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Physicians in rural communities have limited access to continuing medical education (CME) opportunities. We hypothesized that CME could be delivered via a telemedicine network as effectively as in-person. Our institution delivers CME lectures and grand rounds in Burlington, Vermont, for in-person attendees, and also via a telemedicine network that links 14 hospitals in Vermont and rural northeastern New York. All participants complete an evaluation questionnaire to receive CME credit. We compared the questionnaire responses of those attending in person with those attending via the telemedicine network. From October 1, 2000 to June 30, 2003, there were 4733 CME sessions, 650 of which had both in-person and telemedicine attendees. Responses from these 650 sessions were compared. Most questions relating to lecture quality scored higher for in-person attendees. Compared to having the presenter in the room, telemedicine attendance was judged to be "more effective" in 19% (n = 334), "as effective" in 60%, (n = 1074), and "less effective" in 21% (n = 367). Eighteen percent of telemedicine attendees said they would have traveled to attend the session. Telemedicine-delivered CME was considered at least as effective as in-person CME 79% of the time. Travel was avoided for 18% of the remote attendees. CME was delivered where it would not have been obtained for 82% of the remote attendees. Telemedicine systems can be used to deliver CME, in spite of lower overall ratings compared to in-person attendance.

We sought to describe use patterns and user evaluation of remotely-attended continuing medical education (CME) programs in Vermont and upstate New York. Remote attendees were required to return an evaluation form to receive CME credit. The form included name and date of the program; name, location, and specialty of the respondent; and questions regarding program quality, value, effectiveness, and attendee plans if the program had not been available via telemedicine. From April, 1996, through December, 1998, health care providers from 14 remote sites used the network 927 times to attend 394 CME programs at Fletcher Allen Health Care in Burlington, Vermont. After the start-up period, an average of over three programs per week was attended, with an average of 2.4 remote attendees per program. Seventy-seven percent of remote attendees stated that they would not have attended the program if it had not been available over telemedicine, while the remaining 23% said that they avoided traveling due to videoconferencing. When asked the effectiveness of telemedicine technology for attending, 73% said it was as effective as having the presenter in the room, 23% said it was less effective, and 4% said it was more effective. Major technical problems, such as having the call disconnect during the presentation, decreased over time. There were continuing minor logistical problems common to large group videoconferencing. The telemedicine system has increased availability of CME programs for rural providers in Vermont and upstate New York. Most attendees have found the programs to be worthwhile, and technological advancements have improved the quality of the system.