# The Design and Evaluation of an Online Continuing Medical Education App for Medical Professionals in China: Quantitative Study

## TL;DR

This study evaluates the Guoyuan online CME app in China, showing its widespread use but highlighting disparities in course popularity and user satisfaction across medical disciplines.

## Contribution

The study provides empirical evidence on the adoption and effectiveness of a national online CME platform in China, identifying factors influencing satisfaction and competency perception.

## Key findings

- Guoyuan had 94,537 registered users and 1,878,437 attendances from 2018 to 2023.
- Courses in ophthalmology, otolaryngology, and pathology had higher attendance than other disciplines.
- Professional title, discipline, and experience significantly influenced satisfaction and perceived competency enhancement.

## Abstract

As an emerging delivery mode of education, online continuing medical education (CME) increases the accessibility of high-quality medical training for professionals and students in China. Guoyuan (meaning “nationwide” in Chinese) is an online CME platform delivered via a mobile app and operated by the National Telemedicine Center of China since 2018, serving as an illustrative case of mobile online CME implementation.

We identified trends in the adoption and usage of the Guoyuan mobile online CME platform from 2018 to 2023 and provided evidence for the application and optimization of online CME.

We analyzed yearly usage data of the Guoyuan mobile app (The First Affiliated Hospital of Zhengzhou University) in 2018-2023 and collected surveys on the satisfaction and recognition of competency enhancement in online CME in each connected hospital in 2023. Using the IBM SPSS, the nonparametric Kruskal-Wallis H test was used to compare attendance across different disciplines, followed by post hoc pairwise comparisons for course types with significant differences and ordinal logistic regression analysis to examine factors influencing satisfaction with the online CME system and perceived competency enhancement among invited doctors.

From 2018 to 2023, Guoyuan had 94,537 registered trainees, 1672 published course videos, and 1,878,437 attendances. Attendance was higher for courses in ophthalmology, otolaryngology, and pathology than in other disciplines (median attendance 610, IQR 105-2055 vs 283, IQR 106-690 participants). Based on a sample size of 245 participants, ordinal regression analysis showed that discipline category, professional title, and working years significantly influenced satisfaction. General practitioners showed lower overall satisfaction than internal medicine doctors (odds ratio [OR] 0.323, 95% CI 0.110-0.948; OR 0.251, 95% CI 0.087-0.729; and OR 0.196, 95% CI 0.066-0.585; P=.04; P=.01; P=.003). Junior titles reported higher audio-visual clarity (OR 3.151, 95% CI 1.178-8.427; P=.02) and process satisfaction (OR 4.939, 95% CI 1.674-14.576; P=.004). More experienced doctors had higher system usability (OR 1.102, 95% CI 1.012-1.200; P=.03) and process satisfaction (OR 1.141, 95% CI 1.044-1.247; P=.003). Recognition of online CME’s benefits was influenced by multiple factors. Greater clinical experience positively predicted recognition of clinical use (OR 1.106, 95% CI 1.004-1.218; P=.04), while an inverse association was observed with age (OR 0.894, 95% CI 0.802-0.996; P=.04). For research-related benefits, positive predictors included discipline category in obstetrics and gynecology compared to internal medicine (OR 6.217, 95% CI 1.236-31.258; P=.03) and junior professional title (OR 3.791, 95% CI 1.231-11.673; P=.02), whereas intensive care unit was a negative predictor compared to internal medicine (OR 0.111, 95% CI 0.014-0.893; P=.04).

Online mobile CME platforms have gained widespread adoption among medical professionals in China, particularly after the COVID-19 outbreak. However, substantial disciplinary disparities in course availability and user experience persist, indicating the need for further optimization of course design and software interaction.