• case method learning
• coronary heart disease
• participatory learning
• clinical decision process
• continuous medical education

During recent years, numerous recommendations and practice guidelines on the subject of secondary prevention of coronary heart disease have been produced throughout Europe. Congresses, educational meetings, and lectures have been held with the purpose of facilitating the implementation of evidence based clinical practice. Furthermore, printed educational materials including reviews and clinical guidelines have been provided to all physicians concerned. Despite all this effort, the gap is still wide between what is achieved in clinical practice, and what could be achieved according to scientific evidence based goals for secondary prevention in patients with coronary heart disease.¹ The reason for this is probably that there are several barriers and complexities between the guidelines and a behavioural change in real clinical practice.^2,3

The means of changing this lies in the choice of educational method, rather than producing more scientific evidence. A recent comment from a European perspective on guidelines and global risk states that “The real task facing cardiovascular medicine is implementation of these recommendations into clinical practice”.⁴

Thus, the question is: How to perform this? Which physicians are the key target population? Cardiologists, internists, generalists and, or general practitioners? Perhaps the patients? Which implementation methods should be used? Are these methods evidence based? How should the results be evaluated?