On-site to on-line: barriers to the use of computers for continuing education.

BACKGROUND: Continuing education/continuing medical education (CE/CME) programs that adopt self-directed, computer-based instruction formats via the Internet or CD-ROM can ease the demands placed on clinicians who are required by licensing boards to accumulate CE/CME credits as part of their career-long learning. Despite the benefits and availability of computer-based instruction, on-site programs still dominate current CE/CME delivery modes. In order to increase the use of computer-based CE/CME programs, it is important to identify the barriers that inhibit their use.
METHOD: A survey was conducted to assess the practices, preferences, and barriers to use of CE/CME delivery methods among physicians, nurse practitioners, and physician assistants in Nevada.
RESULTS: Of 3,213 surveys sent, 1,120 were completed and returned for an overall response rate of 35%. In-person conferences (93%) and print-based methods (66%) were the most frequently reported methods of acquiring CE/CME. The majority of respondents had access to computer-based technologies. Respondents with more years in clinical practice were less likely to have access to or to use computer-based technologies. The top three preferred CE/CME delivery modes, in rank order, were in-person conferences, print-based self-study, and CD-ROM. The least preferred method of receiving CE/CME was interactive audioconference (telephone conference calls). "Not knowing how" was the most frequently reported reason for not using the Internet for computer-based training and the second most frequent reason for not using a CD-ROM. IMPLICATIONS: Program planners may wish to offer training in new technologies during on-site conferences, provide CD-ROMs as take-home instructional materials, or promote technology awareness in other ways to help clinicians prepare for changes in the electronic delivery of health care and education.