PURPOSE: Clinicians require continuing medical education (CME)/continuing education (CE) credits to maintain licensure. CME/CE programs are often poorly designed and their long-term impact on practice change is rarely measured. Educators were recently “called-to-action” to design offerings tailored to learners’ educational needs, using diverse instructional strategies. Therefore, we developed this program to assess the impact on changes in clinical practice of a multidisciplinary, collaborative, interactive CME/CE program on chronic obstructive pulmonary disease (COPD), designed using adult learning principles.
METHODS: We evaluated data collected from 351 primary care clinicians from multiple disciplines before and after participation in this interactive COPD CME/CE program. Multidisciplinary subject matter experts and education specialists developed the program using a systematic instructional design approach. The American College of Chest Physicians partnered with the American Academy of Nurse Practitioners to deliver and reproduce this program in 20 cities across the United States during 2009-2010. Main Outcome Measure: Self-reported clinical practice changes three months following the program and changes in self-confidence and knowledge/comprehension.
RESULTS: Prior to the program, 173 (54%) participants had never used the Global Initiative of Chronic Obstructive Lung Disease (GOLD) guidelines for COPD. Following the program, clinician self-confidence and knowledge/comprehension significantly improved (mean score: 77.1% to 94.7%, p<0.0001). More importantly, 87% of participants completed 971 commitment-to-change statements and 49% completed the follow-up survey. Of the respondents, 70% completely implemented at least one clinical practice change and 95% self-reported significant practice changes following the program. Changes identified include increased use of the GOLD guidelines, case-finding methods, inhaler instructions, spirometry in smokers with respiratory symptoms, and smoking cessation counseling.
CONCLUSIONS: A carefully designed, interactive, flexible, dynamic, and reproducible COPD CME/CE program, tailored to the needs of primary care clinicians that utilizes diverse instructional models, strategies, and media can have short-term and long-term effects on clinician self-confidence, knowledge and clinical practice.
CLINICAL IMPLICATIONS: Our data stress the need for future programs to implement similar strategies in designing and delivering CME/CE programs and for measuring long-term outcomes.
DISCLOSURE: Sandra Adams: Grant monies (from sources other than industry): NIH, VA Cooperative study, Chest Foundation (GSK Distinguished Scholar Award), Grant monies (from industry related sources): Bayer Pharmaceuticals Corp; Boehringer Ingelheim Pharmaceuticals, Inc; Centocor Inc, GlaxoSmithKline; Novartis Pharmaceuticals AG; Pfizer Inc; Schering-Plough Corp, Other: AstraZeneca Pharmaceuticals LP; Bayer Pharmaceuticals Corp; Boehringer Ingelheim Pharmaceuticals, Inc; GlaxoSmithKline; Novartis Pharmaceuticals AG; Pfizer Inc; Schering-Plough Corp
Jennifer Pitts: Employee: ACCP
JoEllen Wynne: Employee: American Academy of Nurse Practitioners
Barbara Yawn: Grant monies (from industry related sources): GSK, Novartis
Ed Dellert: Employee: ACCP
Nicola Hanania: Grant monies (from sources other than industry): NIH, Grant monies (from industry related sources): GSK, Novartis, Boehringer Ingelheim, Sunovion, Pfizer, MedImmune and Astra Zeneca, Consultant fee, speaker bureau, advisory committee, etc.: GSK, Pfizer, Boehringer Ingelheim, Novartis, Pearl and Dey Inc.
The following authors have nothing to disclose: Edward Diamond, Shuko Lee
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