesize the advantages and disadvantages of VCME to establish the impact of this approach on inequities that physicians face along the intersections of gender, race, and location of practice.

Methods: Guided by the methodological framework of Arksey and O’Malley, the search included six databases and was limited to studies published between January 1991 to April 2021. Eligible studies included those related to accredited/non-accredited post-certification medical education, conferences, or meetings in a virtual setting focused on physicians. Numeric and inductive thematic analyses were performed.  

Results: 282 studies were included in the review. Salient advantages identified were convenience, favourable learning formats, collaboration opportunities, effectiveness at improving knowledge and clinical practices, and cost-effectiveness. Prominent disadvantages included technological barriers, poor design, cost, lack of sufficient technological skill, and time. Analysis of the studies showed that VCME was most common in the general/family practice specialty, in suburban settings, and held by countries in the Global North. A minority of studies reported on gender (35%) and race (4%). 

Discussion: Most studies report advantages of VCME, but disadvantages and barriers exist that are contextual to the location of practice and medical subspecialty. VCME events are largely organized by Global North countries with suboptimized accessibility for Global South attendees. A lack of reported data on gender and race reveals a limited understanding of how VCME affects vulnerable populations, prompting potential future considerations as it evolves. 

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Author Biographies

Courtney Cheng, Royal College of Surgeons in Ireland

Ms. Courtney Cheng is a Medical Student at the Royal College of Surgeons in Ireland and holds a Bachelor of Science (Honours) degree in Life Sciences

Janet Papadakos, Princess Margaret Cancer Centre

Dr. Janet Papadakos Co-directs the Cancer Health Literacy Research Center at Princess Margaret Cancer Center and is Scientist at The Institute for Education Research at the University Health Network. Dr. Papadakos is also Assistant Professor at the University of Toronto. 

Ben Umakanthan, Princess Margaret Cancer Centre

Mr. Ben Umakanthan is a Research Analyst at Princess Margaret Cancer Centre and holds a Masters Degree in Public Health.

Rouhi Fazelzad, Princess Margaret Cancer Centre

Ms. Rouhi Fazelzad is an Information Specialist at Library and Information Services, University Health Network, Princess Margaret Cancer Centre.

Maria Athina (Tina) Martimianakis, University of Toronto

Dr. Maria Athina Tina Martimianakis is Associate Professor and Director of Medical Education Scholarship at the Department of Paediatrics and Scientist and Associate Director, Collaboration and Partnerships at the Wilson Centre, the University of Toronto.

Mohamed Ugas, Princess Margaret Cancer Centre

Mr. Mohamed Ugas is a Research Analyst at Princess Margaret Cancer Centre and holds a Masters Degree in Epidemiology.

References

Accreditation Council for Continuing Medical Education. CME content: definition and examples. [Internet]. 2019. Available from: https://www.accme.org/accreditation-rules/policies/cme-content-definition-and-examples. [Accessed Aug 17, 2020].

American Medical Association. The AMA physician’s recognition award and credit system. [Internet]. 2017. Available from: https://www.ama-assn.org/media/7831/download. [Accessed Aug 17, 2020].

Praharaj SK, Ameen S. The relevance of continuing medical education. Indian J Psychol Med. 2020;42(5 Suppl):97S-102S. https://doi.org/10.1177/0253717620957524

Accreditation Council for Continuing Medical Education. ACCME 2017 data report addendum PDF. [Internet]. 2019. Available from: https://www.accme.org/publications/accme-2017-data-report-addendum-pdf. [Accessed Aug 17, 2020].

Accreditation Council for Continuing Medical Education. ACCME data report steady growth in Accredited Continuing Medical Education – 2019. [Internet]. 2019. Available from: https://www.accme.org/sites/default/files/2020-07/872_2020%2007%2028_2019_Data_Report.pdf. [Accessed Aug 17, 2020].

Canchihuaman FA, Garcia PJ, Gloyd SS, Holmes KK. An interactive internet-based continuing education course on sexually transmitted diseases for physicians and midwives in Peru. PLoS One. 2011;6(5):e19318. https://doi.org/10.1371/journal.pone.0019318

Bonawitz R, Bird L, Le NB, et al. Implementing the mobile continuing medical education (mCME) project in Vietnam: making it work and sharing lessons learned. Mhealth. 2019;5:7. https://doi.org/10.21037/mhealth.2019.02.01

Casebeer L, Engler S, Bennett N, et al. A controlled trial of the effectiveness of internet continuing medical education. BMC Med. 2008;6:37. https://doi.org/10.1186/1741-7015-6-37

Allison JJ, Kiefe CI, Wall T, et al. Multicomponent Internet continuing medical education to promote chlamydia screening. Am J Prev Med. 2005;28(3):285-90. https://doi.org/10.1016/j.amepre.2004.12.013

Harris SB, Leiter LA, Webster-Bogaert S, Van DM, O'Neill C. Teleconferenced educational detailing: Diabetes education for primary care physicians. J Continu Educ Health Prof. 2005 Spring;25(2):87-97. https://doi.org/10.1002/chp.13

Salinas GD. CME effectiveness: utilizing outcomes assessments of 600+ CME programs to evaluate the association between format and effectiveness. J Contin Educ Health Prof. Spring 2015;35 Suppl 1:S38-9. https://doi.org/10.1002/chp.21279

Fordis M, King JE, Ballantyne CM, et al. Comparison of the instructional efficacy of Internet-based CME with live interactive CME workshops: a randomized controlled trial. JAMA. 2005;294(9):1043-1051. https://doi.org/10.1001/jama.294.9.1043

Pelayo M, Cebrián D, Areosa A, Agra Y, Izquierdo JV, Buendía F. Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians. BMC Fam Pract. 2011;12(1):37. https://doi.org/10.1186/1471-2296-12-37

Cook DA, Price DW, Wittich CM, West CP, Blachman MJ. Factors influencing physicians' selection of continuous professional development activities: a cross-specialty national survey. J Contin Educ Health Prof. 2017 Summer;37(3):154-160. https://doi.org/10.1097/ceh.0000000000000163

O’Brien Pott M, Blanshan AS, Huneke KM, Baasch Thomas BL, Cook DA. Barriers to identifying and obtaining CME: a national survey of physicians, nurse practitioners and physician assistants. BMC Med Educ. 2021;21(1):168. https://doi.org/10.1186/s12909-021-02595-x

Jeong D, Presseau J, ElChamaa R, et al. Barriers and facilitators to self-directed learning in continuing professional development for physicians in Canada: a scoping review. Acad Med. 2018;93(8):1245-1254. https://doi.org/10.1097/acm.0000000000002237

Concordia University Irvine. How to balance equity, equality, and fairness. [Internet] 2019. Available from: https://www.cui.edu/academicprograms/education/servant-leadership-institute/perfecting-the-practice/blog/post/how-to-balance-equity-equality-and-fairness. [Accessed Aug 17, 2020].

Stancic N, Mullen PD, Prokhorov AV, Frankowski RF, McAlister AL. Continuing medical education: what delivery format do physicians prefer? J Contin Educ Health Prof. 2003 Summer ;23(3):162-7. https://doi.org/10.1002/chp.1340230307

Curran VR, Keegan D, Parsons W, et al. A comparative analysis of the perceived continuing medical education needs of a cohort of rural and urban Canadian family physicians. Can J Rural Med. 2007 Summer;12(3):161-6.

Schoen MJ, Tipton EF, Houston TK, et al. Characteristics that predict physician participation in a Web-based CME activity: the MI-Plus study. J Contin Educ Health Prof. 2009 Fall;29(4):246-53. https://doi.org/10.1002/chp.20043

Casebeer L, Bennett N, Kristofco R, Carillo A, Centor R. Physician Internet medical information seeking and on-line continuing education use patterns. J Contin Educ Health Prof. Winter 2002;22(1):33-42. https://doi.org/10.1002/chp.1340220105

Harris Jr JM, Novalis-Marine C, Harris RB. Women physicians are early adopters of on-line continuing medical education. J Contin Educ Health Prof. 2003;23(4):221-228. https://doi.org/10.1002/chp.1340230505

Tretter JT, Windram J, Faulkner T, et al. Heart University: a new online educational forum in paediatric and adult congenital cardiac care. The future of virtual learning in a post-pandemic world? Cardiol Young. 2020;30(4):560-567. https://doi.org/10.1017/S1047951120000852

Bhargava S, Farabi B, Rathod D, Singh AK. The fate of major dermatology conferences and meetings of 2020: are e-conferences and digital learning the future? Clin Exp Dermatol. 2020;45(6):759-761. https://doi.org/10.1111/ced.14272

Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19-32. https://doi.org/10.1080/1364557032000119616

National Science Foundation Office of Inspector General. OIG Review of NFSNET. Report. 1993:35.

