Physician Behavior Changes Following CME on the Prospective Payment System in Long-Term Care: A Pilot Study

Habermann, Ralf; Butts, Natasha; Powers, James S.; Pichert, James W.

doi:10.1016/s1525-8610(04)70236-4

Cited by 5 publications

(4 citation statements)

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“…Commitments are also more likely to be implemented if they are clear, measurable, relatively easy to do, realistic, linked to timelines, within the scope of influence of the learner, and deemed important by the learner. 17 , 55 , 58 , 59 In previous studies, learners who reported higher levels of confidence in a change were also more likely to implement it. 30 …”

Section: Discussionmentioning

confidence: 90%

“…20,29,57 Commitments are also more likely to be implemented if they are clear, measurable, relatively easy to do, realistic, linked to timelines, within the scope of influence of the learner, and deemed important by the learner. 17,55,58,59 In previous studies, learners who reported higher levels of confidence in a change were also more likely to implement it. 30 In the context of using commitment-to-change to evaluate education programs, the importance of including other sources of evaluation information and not relying solely on commitment statements and reflections has previously been emphasized.…”

Section: What This Research Adds and Implications For Practicementioning

confidence: 92%

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Do learners implement what they learn? Commitment-to-change following an interprofessional palliative care course

et al. 2022

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Background: Palliative care educators should incorporate strategies that enhance application into practice by learners. Commitment-to-change is an approach to reinforce learning and encourage application into practice; immediately post-course learners commit to making changes in their practices as a result of participating in the course (“statements”) and then several weeks or months later are prompted to reflect on their commitments (“reflections”). Aim: Explore if and how learners implemented into practice what they learned in a palliative care course, using commitment-to-change reflections. Design: Secondary analysis of post-course commitment statements and 4-months post-course commitment reflections submitted online by learners who participated in Pallium Canada’s interprofessional, 2-day, Learning Essential Approaches to Palliative Care (LEAP) Core courses. Setting/participants: Primary care providers from across Canada and different profession who attended LEAP Core courses from 1 April 2015 to 31 March 2017. Results: About 1063 of 4636 learners (22.9%) who participated in the 244 courses delivered during the study period submitted a total of 4250 reflections 4 months post-course. Of these commitments, 3081 (72.5%) were implemented. The most common implemented commitments related to initiating palliative care early across diseases, pain and symptom management, use of clinical instruments, advance care planning, and interprofessional collaboration. Impact extended to patients, services, and colleagues. Barriers to implementation into practice included lack of time, and system-level factors such as lack of support by managers and untrained colleagues. Conclusions: Examples of benefits to patients, families, services, colleagues, and themselves were described as a result of participating in the courses.

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Section: Discussionmentioning

confidence: 90%

Section: What This Research Adds and Implications For Practicementioning

confidence: 92%

Do learners implement what they learn? Commitment-to-change following an interprofessional palliative care course

et al. 2022

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“… Reviewed studies: Curry and Purkis (1986); Dolcourt (2000); Eckstrom et al (2008); Green et al (2003); Habermann et al (2002); Jones (1990); Lockyer et al (2001); Lockyer et al (2005); Mazmanian et al (1998); Mazmanian et al (2001); Pereles et al (1997); Purkis (1982) …”

Section: Figures and Tablementioning

confidence: 99%

Commitment to Practice Change: An Evaluator’s Perspective

Shershneva

Wang

Lindeman³

et al. 2010

Eval Health Prof

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A commitment to practice change (CTC) approach may be used in educational program evaluation to document practice changes, examine the educational impact relative to the instructional focus, and improve understanding of the learning-to-change continuum. The authors reviewed various components and procedures of this approach and discussed some practical aspects of its application using as an example of a study evaluating a presentation on menopausal care for primary care physicians. The CTC approach is a valuable evaluation tool, but it requires supplementation with other data to have a complete picture of the impact of education on practice. From the evaluation perspective, the self-reported nature of the CTC data is a major limitation of this method. Keywords commitment to practice change; program evaluation; continuing educationThe translation of new knowledge into clinical practice can be a slow process, often taking a decade or more for research findings to find their way into routine patient care (Sussman, Valente, Rohrbach, Skara, & Pentz, 2006). The resulting gaps in the quality of healthcare have led to calls for action in many parts of the world (Committee on Quality of Healthcare in America, 2001;Legido-Quigley, McKee, Nolte, & Glinos, 2008). The traditional role of continuing medical education (CME)-updating physicians on the latest scientific evidenceis not sufficient to respond to this reality (Marinopoulos et al., 2007). Therefore, in the past five years there has been a marked shift toward focusing CME activities on improving practice rather than disseminating information (Davis, Davis, & Bloch, 2008;Regnier, Kopelow, Lane, & Alden, 2005). This shift in the goals of CME programming has resulted in a concomitant shift in how CME activities need to be evaluated. Evaluators must now go beyond measuring learner satisfaction and change in medical knowledge to the level of physician performance and patient outcomes. To date, only a limited number of CME evaluations have assessed impact at this level (Tian, Atkinson, Portnoy, & Gold, 2007). There is a pressing need to equip evaluators with valid, reliable and feasible methods of assessing practice and/or patient outcomes (Davis, Barnes, & Fox, 2003;Marinopoulos et al., 2007).The commitment to change (CTC) approach is one tool available to CME evaluators for assessing the impact of education on clinical practice. The central, distinguishing feature of the CTC approach is that it asks participants in an educational activity to write down descriptions of the changes they propose to make as a result of what they learned during the (Purkis, 1982). Since 1982, when the CTC approach was introduced to medical educators as an evaluation method (Purkis, 1982), it has been increasingly used in the CME field to both facilitate and measure practice change (Wakefield, 2004). This trend is likely due, in part, to the perception that the CTC approach is relatively easy to implement and low-cost (Curry & Purkis, 1986;Jones, 1990). There are, however, significant...

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“…Systeme, welche auch in der Lage sind, qualitative Aussagen zu Ergebnissen von Leistungen bereitzustellen, wurden schon verschiedentlich übernommen, entwickelt und weiterentwickelt [2,3]. Die bekannten Administrationssysteme wie beispielsweise das «Resident Assessment Instrument» (RAI) oder BESA vermögen Anhaltspunkte zur Qualität der Leistungen der Institutionen der Langzeitpflege zum Teil auf Knopfdruck zu generieren [4]. Die Systeme sind jedoch primär zur Leistungserfassung, Administration und Verrechnung entwickelt worden [5].…”

Section: Hintergrundunclassified

Gault Millau für Spitäler und Heime: / vom Benchmarking und «Benchmarketing»

2006

Schweiz Ärzteztg

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Physician Behavior Changes Following CME on the Prospective Payment System in Long-Term Care: A Pilot Study

Cited by 5 publications

References 5 publications

Do learners implement what they learn? Commitment-to-change following an interprofessional palliative care course

Do learners implement what they learn? Commitment-to-change following an interprofessional palliative care course

Commitment to Practice Change: An Evaluator’s Perspective

Gault Millau für Spitäler und Heime: / vom Benchmarking und «Benchmarketing»

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