Hillbilly CME & Technology in the Sticks: The New Zealand GPs' experience

Abstract

‘Continuing Medical Education’ (CME) provides a means of facilitating the upkeep in medical competence and serves to maintain practicing membership. While this on-going certification is critical for all health professionals’, access to such opportunities is limited within rural settings. Whilst Information and Communication Technology (ICT) has been perceived as a tool to help ameliorate this issue, disapproving opinions held by rural health professionals highlight that technology mutes or dulls the social aspects of learning, whilst the daily use of computers becomes highly un-motivating for learners. Due to the importance of CME and the need to ensure that rural health professionals continue to be medically competent, the research sought to describe the experience of accessing CME using technology within the New Zealand rural context. Aim: In order to determine this, the following study sought to explore what the experiences of rural general practitioners were when they used technology to obtain CME. Methods: Given that the study needed to explore what these experiences were, a qualitative approach using semi-structured interviews for rich data gathering was chosen. To obtain participants, member general practitioners of the New Zealand Rural General Practice Network (NZRGPN) were approached by email through a small advertisement inserted into their NZRGPN monthly e-zine. As a result of this, seven rural general practitioners volunteered themselves for a thirty minute interview conducted by phone, with the exception of one Skype interview. These interviews were recorded and then transcribed, being analysed and presented in a thematic fashion. Findings: Participants expressed great enthusiasm about using technology for CME and recognised the integral function that technology played in compensating for geographic distance and time. However, experiences with using technology were often encumbered by various issues and challenges. The poor quality of the Internet and broadband services and the lack of personal interaction were identified as key challenges to the successful engagement in CME activities using ICTs. Limitations: Limitations of the study highlight the recall and volunteer biases and caution against the novelty of the Interview Schedule used in the study. Conclusion: In determining rural GP experiences, the study found that many challenges mentioned in the literature continue to persist, despite the level of innovation of ICTs in health. For New Zealand rural GPs, the internet connection was key to determining their experiences of using ICT for CME. This in part is due to the types of CME rural GPs participate in, highlighting a growing interest and commitment to CME offered online. Despite the setbacks caused by broadband, ICT use for CME in rural New Zealand can look forward to infrastructural improvements currently underway. This signals an opportunity to plan for much research in the areas of ICT and CME among the rural workforce.