Veritas Health Innovation. Covidence systematic review software [Internet] 2014. Available from https://www.covidence.org [Accessed Jun 24, 2020].

Moola S, Munn Z, Sears K, et al. Conducting systematic reviews of association (etiology): The Joanna Briggs Institute's approach. Int J Evid Based Healthc. 2015 Sep;13(3):163-9. https://doi.org/10.1097/xeb.0000000000000064

Richardson ML, Norris TE. On-line delivery of continuing medical education over the World-Wide Web: an on-line needs assessment. AJR Am J Roentgenol. 1997;168(5):1161-4.

Sly JL, Lombardi E, Kusel M, Sly PD. Piloting a web-based continuing professional development program for asthma education. Int J Med Inform. 2006;75(10-11):708-13. https://doi.org/10.1016/j.ijmedinf.2005.09.004

Vides-Porras A, Cáceres P, Company A, et al. Gaining insight into the implementation of an e-learning smoking cessation course in Latin American countries. Health Promot Int. 2021;36(2):349-362. https://doi.org/10.1093/heapro/daaa054

Farokhi MR, Zarifsanaiey N, Haghighi F, Mehrabi M. E-learning or in-person approaches in continuous medical education: A comparative study. IIOAB J. 2016;7(2):472-476.

Curran VR, Hoekman T, Gulliver W, Landells I, Hatcher L. Web-based continuing medical education. (II): Evaluation study of computer-mediated continuing medical education. J Contin Educ Health Prof. 2000;20(2):106-19. https://doi.org/10.1002/chp.1340200207

Gandsas A, McIntire K. Minimally Invasive Therapy and Allied Technologies: new solutions to old problems. Minim Invasive Ther Allied Technol. 2002;11(2):35-6. https://doi.org/10.1080/136457002753632420

Greenberg JA, Schwarz E, Paige J, Dort J, Bachman S. At-home hands-on surgical training during COVID19: proof of concept using a virtual telementoring platform. Surg Endosc. 2021;35(5):1963-1969. https://doi.org/10.1007/s00464-021-08470-6

Klein D, Davis P, Hickey L. Videoconferences for rural physicians' continuing health education. J Telemed Telecare. 2005;11 Suppl 1:97-9. https://doi.org/10.1258/1357633054461822

Krupinski EA, Lopez AM, Lyman T, Barker G, Weinstein RS. Continuing education via telemedicine: analysis of reasons for attending or not attending. Telemed J E Health. 2004;10(3):403-9. https://doi.org/10.1089/tmj.2004.10.403

Kulatunga GGAK, Marasinghe RB, Karunathilake IM, Dissanayake VHW. Development and implementation of a web-based continuing professional development (CPD) programme on medical genetics. J Telemed Telecare. 2013;19(7):388-92. https://doi.org/10.1177/1357633X13506525

Lamba P. Teleconferencing in medical education: a useful tool. Australas Med J. 2011;4(8):442-7. https://doi.org/10.4066/AMJ.2011.823

Liaw S-T, Pearce C, Keppell M. Developing a web-based learning network for continuing medical education. J Workplace Learn. 2002;14(3):98-108. https://doi.org/10.1108/13665620210421911

Malassagne B, Mutter D, Leroy J, Smith M, Soler L, Marescaux J. Teleeducation in surgery: European Institute for Telesurgery experience. World J Surg. 2001;25(11):1490-4. https://doi.org/10.1007/s00268-001-0135-z

McEnery KW, Roth SM, Walkup RV. Radiology CME on the Web using secure document transfer and internationally distributed image servers. Proc AMIA Annu Fall Symp. 1996:37-40.

Medina-Presentado JC, Margolis A, Teixeira L, et al. Online continuing interprofessional education on hospital-acquired infections for Latin America. Braz J Infect Dis. 2017;21(2):140-147.https://dx.doi.org/10.1016/j.bjid.2016.11.003

Abawi K, Gertiser L, Idris R, et al. A large-scale Internet/computer-based, training module: dissemination of evidence-based management of postpartum hemorrhage to front-line health care workers. IJEL. 2017;16(4)317-328.

Bollinger RC, McKenzie-White J, Gupta A. Building a global health education network for clinical care and research. The benefits and challenges of distance learning tools. Lessons learned from the Hopkins Center for Clinical Global Health Education. Infect Dis Clin North Am. 2011;25(2):385-98. https://doi.org/10.1016/j.idc.2011.02.006

Murphy K, Munk PL. Continuing medical education: MOOCs (Massive Open Online Courses) and their implications for radiology learning. Can Assoc Radiol J. 2013;64(3):165. https://doi.org/10.1016/j.carj.2013.06.001

Norman JN, Alsajir MB. Tele-education - Postgraduate education. Med Principles Pract. 2001;10(3):115-122. https://doi.org/10.1159/000050354

Peterson MW, Galvin JR, Dayton C, D'Alessandro MP. Realizing the promise: delivering pulmonary continuing medical education over the Internet. Chest. 1999;115(5):1429-36. https://doi.org/10.1378/chest.115.5.1429

Rana R, Kumawat D, Sahay P, et al. Perception among ophthalmologists about webinars as a method of continued medical education during COVID-19 pandemic. Indian J Ophthalmol. 2021;69(4). https://doi.org/10.4103/ijo.IJO_3136_20

Regueiro MD, Greer JB, Binion DG, et al. The inflammatory bowel disease live interinstitutional and interdisciplinary videoconference education (IBD LIVE) series. Inflamm Bowel Dis. 2014;20(10):1687-1695. https://doi.org/10.1097/MIB.0000000000000187

Ruf D, Kriston L, Berner M, Harter M. General practitioners and online continuing medical education - which factors influence its use? Ger Med Sci. 2009;7:Doc08. https://doi.org/10.3205/000067

Taekman JM, Kingsley CP, Shelley KH. Medical education over the Internet. Acad Med. 1996;71(5):525.

Tello R, Davison BD, Blickman JG. The virtual course: delivery of live and recorded continuing medical education material over the Internet. AJR Am J Roentgenol. 2000;174(6):1519-21. https://doi.org10.2214/ajr.174.6.1741519

Whitten P, Ford DJ, Davis N, Speicher R, Collins B. Comparison of face-to-face versus interactive video continuing medical education delivery modalities. J Continu Ed Health Prof. 1998;18(2):93-99. https://doi.org/10.1002/chp.1340180205

Bagayoko CO, Perrin C, Gagnon M-P, Geissbuhler A. Continuing distance education: a capacity-building tool for the de-isolation of care professionals and researchers.J Gen Intern Med. 2013;28 Suppl 3:S666-70. https://doi.org/10.1007/s11606-013-2522-1

Boatin A, Ngonzi J, Bradford L, Wylie B, Goodman A. Teaching by teleconference: a model for distance medical education across two continents. Open J Obstet Gynecol. 2015;5(13):754-761. https://doi.org/10.4236/ojog.2015.513106

Butterworth K, Hayes B, Zimmerman M, Knoble S. Needs assessment for continuing medical education in Nepal. Med Teach. 2009;31(5):463. http://doi.org/10.1080/01421590903051315

Callas PW, Ricci MA, Caputo MP. Improved rural provider access to continuing medical education through interactive videoconferencing. Telemed J E Health. 2000;6(4):393-9. https://doi.org/10.1089/15305620050503861

Curran V, Kirby F, Allen M, Sargeant J. A mixed learning technology approach for continuing medical education. Med Educ Online. 2003;8(1):4341. https://doi.org/10.3402/meo.v8i.4341

Curran V, Kirby F, Allen M, Sargeant J. A mixed learning technology strategy for providing continuing medical education to rural physicians. J Telemed Telecare. 2003;9(5):305-7. https://doi.org/10.1258/135763303769211364

Curran V, Lockyer J, Sargeant J, Fleet L. Evaluation of learning outcomes in Web-based continuing medical education. Acad Med. 2006;81(10 Suppl):S30-4. https://doi.org/10.1097/01.ACM.0000236509.32699.f5

Curran VR, Fleet L, Kirby F. Factors influencing rural health care professionals' access to continuing professional education. Aust J Rural. 2006;14(2):51-5. https://doi.org/10.1111/j.1440-1584.2006.00763.x

Datta C. The rise of e-learning and opportunities for Indian family physicians. J Family Med Prim Care. 2012;1(1):7-9. https://doi.org/10.4103/2249-4863.94441

de Carvalho Mesquita K, da Silva JA, Igreja ACdSM. Aplicabilidade da educação a distância na educação médica continuada. Brasília Med. 2012;49(2):111-117.

