New horizons for research in continuing medical education.

Research must investigate the three overlapping areas of continuing medical education: it must discover and document what, how, and why physicians learn and change; how better programs of education can be designed to fit into this process; and in what ways the organizations that provide CME can or should differ in their policies, procedures, and resources. In terms of physician learning, for example, the basic assumption must be that physicians are like other adults in the general ways they learn in voluntary settings, yet have specific differences from other professional groups and from their physician colleagues in other specialties. Making the changes necessary for informed medical practice depends on understanding the role of learning in changes--which in turn depends on CME research. But barriers hinder much-needed research: conducting CME research is seldom rewarded in medical centers; CME is usually not a highly valued component of the institution; funding sources are few and support is limited; and persistent debate over the relative merits of qualitative and quantitative methods diverts energy that should be going into productive, cooperative research. The urgency of needed changes in medical practice and organization may give the necessary impetus for interdisciplinary, collaborative CME research projects that will take a longer-term view of the effect of learning on physician change.