La formazione permanente in Italia, il possibile ruolo delle evidence based medicine: qualcosa si muove

Objective. To describe an independent distance-learning program that adopts evidence based medicine (EBM) methodology in Italy. Methods. An annotated experience of EBM permanent training initiatives developed by the Italian Cochrane Centre and Zadig scientific publisher in partnership with AIFA and the Italian Ministry of Health. Results. The Ministry of Health launched in 2001 a national program to support "independent information". The dissemination included the translation and free distribution to health professionals of Clinical Evidence (CE). In 2003 the distribution reached all physicians (300.000) and, since 2005, Italian CE third edition is fully available online. The implementation plan included the development of a free-access e-learning Continuing Medical Education (CME) system, based on CE, called ECCE (Continuing Education Clinical Evidence). Doctors have access to an online CE and related clinical vignettes. Solving the vignettes provides CME credits. Two surveys assessed doctors' judgement about CE and ECCE. Positive comments outweighed the negative or neutral comments. ECCE fitted well within the general practice although some clinicians suggested that it might have limited scope as knowledge transfer tool, but potential attraction as a method to collect CME credits. Conclusions. Free distribution and implementation of CE through distance learning programme to Italian doctors have been well received, confirming their preference for problem-driven information and the key role of a strong endorsement from Health Authorities for their implementation.