DeLacy FB, Nehme J, Lacy AM, Chand M. Educational technology: revolutionizing surgical education. Br J Hosp Med (Lond). 2017;78(8):426-427. https://doi.org/10.12968/hmed.2017.78.8.426

Dinh M, Tan T, Bein K, Hayman J, Wong YK, Dinh D. Emergency department knowledge management in the age of Web 2.0: evaluation of a new concept. Emerg Med Australas. 2011;23(1):46-53.https://doi.org/10.1111/j.1742-6723.2010.01373.x

Dufour JC, Cuggia M, Soula G, Spector M, Kohler F. An integrated approach to distance learning with digital video in the French-speaking Virtual Medical University. Int J Med Inform. 2007;76(5-6):369-376. http://doi.org/10.1016/j.ijmedinf.2007.01.011

Fordis M, King JE, Ballantyne CM, et al. Comparison of the instructional efficacy of Internet-based CME with live interactive CME workshops: a randomized controlled trial. JAMA. 2005;294(9):1043-51. https://doi.org/10.1001/jama.294.9.1043

Hoedebecke K, Mahmoud M, Yakubu K, et al. Collaborative global health e-learning: a massive open online course experience of young family doctors. J Family Med Prim Care. 2018;7(5):884-887. https://doi.org/10.4103/jfmpc.jfmpc_186_18

Janes R, Arroll B, Buetow S, Coster G, McCormick R, Hague I. Rural New Zealand health professionals' perceived barriers to greater use of the internet for learning. Rural Remote Health. 2005;5(4):436.

Kanneganti A, Lim KMX, Chan GMF, et al. Pedagogy in a pandemic - COVID-19 and virtual continuing medical education (vCME) in obstetrics and gynecology. Acta Obstet Gynecol Scand. 2020;99(6):692-695. https://doi.org/10.1111/aogs.13885

Lupiáñez-Villanueva F, Mayer MA, Torrent J. Opportunities and challenges of Web 2.0 within the health care systems: an empirical exploration. Inform Health Soc Care. Sep 2009;34(3):117-26. https://doi.org/10.1080/17538150903102265

Mamary E, Charles P. Promoting self-directed learning for continuing medical education. Medical Teach. 2003;25(2):188-90. https://doi.org/10.1080/0142159031000092607

Masud S, Ayub A, Mahboob U. Use of massive online open courses as a potential resource to provide continuing medical education in Pakistan. J Coll Physicians Surg Pak. 2016;26(2):160-1. https://doi.org/02.2016/JCPSP.160161

Bermejo-Caja CJ, Koatz D, Orrego C, et al. Acceptability and feasibility of a virtual community of practice to primary care professionals regarding patient empowerment: a qualitative pilot study. BMC Health Serv Res. 2019;19(1):403. https://doi.org/10.1186/s12913-019-4185-z

Mohan D, Fischhoff B, Angus DC, et al. Serious games may improve physician heuristics in trauma triage. Proc Natl Acad Sci U S A. 2018;115(37):9204-9209. https://doi.org/10.1073/pnas.1805450115

Nahai F. Distance learning in plastic surgery: are live meetings destined for the scrapheap? Aesthet Surg J. 2012;32(5):659-60. https://doi.org/10.1177/1090820X12448817

Neto RM. Distance education in medical ultrasound in Brazil. Obstet Gynecol. 2015;9(2):197-202. http://doi.org/10.5005/jp-journals-10009-1406

Newman TH, Robb H, Michaels J, et al. The end of conferences as we know them? Trainee perspectives from the Virtual ACCESS Conference 2020. BJU Int. 2021;127(2):263-265. https://doi.org/10.1111/bju.15330

Nofal MR, Halim N, Le BN, et al. Unpacking the "Black Box": How an SMS-Based Continuing Medical Education Intervention Improved Medical Knowledge Among HIV Clinicians in Vietnam. Glob Health Sci Pract. 2018;6(4):668-679. https://doi.org/10.9745/GHSP-D-18-00298

O’Brien Pott M, Blanshan AS, Huneke KM, Baasch Thomas BL, Cook DA. What influences choice of continuing medical education modalities and providers? A National Survey of US physicians, nurse practitioners, and physician assistants. Acad Med. 2020;96(1):93-100. https://doi.org/10.1097/ACM.0000000000003758

Ottesen TD, Montoya RL, Ogunleye TD, et al. Implementation and impact evaluation of a virtual orthopaedic continuing medical education conference in a low-resource country. J Surg Educ. 2021; 78(5):1629-1636.https://doi.org/10.1016/j.jsurg.2021.01.002

Penna GCe, Mendes HG, Dias MAdS, et al. Avaliação do emprego de videoconferências para a capacitação à distância dos médicos das equipes de saúde da família dentro do projeto nacional telessaúde. Evaluation of the use of videoconferencing for distance training of doctors in the family health teams within the national telehealth project. Rev Med Minas Gerais. 2015;25(1):108-14

Prinz JC, Hartmann D, Wolff H, et al. Dermatology continuing medical education during Corona times and beyond: Experience from the 2020 digital advanced training week for practical dermatology and venerology and lessons for future concepts. Hautarzt. 2021;72(4):362-366. https://doi.org/10.1007/s00105-020-04755-4

Ramanathan R, Aldis R, Gupta S, Desai M, Bollinger Jr RC, Reed VA. Mixed methods evaluation of an international internet-based continuing medical education course for pediatric HIV providers in Pune, India. Educ Health (Abingdon). 2011;24(1):540.

Ramsay R, Nashat NH, Thuraisingham C, et al. Reimagining medical education for primary care in the time of COVID-19: a world view. Educ Prim Care. 2021;32(1):2-5. https://doi.org/10.1080/14739879.2020.1851147

Rebbeck T, Macedo L, Paul P, Trevena L, Cameron ID. General practitioners' knowledge of whiplash guidelines improved with online education. Aust Health Rev. 2013;37(5):688-94. https://doi.org/10.1071/AH13057

Ruiz-Barrera MA, Agudelo-Arrieta M, Aponte-Caballero R, et al. Developing a Web-Based Congress: The 2020 International Web-Based Neurosurgery Congress Method. World Neurosurg. 2021;148:e415-e424. https://doi.org/10.1016/j.wneu.2020.12.174

Abboudi H, Khan MS, Aboumarzouk O, et al. Current status of validation for robotic surgery simulators a systematic review. BJU International. 2013;111(2):194-205. http://doi.org/10.1111/j.1464-410X.2012.11270.x

Tarchichi TR, Szymusiak J. Continuing medical education in the time of social distancing: the case for expanding podcast usage for continuing education. J Contin Educ Health Prof. 2021;41(1):70-74. https://doi.org/10.1097/ceh.0000000000000324

Willman AS. Use of Web 2.0 tools and social media for continuous professional development among primary healthcare practitioners within the Defence Primary Healthcare: a qualitative review. BMJ Mil Health. 2020;166(4):232-235. https://doi.org/10.1136/jramc-2018-001098

Zereshkian A, Wong R, Leifer R, et al. Continuing professional development needs amongst University of Toronto's Department of Radiation Oncology Faculty. J Cancer Educ. 2021;36(1):118-125. https://doi.org/10.1007/s13187-019-01607-1

Archibald D, Burns JK, Fitzgerald M, Merkley VF. Aligning practice data and institution-specific CPD: medical quality management as the driver for an eLearning development process. J Eur CME. 2020;9(1):1754120. https://doi.org/10.1080/21614083.2020.1754120

Vollmar HC, Schurer-Maly CC, Lelgemann M, Koneczny N, Koch M, Butzlaff M. Online continuing medical education based on national disease management guidelines. The e-learning platform leitnien-wissen.de. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2006;49(5):412-417. https://doi.org/10.1007/s00103-006-1251-6

Adler G, Pritchett LR, Kauth MR. Meeting the continuing education needs of rural mental health providers. Telemed J E Health. 2013;19(11):852-6. https://doi.org/10.1089/tmj.2013.0010

Allen M, Sargeant J, MacDougall E, Proctor-Simms M. Videoconferencing for continuing medical education: from pilot project to sustained programme. J Telemed Telecare. 2002;8(3):131-7. https://doi.org/10.1177/1357633X0200800302

Chao J. Continuing medical education software: a comparative review. J Fam Pract. 1992;34(5):598-604.

