Internet-Based Training on AMA Guides to the Evaluation of Permanent Impairment - New Learning Strategies

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Internet-based training has many advantages for professionals since it is consistent with their needs as adult learners, can provide immediate access to needed resources, is less disruptive to schedules and eliminates the challenges and costs involved with travel to traditional programs.

Brigham and Associates, Inc. has been at the forefront of the medicolegal field in providing computer-based training, both as web-based seminars (webinars) and online educational content. Their target audiences are claims professionals, attorneys and physicians involved in the workers' compensation, automobile casualty, personal injury and disability fields.

In September 2006, Brigham and Associates, Inc. launched GuidesIQ ( online training on the AMA Guides to the Evaluation of Permanent Impairment; this resource consists of streaming Flash-based PowerPoint presentations, streaming video media, digital publications and self-assessments. The user feedback has been very positive. The need for this was based on the observation that the majority of impairment evaluations are performed incorrectly (

For the past two years Brigham and Associates, Inc. have provided webinars on a variety of medical and legal topics ( The most recent program was entitled "Psychological Workers' Compensation Claims -- Answers to Your Unanswered Questions" and featured two distinguished mental health professionals, Norma J. Leclair, Ph.D, RN, LCPC (licensed clinical professional counselor) and Steven Leclair, Ph.D.,CRC (psychologist and certified rehabilitation counselor) of The Leclair Company ( Based on the excellent response and technology enhancements, the firm is now able to accommodate up to 1,000 participants per event. In addition, learners can replay prior presentations. Several programs focusing on medicolegal topics are planned for 2007.

Two recent studies support the efficacy of online training for physicians. A study was performed by the Continuing Medical Education and Professional Development, Department of Psychiatry, University of British Columbia, on the use of new technology to deliver and evaluate physician continuing medical education on lateral epicondylitis and return to work (1). The study revealed videoconferencing and online training were at least as effective as conference lectures and instructor-led small group outreach sessions in their impact on physician knowledge. They concluded "use of effective videoconferencing and online learning activities will increase physician access to quality CME related to workplace injury management and will overcome access barriers intrinsic to types of CME interventions based on instructor-student face-to-face interactions."

In September 2006, WebMD released a study that indicates physicians who participate in online CME programs on Medscape from WebMD ( are 50 percent more likely to make evidence-based diagnostic and treatment recommendations for their patients which helps lead to improved patient care (2). The research, a randomized controlled study commissioned by WebMD and conducted by independent research group Outcomes, Inc., found that physicians who participate in Medscape CME activities are 50 percent more likely to provide their patients with evidence-based recommendations than matched physicians who did not participate in the online activities. "This research provides strong evidence that online CME is a highly effective and efficient means for educating physicians," said Steve Zatz, MD, EVP, Professional Services, WebMD. "As the leading provider of online CME, WebMD is helping to transform the lifelong learning process for physicians by providing instant access to credible, relevant and searchable medical information at the exact time when physicians need it most."

Internet-based education is particularly appropriate for the needs of adult learners, i.e. physicians, attorneys and claims staff. Adults are autonomous and self-directed; therefore they prefer to select their training needs. Providing training that is available when needed, i.e. on demand, is consistent with adult needs for relevancy and practicality.

For busy professionals, attending a traditional seminar or conference does pose logistical challenges, including travel and associated expense. For physicians, the expense of being away from a medical practice, i.e. lost opportunity costs, is typically the largest expense. Often the cost of the traditional seminar or conference and the associated travel expense is less than the costs of lost billing which may be thousands of dollars per day, depending on specialty.

Internet-based education, both streaming on-demand and web-based seminars, will increasingly be the preferred method for continuing professional education.

About Brigham and Associates:

Brigham and Associates was founded in 1995, and is recognized as the nation's leading resources on impairment and disability evaluation. For over 10 years Brigham and Associates have listened to their clients, surpassed expectations and developed the reputation of being thorough and impartial. Their well-trained staff utilizes advanced Web-based technology and database systems to provide cost-effective, high quality impairment review services, including consultation, case reviews, training and educational products.


Mindy Brigham, Pacific Regional Manager

Brigham and Associates


(1): Karlinsky H, Dunn C, Clifford B, Atkins J, Pachev G,Cunningham K,Fenrich P,Bayani Y. Workplace injury management: using new technology to deliver and evaluate physician continuing medical education. J Occup Rehabil. 16(4):719-730, December 2006.



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