Self-directed delivery modes for continuing medical education (CME) are the most effective approaches for improving physician performance. However, instructor-directed programs are still the most popular methods used for CME. The purpose of the study was to assess the utilization, preferences and barriers to use of nine different CME delivery methods by physicians. A self-administered survey of all licensed physicians in Nevada was conducted over a three-month period. Results were analyzed using SPSS for windows (version 10). In-person conferences (92%) and journal review (64%) were the most frequently utilized modes of instruction. Rural physicians were more likely to use interactive video. The top three ranked preferences were in-person conference, print-based self-study and CD-ROM. It is concluded that computer training, dedicated time in the workplace for self-directed methods, and the development of more interactive CD-ROM and Internet programs will encourage the use of self-directed CME.