Chatziralli I, Ventura CV, Touhami S, et al. Transforming ophthalmic education into virtual learning during COVID-19 pandemic: a global perspective. Eye (Lon). 2021;35(5):1459-1466. https://doi.org/10.1038/s41433-020-1080-0

Cho MJ, Hong JP. The emergence of virtual education during the COVID-19 pandemic: The past, present, and future of the plastic surgery education. J Plast Reconstr Aesthet Surg. 2021;74(6):1413-1421. https://doi.org/10.1016/j.bjps.2020.12.099

Ghanem O, Logghe HJ, Tran BV, Huynh D, Jacob B. Closed Facebook TM groups and CME credit: a new format for continuing medical education. Surg Endosc. 2019;33(2):587-591. https://doi.org/10.1007/s00464-018-6376-9

Greenwood J, Williams R. Continuing professional development for Australian rural psychiatrists by videoconference. Australas Psychiatry. 2008;16(4):273-6. https://doi.org/10.1080/10398560801982994

Kisilevsky E, Margolin E, Kohly RP. Access, an unintended consequence of virtual continuing medical education during COVID-19: a department's experience at the University of Toronto. Can J Ophthalmol. 2021;56(1):e18-e19. https://doi.org/10.1016/j.jcjo.2020.10.002

Knipfer C, Wagner F, Knipfer K, et al. Learners' acceptance of a webinar for continuing medical education. Int J Oral Maxillofac Surg. 2019;48(6):841-846. https://dx.doi.org/10.1016/j.ijom.2018.11.010

Levy BT, Albrecht L, Gjerde CL. Using videoconferencing to train community family medicine preceptors. Acad Med. 1998;73(5):616-7. https://doi.org/10.1097/00001888-199805000-00094

Lewis CE, Relan A, Hines OJ, Tillou A, Hiatt JR. Morbidity and mortality as a televideoconference: A randomized prospective evaluation of learning and perceptions. J Am Coll Surg. 2011;212(3):400-405. http://doi.org/10.1016/j.jamcollsurg.2010.12.002

Lott DR. Can Distance Education Solve Rural Physicians' Professional Isolation Problems? J Contin High Educ. 1996; 44(3)25-28. https://doi.org/10.1080/07377366.1996.10400300

Lynch J, Weaver L, Hall P, et al. Using telehealth technology to support CME in end-of-life care for community physicians in Ontario. Telemed J E Health. 2004;10(1):103-7. https://doi.org/10.1089/153056204773644643

Michelson G, Scibor M, Keppler K, Dick B, Kuchenbecker J. Online medical education in ophthalmology. Ophthalmologe. 2000;97(4):290-294. https://doi.org/10.1007/s003470050530

Omil-Lima D, Fernstrum A, Gupta K, et al. Urologic education in the era of COVID-19: results from a webinar-based reconstructive urology lecture series. Urology. 2021;152:2-8. https://doi.org/10.1016/j.urology.2021.03.004

Sen Gupta TK, Wallace DA, Clark SL, Bannan G. Videoconferencing: practical advice on implementation. Aus J Rural Health. 1998;6(1):2-4. https://doi.org/10.1111/j.1440-1584.1998.tb00273.x

Walsh K. E-learning in medical education: the potential environmental impact. Educ Prim Care. 2018;29(2):104-106. https://doi.org/10.1080/14739879.2017.1389619

Wang Z-Y, Zhang L-J, Liu Y-H, Jiang W-X, Tang S-L, Liu X-Y. Process evaluation of E-learning in continuing medical education: evidence from the China-Gates Foundation Tuberculosis Control Program. Infectious Dis Poverty. 2021;10(1):23. https://doi.org/10.1186/s40249-021-00810-x

White LE, Krousel-Wood MA, Mather F. Technology meets healthcare: Distance learning and telehealth. Ochsner J. 2001;3(1):22-29.

Allen JW. Surgical Internet at a glance: continuing medical education. Am J Surg. 2001;181(2):89-90. https://doi.org/10.1016/s0002-9610(00)00570-5

Chen T-H, Buenconsejo-Lum LE, Braun KL, Higa C, Maskarinec GG. A pilot evaluation of distance education modalities for health workers in the U.S.-Affiliated Pacific Islands. Pac Health Dialog. 2007;14(1):22-30.

Davis P, McCracken P. Restructuring rural continuing medical education through videoconferencing. J Telemed Telecare. 2002;8 Suppl 2:108-9. https://doi.org/10.1177/1357633X020080S249

Diehl LA, Souza RM, Gordan PA, Esteves RZ, Coelho IC. InsuOnline, an electronic game for medical education on insulin therapy: a randomized controlled trial with primary care physicians. J Med Internet Res. 2017;19(3):e72. https://doi.org/10.2196/jmir.6944

Feldacker C, Jacob S, Chung MH, Nartker A, Kim HN. Experiences and perceptions of online continuing professional development among clinicians in sub-Saharan Africa. Hum Resour Health. 2017;15(1):89. https://doi.org/10.1186/s12960-017-0266-4

Gupta MP, Sridhar J, Wykoff CC, Yonekawa Y. Ophthalmology conferences in the coronavirus disease 2019 era. Curr Opin Opthalmol. 2020;31(5):396-402. https://doi.org/10.1097/ICU.0000000000000688

Hemmati N, Omrani S, Hemmati N. A comparison of Internet-based learning and traditional classroom lecture to learn CPR for continuing medical education. Turk Online J Dist Educ. 2013;14(1):256-265.

Jarvis-Selinger S, Gullion J, Lauscher HN, Ho K. Integrating continuing professional development and graduate curriculum in a case-based interprofessional online course: telemedicine in action. J Contin Educ Health Prof. 2007;27(4):253-4. https://doi.org/10.1002/chp.145

Krebs TL, Berg WA, Roys SR, Ratakonda S, Pomerantz SM, Siegel EL. MammoWeb continuing medical education (CME): a web-based breast imaging CME program. J Digit Imaging. 1999;12(2 Suppl 1):124-6. https://doi.org/10.1007/BF03168777

Kresevic D, Burant C, Denton J, Heath B, Kypriotakis G. The use of multimodal strategies for distance education in the GRECCs. Gerontol Geriatr Educ. 2011;32(1):54-79. https://doi.org/10.1080/02701960.2011.550216

Leite MTM, Carlini AL, Ramos MP, Sigulem D. Educação médica continuada online: potencial e desafios no cenário brasileiro. Online continuing medical education: potential and challenges in the Brazilian context. Rev Bras Educ Méd. 2010/03 2010;34(1):141-149. https://doi.org/10.1590/S0100-55022010000100017

Lockyer J, Sargeant J, Curran V, Fleet L. The transition from face-to-face to online CME facilitation. Med Teach. 2006;28(7):625-30. https://doi.org/10.1080/01421590600922909

MacWalter G, McKay J, Bowie P. Utilisation of internet resources for continuing professional development: a cross-sectional survey of general practitioners in Scotland. BMC Med Educ. 2016;16:24. https://doi.org/10.1186/s12909-016-0540-5

Mazzoleni MC, Maugeri C, Rognoni C, Cantoni A, Imbriani M. Is it worth investing in online continuous education for healthcare staff? Stud Health Technol Inform. 2012;180:939-43.

Nelsen BR, Chen YK, Lasic M, Bader AM, Arriaga AF. Advances in anesthesia education: increasing access and collaboration in medical education, from E-learning to telesimulation. Curr Opin Anaesthesiol. 2020;33(6):800-807. https://doi.org/10.1097/aco.0000000000000931

Tucker AP, Miller A, Sweeney D, Jones RW. Continuing medical education: A needs analysis of anaesthetists. Anaesth Intensive Care. 2006;34(6):765-769. https://doi.org/10.1177/0310057X0603400604

Tullo E, Newton J, Clapp A. What can e-learning offer geriatric medicine in the UK? Rev Clin Gerontol. 2012;22(3):235-242. http://doi.org/10.1017/S0959259812000081

Wiecha J, Barrie N. Collaborative online learning: a new approach to distance CME. Acad Med. 2002;77(9):928-9.

Yee M, Simpson-Young V, Paton R, Zuo Y. How do GPs want to learn in the digital era? Aust Fam Physician. 2014;43(6):399-402.

Mazzoleni MC, Rognoni C, Finozzi E, et al. Usage and effectiveness of e-learning courses for continuous medical education. Stud Health Technol Inform. 2009;150:921-5.

Comer A, Harris AD, Shardell M, et al. Attaining safety for patients through interdisciplinary risk reduction efforts (ASPIRRE) subgroup. Web-based training improves knowledge about central line bloodstream infections. Infect Control Hosp Epidemiol. 2011;32(12):1219-22. https://doi.org/10.1086/662585

Humphreys H, McHugh S, Dimitrov BD, Cowman S, Tierney S, Hill AD. Web-based training to improve knowledge and change practice in preventing healthcare infection. Infect Control Hosp Epidemiol. 2012;33(6):644-5. https://doi.org/10.1086/665717

Curran V, Kirby F, Parsons E, Lockyer J. Short report: satisfaction with on-line CME. Evaluation of the ruralMDcme website. Can Fam Physician. 2004;50:271-4.

Della Corte F, La Mura F, Petrino R. E-learning as educational tool in emergency and disaster medicine teaching. Minerva Anestesiol. 2005;71(5):181-95.

