Linking open access to practice: promoting clinical evidence in a national continuing medical education program in Italy

The Italian Ministry of Health launched in 2001 a national program to support “independent information”. The dissemination included the translation and free distribution to all health professionals (300.000) of three reference books – British National Formulary; Medicines for Children and Clinical Evidence. The implementation plan includes the development of a free-access e-learning Continuing Medical Education (CME) system, based on Clinical Evidence, called ECCE. Doctors have access to a Clinical Evidence electronic version and related clinical vignettes. Solving the vignettes provides CME credits. Our objective was to understand the factors influencing knowledge transfer using a CME distance programme, based on clinical vignettes driven by the Clinical Evidence in general medical practice. As of June 10th 2007, more than 30 000 doctors voluntarily subscribed to ECCE (11.8%). Two surveys assessed doctors’ judgement about Clinical Evidence and ECCE. Free distribution and implementation of Clinical Evidence 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.