Introduction: Most physicians lack sufficient knowledge and skills to effectively manage chronic non-cancer pain. Chronic pain educational methods have not been previously studied using a rigorous design and there have been no studies of any type comparing national expert speakers to Internet-based CME under similar conditions. This study determined the relative effectiveness of national expert speakers compared to expert-developed Internet-based CME in improving physician skills in managing chronic non-cancer pain.

Methods: A randomized controlled trial included 136 primary care physicians attending a 2-day CME meeting. Participants were randomly assigned to: 1) 4 hours of pain management lectures delivered by national expert speakers, 2) 4-hour use of an Internet pain management CME program developed by national experts and delivered by individual laptop computers, or 3) 4 hours of lectures on palliative care (control). The primary outcome was physician performance on a reliable and clinically validated survey-based measure of pain management competence, before, immediately after, and 3 months following the intervention. This study was determined to be exempt from Federal Policy for the Protection of Human Subjects by Argus IRB.

Results: All physicians attended their assigned program and 95 physicians (70%) completed all three surveys. Dropouts were evenly balanced between study groups. There were no differences in physician demographics or baseline survey scores. Scores improved significantly following both pain education programs (lectures: 138.0 to 150.6; Internet: 143.6 to 150.4; P<0.05 for both) and were maintained at 3 months. There was slight but insignificant improvement in the control group (palliative care lectures).

Conclusions: This study demonstrated that an Internet CME progam and lectures delivered by national expert speakers were equally effective in improving the pain management skills of community physicians. Although both CME methods were effective in improving educational outcomes, Internet-based CME may be much more efficient and less costly.