Le TT, Rait MA, Jarlsberg LG, Eid NS, Cabana MD. A randomized controlled trial to evaluate the effectiveness of a distance asthma learning program for pediatricians. J Asthma. 2010;47(3):245-50. https://doi.org/10.3109/02770900903560209

Mehta N, Geissel K, Rhodes E, Salinas G. Comparative effectiveness in CME: evaluation of personalized and self-directed learning models. J Contin Educ Health Prof. 2015;35 Suppl 1:S24-6. https://doi.org/10.1002/chp.21284

Oliveira AC, Mattos S, Coimbra M. Development and assessment of an e-learning course on pediatric cardiology basics. JMIR Med Educ. 2017;3(1):e10. https://doi.org/10.2196/mededu.5434

Raggio V, Roche L, Esperón P, Stoll M. Curso on-line: Introducción a la medicina genómica. On-line Course: Introduction to genomic medicine. Rev Méd Urug. 2007;23(2):116-121.

Sargeant J, Curran V, Jarvis-Selinger S, et al. Interactive on-line continuing medical education: physicians' perceptions and experiences. J Contin Educ Health Prof. 2004;24(4):227-36. https://doi.org10.1002/chp.1340240406.

Stancic N, Mullen PD, Prokhorov AV, Frankowski RF, McAlister AL. Continuing medical education: what delivery format do physicians prefer? J Contin Educ Health Prof. 2003;23(3):162-7. https://doi.org/10.1002/chp.1340230307

Gill CJ, Le NB, Halim N, et al. mCME project V.2.0: randomised controlled trial of a revised SMS-based continuing medical education intervention among HIV clinicians in Vietnam. BMJ Glob Health. 2018;3(1):e000632. https://doi.org/10.1136/bmjgh-2017-000632

Krishnamachari B, Rehman M, Cohn JE, et al. Video education on hereditary breast and ovarian cancer (HBOC) for physicians: an interventional Study. J Cancer Educ. 2018;33(6):1213-1221. https://doi.org/10.1007/s13187-017-1233-4

Chen HS, Guo FR, Chen CY, Chen JH, Kuo TS. Review of telemedicine projects in Taiwan. Int J Med Inform. 2001;61(2-3):117-29. https://doi.org/10.1016/s1386-5056(01)00134-4

Geissbuhler A, Bagayoko CO, Ly O. The RAFT network: 5 years of distance continuing medical education and tele-consultations over the Internet in French-speaking Africa. Inte J Med Inform. 2007;76(5-6):351-6. https://doi.org/10.1016/j.ijmedinf.2007.01.012

Gerbert B, Bronstone A, Maurer T, Berger T, McPhee SJ, Caspers N. The effectiveness of an Internet-based tutorial in improving primary care physicians' skin cancer triage skills. J Cancer Educ. 2002;17(1):7. https://doi.org/10.1080/08858190209528784

Goodyear-Smith F, Whitehorn M, McCormick R. Experiences and preferences of general practitioners regarding continuing medical education: a qualitative study. N Z Med J. 2003;116(1172):U399.

Klein M, Niebuhr V, D'Alessandro D. Innovative online faculty development utilizing the power of social media. Acad Pediatr. 2013;13(6):564-9. https://doi.org/10.1016/j.acap.2013.07.005

Margolis A, Gonzalez-Martinez F, Noboa O, et al. Online continuing medical education for the Latin American nephrology community. Stud Health Technol Inform. 2015;216:372-5.

Murphy-Southwick C, McBride M. Geriatric education across 94 million acres: adapting conference programming in a rural state. Gerontol Geriatr Educ. 2006;26(4):25-36.

Sherman A. Continuing medical education methodology: current trends and applications in wound care. J Diabetes Sci Technol. 2010;4(4):853-6. https://doi.org/10.1177/193229681000400413

Bond SE, Crowther SP, Adhikari S, et al. Design and implementation of a novel web-based e-learning tool for education of health professionals on the antibiotic Vancomycin. J Med Internet Res. 2017;19(3):e93. https://doi.org/10.2196/jmir.6971

Anthierens S, Tonkin-Crine S, Douglas E, et al. General practitioners' views on the acceptability and applicability of a web-based intervention to reduce antibiotic prescribing for acute cough in multiple European countries: a qualitative study prior to a randomised trial. BMC Fam Pract. 2012;13:101. https://doi.org/10.1186/1471-2296-13-101

Bassey IE, Ekanem IA, Olasode BJ, Jombo GTA. Web-based learning as an important bridge in information divide in contemporary practice of pathology in the developing world: findings from Nigeria. Internet J Third World Med. 2010;8(2)

Bellande BJ. The future of CME. South Med J. 1991;84(8):1007-11. https://doi.org/10.1097/00007611-199108000-00014

Nafrawi AG. The future of CME. South Med J. 1992;85(2):221. https://doi.org/10.1097/00007611-199202000-00032

Bonevski B, Magin P, Horton G, Bryant J, Randell M, Kimlin MG. An internet based approach to improve general practitioners' knowledge and practices: the development and pilot testing of the "ABC's of vitamin D" program. Int J Med Inform. 2015;84(6):413-22. https://doi.org/10.1016/j.ijmedinf.2015.01.006

Burgos F, Disdier C, De Santamaria EL, et al. Telemedicine enhances quality of forced spirometry in primary care. Eur Respir J. 2012;39(6):1313-1318. http://doi.org/10.1183/09031936.00168010

Carrizosa J, Braga P, Albuquerque M, et al. Epilepsy for primary health care: a cost-effective Latin American E-learning initiative. Epileptic Disord. 2018;20(5):386-395. https://doi.org/10.1684/epd.2018.0997

Cates JR, Diehl SJ, Fuemmeler BF, et al. Toward optimal communication about HPV vaccination for preteens and their parents: evaluation of an online training for pediatric and family medicine health care providers. J Public Health Manag Pract. 2020;26(2):159-167. https://doi.org/10.1097/phh.0000000000001022

Chandrasekaran A, Thukral A, Deorari AK. E-learning in newborn health - a paradigm shift for continuing professional development for doctors and nurses. Indian J Pediatr. 2014;81(12):1376-80. https://doi.org/10.1007/s12098-014-1362-2

Chio KS. Effective Practices in Providing Online, In-Service Training to Health Professionals in Low-Resource Settings. Inter J Train Dev. 2012;16(3):228-234.

Hogg W. The computer, CME and the family physician. CMAJ. 1991;144(3):346-351.

Jennings AA, Boyle S, Foley T. The development and evaluation of an online dementia resource for primary care based health professionals. Internet Interv. 2018;11:47-52. http://doi.org/10.1016/j.invent.2018.01.004

Kauffman L, Weisberg EM, Zember WF, Fishman EK. # RadEd: How and why to use Twitter for online radiology education. Curr Probl Diag Radiol. 2021;50(3):369-373. https://doi.org/10.1067/j.cpradiol.2021.02.002

Kemper KJ, Gardiner P, Gobble J, Mitra A, Woods C. Randomized controlled trial comparing four strategies for delivering e-curriculum to health care professionals [ISRCTN88148532]. BMC Med Educ. 2006;6:2. https://doi.org/10.1186/1472-6920-6-2

Lund A, Lam K, Parks P. Disaster Medicine Online: evaluation of an online, modular, interactive, asynchronous curriculum. CJEM. 2002;4(6):408-13. https://doi.org/10.1017/s1481803500007910

Marcinkiewicz A, Cybart A, Chrominska-Szosland D, Nosko J. Nowe formy ksztalcenia w medycynie pracy. [New forms of training in occupational medicine]. Med Pr. 2003;54(6):573-578.

