Evaluation of continuing education in the health professions. The state of the art.

In this article the author discusses three "levels" of the state of the art: the "ideal," for program evaluation; the "practical," with political limitations; and the "actual," for current practices. Starting with a review of the developmental stages of effectiveness variables (from attendance and "happiness' through professional performance and patient outcomes), the article updates a review by Lloyd and Abrahamson (1979) and then discusses current practices. Evaluation as a potential contamination factor leads into consideration of evaluation versus research. Finally a review of "lessons learned" over the last twenty years introduces a look ahead into exploitation of the state of the art.