1 2Department of Health in Emergency and Disaster, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 3Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden;

2 Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;

3 Department of Medical Education, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran;

4 Shiraz Institute for Cancer Research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran;

5 University of Toronto, University Health Network, Canadian Network for Mood and Anxiety Treatments, Toronto Western Hospital, Toronto, ON, Canada

6 3Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden;8Research Deputy of Medical Education Department, Tehran University of Medical Sciences, Tehran, Iran


Introduction: Continuing Medical Education (CME) has beenconsidered as a lifelong commitment for doctors to provide theoptimal care for patients. Despite a long history of creating CMEprograms, outcomes are far from ideal. The present qualitativestudy aims to clarify the barriers affecting effectiveness of the CMEprograms in Iran based on the experiences of general practitioners.Methods: Sixteen general practitioners were recruited toparticipate in in-depth interviews and field observationsconcerning experiences with CME. The study was performedusing a qualitative content analysis method. The codes, categoriesand themes were explored through an inductive process in whichthe researchers moved from specific to general.Results: The participants’ experiences identified a numberof barriers, particularly insufficient interaction with theinstructors; additional problems included the teachers’ use ofan undifferentiated approach; unreal and abstract CME; andignorance of the diverse reasons to participate in CME.Conclusion: Based on the study results, there are multiple barriers toeffective implementation of CME in Iran. The key barriers includeinsufficient interaction between the trainees and providers, whichmust be considered by other stakeholders and program designers.Such interactions would facilitate improved program design, invitemore specific tailoring of the education to the participants, allow formore effective educational methods and set the stage for outcomeevaluation from the learners actually applying their new knowledgein practice. Replication of these findings with another sample wouldimprove confidence in these recommendations, but these findingsare broadly consistent with findings in the educational literature onimproving the efficacy of CME.Keywords: Continuing medical education; General practitioners; Qualitative study