Melo MD, Silva NL, Liu PM, et al. E-Learning and Simulation on a pré-hospital emergency course: a participant’s perspective. Curso de emergência utilizando E-learning e simulação: visão do participante. Rev Bras Educ Méd. 2016;40(4):713-719. https://doi.org/10.1590/1981-52712015v40n4e02482014

Stoner SA, Mikko AT, Carpenter KM. Web-based training for primary care providers on screening, brief intervention, and referral to treatment (SBIRT) for alcohol, tobacco, and other drugs. J Subst Abuse Treat. 2014;47(5):362-70. https://doi.org/10.1016/j.jsat.2014.06.009

Huang K-J, Cen G, Qiu Z-J, Jiang T, Cao J, Fu C-Y. Application of international videoconferences for continuing medical education programs related to laparoscopic surgery. Telemed J E Health. 2014;20(2):157-60. https://doi.org/10.1089/tmj.2013.0070

Isbej L, Uribe J, Carrasco O, et al. Experiencia de educacion continua en linea en gastroenterologia para medicos no especialistas. [Experience of continuing online education in gastroenterology for non specialist medical doctors]. Rev Med Chil. 2019;147(8):1059-1066. https://doi.org/10.4067/S0034-98872019000801059

Casebeer L, Allison J, Spettell CM. Designing tailored Web-based instruction to improve practicing physicians' chlamydial screening rates. Acad Med. 2002;77(9):929. https://doi.org/10.1097/00001888-200209000-00032

Schroeder AN, Hall MM, Kruse RC. Sports ultrasound training during a pandemic: developing a "Hands-on" skill through distance learning. Am J Phys Med Rehabil. 2020;99(9):860-862. https://doi.org/10.1097/phm.0000000000001515

Larson Williams A, Hawkins A, Sabin L, et al. Motivating HIV providers in Vietnam to learn: a mixed-methods analysis of a mobile health continuing medical education intervention. JMIR Med Educ. 2019;5(1):e12058. https://doi.org/10.2196/12058

Kimura S, Onishi H, Kawamata M. Characteristics and perceptions of twice-weekly webinars for primary care physicians in Japan: a qualitative study. Int J Med Educ. 2018;9:229-238. https://doi.org/10.5116/ijme.5b6b.21e1

Melus-Palazon E, Bartolome-Moreno C, Palacin-Arbues JC, et al. Experience with using second life for medical education in a family and community medicine education unit. BMC Med Educ. 2012;12:30. https://doi.org/10.1186/1472-6920-12-30

Nchise A, Boateng R, Mbarika V, Saiba E, Johnson O. The challenge of taking baby steps-Preliminary insights into telemedicine adoption in Rwanda. Health Pol Technol. 2012;1(4):207-213. http://doi.org/10.1016/j.hlpt.2012.10.004

Vervoort D, Ma X, Bookholane H, Nguyen TC. Conference cancelled: The equitable flip side of the academic surgery coin. Am J Surg. 2020;220(6):1539-1540. https://doi.org/10.1016/j.amjsurg.2020.07.008

Wallis JW, Parker JA. Use of the Internet for teaching in nuclear medicine. Semin Nucl Med. 1998;28(2):165-76. https://doi.org10.1016/s0001-2998(98)80006-8

Allen M, Sargeant J, Mann K, Fleming M, Premi J. Videoconferencing for practice-based small-group continuing medical education: feasibility, acceptability, effectiveness, and cost. J Contin Educ Health Prof. 2003;23(1):38-47. https://doi.org/10.1002/chp.1340230107

Butzlaff M, Telzerow A, Lange S, Kruger N. Arzte, internet und neues wissen nutzung und effizienz von neuen weiterbildungsmedien im krankenhaus. [Physicians, internet and new knowledge. Utilization and efficiency of new continuing education media in the hospital]. Med Klin (Munich). 2001;96(6):309-20. https://doi.org/10.1007/pl00002211

Casanova Dias M, Giacco D, Hanon C. Early career psychiatrists' preferences on e-learning: Viewpoint from the EPA committee on education. Eur Psychiatry. 2017;42:86-88. http://doi.org/10.1016/j.eurpsy.2016.12.003

Crandall LA, Coggan JM. Impact of new information technologies on training and continuing education for rural health professionals. J Rural Health. 1994;10(3):208-15. https://doi.org/10.1111/j.1748-0361.1994.tb00231.x

Gjersvik PJ, Nylenna M, Aasland OG. Hvordan holder norske hudleger seg faglig oppdatert? [How do Norwegian dermatologists keep themselves professionally updated?]. Tidsskr Nor Laegeforen. 2001;121(30):3515-8.

Jafari P, Kostas T, Levine S, et al. ECHO-Chicago Geriatrics: using telementoring to "geriatricize" the primary care workforce. Gerontol Geriatr Educ. 2019:1-9. http://doi.org/10.1080/02701960.2019.1572005

Kristensen I, Lindh J, Nilsson P, et al. Telemedicine as a tool for sharing competence in paediatric radiotherapy: implementation and initial experiences from a Swedish project. Acta Oncol. 2009;48(1):146-52. https://doi.org/10.1080/02841860802409520

Landman A, Yagi Y, Gilbertson J, Dawson R, Marchevsky A, Becich MJ. Prototype Web-based continuing medical education using FlashPix images. Proc AMIA Symp. 2000:462-6.

Lim CCT, Yang GL. Electronic teaching files and continuing professional development in radiology. Biomed Imaging Interv J. 2006;2(2):e5. http://doi.org/10.2349/biij.2.2.e5

Murad A, Lederman R, Bosua R, Chang S, Wark JD. Enhancing general practitioners participation in a virtual community of practice for continuing medical education: an exploratory study. Stud Health Technol Inform. 2017;239:97-103.

Sethi SK, Singla S. Virtual pediatric renal grand rounds: An innovative e-learning. Pediatr Nephrol. 2011;26(1):159-160. http://doi.org/10.1007/s00467-010-1613-z

Sethi SK, Desai TP, Jhaveri KD. Online blogging during conferences: An innovative way of e-learning. Kidney Int. 2010;78(12):1199-1201. http://doi.org/10.1038/ki.2010.395

Sweetman G, Brazil V. Education links between the Australian rural and tertiary emergency departments: Videoconference can support a virtual learning community. Emerg Med Australas. 2007;19(2):176-177. http://doi.org/10.1111/j.1742-6723.2007.00951.x

Ure B, Zoeller C, Lacher M. The role of new information technology meeting the global need and gap of education in pediatric surgery. Semin Pediatr Surg. 2015;24(3):134-7. https://doi.org/10.1053/j.sempedsurg.2015.02.012

Vervoort D, Dearani JA, Starnes VA, Thourani VH, Nguyen TC. Brave New World: Virtual conferencing and surgical education in the Coronavirus Disease 2019 era. J Thorac Cardiovasc Surg. 2021;161(3):748-752. https://doi.org/10.1016/j.jtcvs.2020.07.094

Yadav H, Lin WY. Teleprimary care in Malaysia: a tool for teleconsultation and distance learning in health care. Asia Pac J Public Health. 2001;13 Suppl:S58-61.

Kerfoot BP, Baker H. An online spaced-education game for global continuing medical education: a randomized trial. Ann Surgery. 2012;256(1):33-8. https://doi.org/10.1097/SLA.0b013e31825b3912

Wang F. Valuation of online continuing medical education and telemedicine in Taiwan. J Educ Technol Society. 2008;11(4):190-198.

Allison JJ, Kiefe CI, Wall T, et al. Multicomponent Internet continuing medical education to promote chlamydia screening. Am J Prev Med. 2005;28(3):285-90. https://doi.org/10.1016/j.amepre.2004.12.013

Bos-Bonnie LHA, van Bergen JEAM, Te Pas E, Kijser MA, van Dijk N. Effectiveness of an individual, online e-learning program about sexually transmitted infections: a prospective cohort study. BMC Fam Pract. 2017;18(1):57. https://doi.org/10.1186/s12875-017-0625-1

Calabro GE, Tognetto A, Mazzaccara A, et al. Scienze omiche e capacity building dei professionisti sanitari: corso di formazione a distanza per i medici italiani [Omic sciences and capacity building of health professionals: a distance learning training course for Italian physicians, 2017-2018]. Ig Sanita Pubbl. 2019;75(2):105-124.

Carroll JC, Grad R, Allanson JE, et al. The gene messenger impact project: an innovative genetics continuing education strategy for primary care providers. J Contin Educ Health Prof. 2016;36(3):178-85. https://doi.org/10.1097/CEH.0000000000000079

Casebeer L, Andolsek K, Abdolrasulnia M, et al. Evaluation of an online bioterrorism continuing medical education course. J Contin Educ Health Prof. 2006;26(2):137-44. https://doi.org/10.1002/chp.62

Casebeer L, Brown J, Roepke N, et al. Evidence-based choices of physicians: a comparative analysis of physicians participating in Internet CME and non-participants. BMC Med Educ. 2010;10:42. https://doi.org/10.1186/1472-6920-10-42

Casebeer LL, Strasser SM, Spettell CM, et al. Designing tailored Web-based instruction to improve practicing physicians' preventive practices. J Med Internet Res. 2003;5(3):e20. https://doi.org/10.2196/jmir.5.3.e20

Choi Y, Peairs KS, Sateia HF, Riddell R, Zhang C, McGuire MJ. High value care in cancer surveillance and screening: evaluating an e-curriculum for primary care providers. J Cancer Educ. 2021. https://doi.org10.1007/s13187-021-01986-4

Curran VR, Fleet LJ, Kirby F. A comparative evaluation of the effect of Internet-based CME delivery format on satisfaction, knowledge and confidence. BMC Med Educ. 2010;10:10. https://doi.org/10.1186/1472-6920-10-10

