In virtually every situation some response to this need has been made, so continuing education does take place ---even though it may in many instances be ineffective or insufficient. Continuing education may be initiated by the health workers themselves, by their supervisors, by the managers of the health system, or by other agencies such as professional associations, publishers, and drug companies. The form of the continuing education may be written materials （journal, books, advertisements）, meetings, courses, supervisory visits, or a variety of other methods.
　　With this diversity of approach it is not surprising / that the effectiveness of continuing education should be variable. So it is natural // that in many countries there is concern / that more continuing education should be provided and / that it should be more effective.
　　The approach suggested / that to achieve this aim is to develop a system of continuing education. This term needs some explanation / as it is capable of being interpreted in many ways. A system is not the same thing as an organization / that provides continuing education. It is much more than that. It is the sum of the educational activities, the organizational structure / that supports and manages those activities, the management, and the external agencies involved in the provision of health care. The system should comprise a nationwide coordinated program / in which technology and resources are optimally used（被合理利用的）.
　　注解：
　　1. be aware of 知道

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