Effect of a Primary Care Continuing Education Program on Clinical Practice of Chronic Obstructive Pulmonary Disease: Translating Theory Into Practice

• Published in: Mayo Clinic proceedings Vol. 87; no. 9; pp. 862 - 870
• Main Authors: Adams, Sandra G., MD, MS, FCCP, Pitts, Jennifer, MA, Wynne, JoEllen, RN, MSN, FNP-BC, Yawn, Barbara P., MD, MS, FAAFP, Diamond, Edward J., MD, MBA, FCCP, Lee, Shuko, MS, Dellert, Ed, RN, MBA, Hanania, Nicola A., MD, MS, FCCP
• Format: Journal Article
• Language: English
• Published: Rochester, MN Elsevier Inc 01.09.2012; Mayo Foundation; Elsevier, Inc; Elsevier Limited
• Subjects: Adult; Aged; Biological and medical sciences; Care and treatment; Clinical Competence; Continuing medical education; Diagnosis; Education, Medical, Continuing; Educational Measurement; Evidence-Based Medicine; Female; General aspects; Humans; Internal Medicine; Lung diseases, Obstructive; Male; Medical sciences; Middle Aged; Miscellaneous; Original; Physicians, Primary Care - education; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - therapy; Risk factors; United States; United States; GOLD; Global Initiative for Chronic Obstructive Lung Disease; DO; ACCP; American College of Chest Physicians; medical doctor; MD; advanced practice nurse; CME; continuing medical education; CE; American Academy of Nurse Practitioners; CI; SME; continuing education; subject matter expert; ADDIE; doctor of osteopathy; PA; Analysis, Design, Development, Implementation, and Evaluation; physician assistant; confidence interval; AANP; APN; COPD; chronic obstructive pulmonary disease; Continuing education; Lung disease; Respiratory disease; Primary health care; Theory; Health education; Medicine; Educational program; Professional practice; Translating; Bronchus disease; Chronic obstructive pulmonary disease; Public health
• ISSN: 0025-6196; 1942-5546
• DOI: 10.1016/j.mayocp.2012.02.028

Abstract Objectives To describe the development and implementation process and assess the effect on self-reported clinical practice changes of a multidisciplinary, collaborative, interactive continuing medical education (CME)/continuing education (CE) program on chronic obstructive pulmonary disease (COPD). Methods Multidisciplinary subject matter experts and education specialists used a systematic instructional design approach and collaborated with the American College of Chest Physicians and American Academy of Nurse Practitioners to develop, deliver, and reproduce a 1-day interactive COPD CME/CE program for 351 primary care clinicians in 20 US cities from September 23, 2009, through November 13, 2010. Results We recorded responses to demographic, self-confidence, and knowledge/comprehension questions by using an audience response system. Before the program, 173 of 320 participants (54.1%) had never used the Global Initiative for Chronic Obstructive Lung Disease recommendations for COPD. After the program, clinician self-confidence improved in all areas measured. In addition, participant knowledge and comprehension significantly improved (mean score, 77.1%-94.7%; P <.001). We implemented the commitment-to-change strategy in courses 6 through 20. A total of 271 of 313 participants (86.6%) completed 971 commitment-to-change statements, and 132 of 271 (48.7%) completed the follow-up survey. Of the follow-up survey respondents, 92 of 132 (69.7%) reported completely implementing at least one clinical practice change, and only 8 of 132 (6.1%) reported inability to make any clinical practice change after the program. Conclusion A carefully designed, interactive, flexible, dynamic, and reproducible COPD CME/CE program tailored to clinicians' needs that involves diverse instructional strategies and media can have short-term and long-term improvements in clinician self-confidence, knowledge/comprehension, and clinical practice.