Gagnon M-P, Legare F, Labrecque M, Fremont P, Cauchon M, Desmartis M. Perceived barriers to completing an e-learning program on evidence-based medicine. Inform Prim Care. 2007;15(2):83-91. https://doi.org/10.14236/jhi.v15i2.646

Gallardo-Rincon H, Saucedo-Martinez R, Mujica-Rosales R, et al. Online continuing medical education as a key link for successful noncommunicable disease self-management: the CASALUD TM Model. Diabetes Metab Syndr Obes. 2017;10:443-455. https://doi.org/10.2147/DMSO.S137891

Hampton CL, et al. The interactive videoconference: an effective CME delivery system. J Continu Educ Health Prof. 1994;14(2):83-89. https://doi.org/10.1002/chp.4750140204

Harris JM, Salasche SJ, Harris RB. Can Internet-based continuing medical education improve physicians' skin cancer knowledge and skills? J Gen Intern Med. 2001;16(1):50-6. https://doi.org/10.1111/j.1525-1497.2001.00615.x

Henny KD, Duke CC, Sutton MY. Uptake of online HIV-related continuing medical education training among primary care providers in Southeast United States, 2017-2018. AIDS Care. 2021;33(12):1515-1524. https://doi.org/10.1080/09540121.2020.1822986

Hicks KK, Murano PS. Online nutrition and T2DM continuing medical education course launched on state-level medical association. Adv Med Educ Pract. 2017;8:413-418. https://doi.org/10.2147/AMEP.S138278

Kerfoot BP, Turchin A, Breydo E, Gagnon D, Conlin PR. An online spaced-education game among clinicians improves their patients' time to blood pressure control: a randomized controlled trial. Circ Cardiovasc Qual Outcomes. 2014;7(3):468-74. https://doi.org/10.1161/circoutcomes.113.000814

Lineker SC, Fleet LJ, Bell MJ, et al. Getting a grip on Arthritis online: responses of rural/remote primary care providers to a web-based continuing medical education programme. Can J Rural Med. 2019;24(2):52-60. https://doi.org/10.4103/CJRM.CJRM_10_18

Markova A, Weinstock MA, Risica P, et al. Effect of a web-based curriculum on primary care practice: basic skin cancer triage trial. Fam Med. 2013;45(8):558-68.

Mazzuoccolo LD, Marciano S, Echeverria CM. Implementacion de una modalidad de educacion medica a distancia en psoriasis. [Implementation of a telementoring model of medical education in psoriasis]. Medicina (B Aires). 2016;76(6):359-361.

McFadden P, Crim A. Comparison of the effectiveness of interactive didactic lecture versus online simulation-based CME programs directed at improving the diagnostic capabilities of primary care practitioners. J Contin Educ Health Prof. 2016;36(1):32-7. https://doi.org/10.1097/CEH.0000000000000061

Mistraletti G, Umbrello M, Anania S, et al. Neurological assessment with validated tools in general ICU: multicenter, randomized, before and after, pragmatic study to evaluate the effectiveness of an e-learning platform for continuous medical education. Minerva Anestesiol. 2017;83(2):145-154. https://doi.org/10.23736/S0375-9393.16.11103-4

Ng EWM, Le Marne F, Sinclair KG, et al. Evaluation of an educational video providing key messages for doctors to counsel families following a first afebrile seizure. J Paediatr Child Health. Feb 2021;57(2):198-203. https://doi.org/10.1111/jpc.15171

Nicastro E, Lo Vecchio A, Liguoro I, et al. The impact of e-learning on adherence to guidelines for acute gastroenteritis: a single-arm intervention study. PloS One. 2015;10(7):e0132213. https://doi.org/10.1371/journal.pone.0132213

Ozturk E, van Iersel M, van Loon K, et al. Interactive online learning on perioperative management of elderly patients. Am J Surg. 2018;216(3):624-629. https://doi.org/10.1016/j.amjsurg.2018.01.071

Pelayo M, Cebrian D, Areosa A, Agra Y, Izquierdo JV, Buendia F. Effects of online palliative care training on knowledge, attitude and satisfaction of primary care physicians. BMC Fam Pract. 2011;12:37. https://doi.org/10.1186/1471-2296-12-37

Samuelson KW, Koenig CJ, McCamish N, et al. Web-based PTSD training for primary care providers: a pilot study. Psychol Serv. 2014;11(2):153-61. https://doi.org/10.1037/a0034855

Thielmann A, Puth M-T, Weltermann B. Improving knowledge on vaccine storage management in general practices: Learning effectiveness of an online-based program. Vaccine. 2020;38(47):7551-7557. https://doi.org/10.1016/j.vaccine.2020.09.049

Woods JM, Scott HF, Mullan PC, et al. Using an eLearning module to facilitate sepsis knowledge acquisition across multiple institutions and learner disciplines. Pediatr Emerg Care. 2021;37(12)31070-e1074.http://dx.doi.org/10.1097/PEC.0000000000001902

Young KJ, Kim JJ, Yeung G, Sit C, Tobe SW. Physician preferences for accredited online continuing medical education. J Contin Educ Health Prof. 2011;31(4):241-6. https://doi.org/10.1002/chp.20136

Curran VR, Hoekman T, Gulliver W, Landells I, Hatcher L. Web-based continuing medical education (I): field test of a hybrid computer-mediated instructional delivery system. J Contin Educ Health Prof. 2000;20(2):97-105. https://doi.org/10.1002/chp.1340200206

Dubner SJ, Moss AJ, Schapachnik ES, et al. Web-based virtual cardiac symposia: A new approach for worldwide professional medical education. Ann Noninvasive Electrocardiol. 2007;12(2):165-170. http://doi.org/10.1111/j.1542-474X.2007.00156.x

Haller U, Gabathuler H. Telemedical training at the Department of Gynaecology, University Hospital Zurich. Curr Probl Dematol. 2003;32:39-42. https://doi.org/10.1159/000067376

El-Ghandour NMF, Ezzat AAM, Zaazoue MA, Gonzalez-Lopez P, Jhawar BS, Soliman MAR. Virtual learning during the COVID-19 pandemic: a turning point in neurosurgical education. Neurosurg Focus. 2020;49(6):E18. https://doi.org/10.3171/2020.9.Focus20634

Bitterman JE, Schappert J, Schaefer J. Overcoming remoteness in CME videoteleconferencing: "I want my MD TV.". J Contin Educ Health Prof. 2000;20(1):7-12. https://doi.org/10.1002/chp.1340200103

Burkholder TW, Bellows JW, King RA. Free open access medical education (FOAM) in emergency medicine: the global distribution of users in 2016. West J Emerg Med. 2018;19(3):600-605. https://doi.org/10.5811/westjem.2018.3.36825

Curran V, Fleet L, Simmons K, Ravalia M, Snow P. Exploratory study of rural physicians' self-directed learning experiences in a digital age. J Contin Educ Health Prof. 2016;36(4):284-289. https://doi.org/10.1097/CEH.0000000000000111

de'Angelis N, Gavriilidis P, Martinez-Perez A, et al. Educational value of surgical videos on YouTube: quality assessment of laparoscopic appendectomy videos by senior surgeons vs. novice trainees. World J Emerg Surg. 2019;14:22. https://doi.org/10.1186/s13017-019-0241-6

Della Mea V, Carbone A, Greatti E, Beltrami CA. Introducing videoconferencing into educational oncopathology seminars: technical aspects, user satisfaction and open issues. J Telemed Telecare. 2003;9(2):95-8. https://doi.org/10.1258/135763303321327957

Dhanasekaran K, Babu R, Kumar V, Singh S, Hariprasad R. Factors influencing the retention of participants in online cancer screening training programs in India. BMC Med Educ. 2020;20(1):220. https://doi.org/10.1186/s12909-020-02144-y

Gall JA. Continuing education in forensic medicine: An exercise in distance learning. J Clin Forensic Med. 1997;4(3):117-120. https://doi.org/10.1016/s1353-1131(97)90090-0

Hadadgar A, Changiz T, Dehghani Z, et al. A theory-based study of factors explaining general practitioners' intention to use and participation in electronic continuing medical education. J Contin Educ Health Prof. 2016;36(4):290-294. https://doi.org/10.1097/CEH.0000000000000123

Kua V, Belii A, Pontone S, Beydon L. Enquête nationale sur la formation médicale continue des anesthésistes-réanimateurs [National survey in France about continuing medical education among anaesthesiologists]. Ann Fr Anesth Reanim. 2006;25(2):144-151. http://doi.org/10.1016/j.annfar.2005.08.024

Llambi L, Margolis A, Toews J, et al. Distance education for physicians: adaptation of a Canadian experience to Uruguay. J Contin Educ Health Prof. 2008;28(2):79-85.https://doi.org/10.1002/chp.161

Misra UK, Kalita J, Mishra SK, Yadav RK. Telemedicine for distance education in neurology: preliminary experience in India. J Telemed Telecare. 2004;10(6):363-5. https://doi.org/10.1258/1357633042602044

Nasir A, Khader A, Nasir L, Abuzayed I, Seita A. Paediatric continuing medical education needs and preferences of UNRWA physicians in Jordan. East Mediterr Health J. 2016;22(1):47-51.

