Open Access Highly Accessed Research article

Evidence-based choices of physicians: a comparative analysis of physicians participating in Internet CME and non-participants

Linda Casebeer1*, Jennifer Brown2, Nancy Roepke1, Cyndi Grimes2, Blake Henson1, Ryan Palmore1, U Shanette Granstaff1 and Gregory D Salinas1

Author affiliations

1 CE Outcomes, LLC, 107 Frankfurt Circle, Birmingham, AL, 35211, USA

2 MedscapeCME, 370 Seventh Avenue, Suite 1101, New York, NY 10001-3967, USA

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Citation and License

BMC Medical Education 2010, 10:42  doi:10.1186/1472-6920-10-42

Published: 10 June 2010



The amount of medical education offered through the Internet continues to increase, providing unprecedented access for physicians nationwide. However, the process of evaluating these activities is ongoing. This study is a continuation of an earlier report that found online continuing medical education (CME) to be highly effective in making evidence-based decisions.


To determine the effectiveness of 114 Internet CME activities, case vignette-based surveys were administered to U.S.-practicing physicians immediately following participation, and to a representative control group of non-participants. Survey responses were analyzed based on evidence presented in the content of CME activities. An effect size for each activity was calculated using Cohen's d to determine the amount of difference between the two groups in the likelihood of making evidence-based clinical decisions.


In a sample of 17,142 U.S. physicians, of the more than 350,000 physicians who participated in 114 activities, the average effect size was 0.82. This indicates an increased likelihood of 48% that physicians participating in online activities were making clinical choices based on evidence.


Physicians who participated in online CME activities continue to be more likely to make evidence-based clinical choices than non-participants in response to clinical case vignettes.