Ricci MA, Caputo MP, Callas PW, Gagne M. The use of telemedicine for delivering continuing medical education in rural communities. Telemed J E Health. 2005;11(2):124-9. https://doi.org/10.1089/tmj.2005.11.124

Rusatira JC, Tomaszewski B, Dusabejambo V, et al. Enabling access to medical and health education in Rwanda using mobile technology: needs assessment for the development of mobile medical educator apps. JMIR Med Educ. 2016;2(1):e7. https://doi.org/10.2196/mededu.5336

Schoen MJ, Tipton EF, Houston TK, et al. Characteristics that predict physician participation in a Web-based CME activity: the MI-Plus study. J Contin Educ Health Prof. 2009;29(4):246-53. https://doi.org/10.1002/chp.20043

Scott KW, Dushime T, Rusanganwa V, Woskie L, Attebery C, Binagwaho A. Leveraging massive open online courses to expand quality of healthcare education to health practitioners in Rwanda. BMJ Open Qual. 2019;8(4):e000532. https://doi.org/10.1136/bmjoq-2018-000532

Gavrin JR. Internet resources for professional continuing education credits in pain and palliative care. J Pain Palliat Care Pharmacother. 2006;20(1):37-42. https://doi.org/10.1300/J354v20n01_09

Bolderston A, Watson J, Woznitza N, et al. Twitter journal clubs and continuing professional development: an analysis of a #MedRadJClub tweet chat. Radiography (Lond). 2018;24(1):3-8. http://doi.org/10.1016/j.radi.2017.09.005

Curran JA, Murphy AL, Sinclair D, McGrath P. Factors influencing rural and urban emergency clinicians' participation in an online knowledge exchange intervention. Rural Remote Health. 2013;13(1):2175.

Curran V, Kirby F, Parsons E, Lockyer J. Discourse analysis of computer-mediated conferencing in World Wide Web-based continuing medical education. J Contin Educ Health Prof. 2003;23(4):229-38. https://doi.org/10.1002/chp.1340230506

Guan J, Tregonning S, Keenan L. Social interaction and participation: formative evaluation of online CME modules. J Contin Educ Health Prof. 2008;28(3):172-9. https://doi.org/10.1002/chp.174

Patelis N, Matheiken SJ, Beard JD. The challenges of developing distance learning for surgeons. European journal of vascular and endovascular. Eur J Vasc Endovasc Surg. 2015;49(3):237-8. https://doi.org/10.1016/j.ejvs.2014.09.001

Pavese P, Coulouma M, Sellier E, Stahl JP, Wintenberger C, Francois P. CD-ROM continuous medical education model for the management of urinary tract infections in family practice. Med Mal Infect. 2012;42(7):321-6. https://doi.org/10.1016/j.medmal.2012.05.010

Sandars J, Langlois M. Online learning networks for general practitioners: Evaluation of a pilot project. Educ Primary Care. 2005;16(6):688-696.

Curran VR, Lockyer J, Kirby F, Sargeant J, Fleet L, Wright D. The nature of the interaction between participants and facilitators in online asynchronous continuing medical education learning environments. Teach Learn Med. 2005;17(3):240-5. https://doi.org/10.1207/s15328015tlm1703_7

Brace-Govan J, Gabbott M. General practitioners and online continuing professional education: projected understandings. J Educt Technol Society. 2004;7(1):51-62.

Ogrinc G, Splaine ME, Foster T, Regan-Smith M, Batalden P. Exploring and embracing complexity in a distance-learning curriculum for physicians. Acad Med. 2003;78(3):280-5. https://doi.org/10.1097/00001888-200303000-00010

Williams P, Gunter B, Nicholas D. Health education online: issues arising from the development and roll-out of a pilot distance education programme for NHS staff. Health Educ. 2006;106(3):210-226. https://doi.org/10.1108/09654280610658550

Pullen D. Doctors online: learning using an Internet based content management system. Int J Educ Dev Info Comm Technol. 2013;9(1):50-63.

Shah N, Ashraf H, Anwar F, Khan A, Akhtar H, Abro MA. Status of postgraduate training and continuing medical education of family physicians in Pakistan. Pak J Med Sci. 2012;28(1):4-8.

Al-Sughayr A, Al-Abdulwahhab B, Al-Yemeni M. Primary health care physicians' knowledge, use, and attitude towards online continuous medical education in Saudi Arabia. Saudi Med J. 2010;31:1049-53.

Sandars J, Walsh K, Homer M. High users of online continuing medical education: a questionnaire survey of choice and approach to learning. Med Teach. 2010;32(1):83-5. https://doi.org/10.3109/01421590903199171

Bower EA, Girard DE, Wessel K, Becker TM, Choi D. Barriers to innovation in continuing medical education. J Contin Educ Health Prof. 2008;28(3):148-156. https://doi.org/10.1002/chp.176

Naldi L, Manfrini R, Martin L, Deligant C, Dri P. Feasibility of a web-based continuing medical education program in dermatology: the DermoFAD experience in Italy. Dermatology. 2006;213(1):6-11. https://doi.org/10.1159/000092830

Innovation, Science, and Economic Development Canada. High-speed access for all: Canada’s connectivity strategy (2019).

Government of Canada. National broadband internet service availability map. Government of Canada. [Internet]. 2021. Available from: https://www.ic.gc.ca/app/sitt/bbmap/hm.html?lang=eng. [Accessed on March 25, 2021]

Pickering JD, Henningsohn L, DeRuiter MC, de Jong PGM, Reinders MEJ. Twelve tips for developing and delivering a massive open online course in medical education. Med Teach. 2017;39(7):691-696. https://doi.org/10.1080/0142159X.2017.1322189

Caffarella RS. Viewing cultural barriers as opportunities to enhance learning: an international perspective. Adult Educ Res Conference. 2010. Available from: https://newprairiepress.org/aerc/2010/papers/10. [Accessed Mar 25, 2021].

Harris JM, Jr., Novalis-Marine C, Harris RB. Women physicians are early adopters of on-line continuing medical education. J Contin Educ Health Prof. 2003;23(4):221-8. https://doi.org/10.1002/chp.1340230505

Brubaker L. Women physicians and the COVID-19 Pandemic. JAMA. 2020;324(9):835-836. https://doi.org/10.1001/jama.2020.14797

Jolly S, Griffith KA, DeCastro R, Stewart A, Ubel P, Jagsi R. Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician-researchers. Ann Intern Med. 2014;160(5):344-353. https://doi.org/10.7326/M13-0974

Ly DP, Jena AB. Sex differences in time spent on household activities and care of children among US physicians, 2003-2016. Mayo Clin Proc. 2018;93(10):1484-1487. https://doi.org/10.1016/j.mayocp.2018.02.018

Shah S, Diwan S, Kohan L, et al. The technological impact of COVID-19 on the future of education and health care delivery. Pain Physician. 2020; 23(4S):S367-S380.

Setia S, Tay JC, Chia YC, Subramaniam K. Massive open online courses (MOOCs) for continuing medical education - why and how? Adv Med Educ Pract. 2019;10:805-812. https://doi.org/10.2147/amep.S219104

Ismail II, Abdelkarim A, Al-Hashel JY. Physicians’ attitude towards webinars and online education amid COVID-19 pandemic: When less is more. PloS One. 2021;16(4):e0250241. https://doi.org/10.1371/journal.pone.0250241

Kanneganti A, Sia C-H, Ashokka B, Ooi SBS. Continuing medical education during a pandemic: an academic institution’s experience. Postgrad Med J. 2020;96(1137):384. https://doi.org/10.1136/postgradmedj-2020-137840

Duma N, Durani U, Woods CB, et al. Evaluating unconscious bias: Speaker introductions at an international oncology conference. J Clin Oncol. 2019;37(15_suppl):10503-10503. https://doi.org/10.1200/JCO.2019.37.15_suppl.10503

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2023-01-10

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Cheng C, Papadakos J, Umakanthan B, Fazelzad R, Martimianakis MA (Tina), Ugas M, Giuliani ME. On the advantages and disadvantages of virtual continuing medical education: a scoping review. Can. Med. Ed. J [Internet]. 2023 Jan. 10 [cited 2024 Nov. 21];14(3):41-74. Available from: https://dev.journalhosting.ucalgary.ca/index.php/cmej/article/view/75681

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