Developing a program to enhance the clinical relevance of preventive health services training: Conceptual and program development issues

In 2002, a multidisciplinary task force distributed “A Model Course for Public Health Education in Chiropractic Colleges” to all U.S. chiropractic colleges. This updated didactic curriculum emphasized relevant health promotion and clinical preventive services (CPS) articulated by Healthy People 2010 and recommended by the U.S. Preventive Services Task Force for health care providers (including chiropractors).

In 2005, Globe et al published the outcomes of a pre and post curriculum introduction of this model course which revealed no clinically meaningful impact on intern behavior in terms of increasing CPS recommendations on nine key clinical preventive health targets. These disappointing results led to a program re-design based on broader empirically-supported strategies, beyond the model course didactics alone, demonstrated to optimize evidence-based CPS among health care providers.

As one of several reports from the broader project, this presentation focuses on key considerations in the complex process of conceptualizing, designing, and implementing an enhanced evidence-based educational program aimed at inculcating preventive best practices early in the chiropractic training process over and above that provided by simple didactics alone. In addition to reviewing the program development process and surveying the evidence-based methods selected (e.g., academic detailing, guideline compliance prompts, examination form prompts and reminders), detailed consideration will be given to specifics of the program development process likely to be of interest to other institutions (e.g., issues around group and system dynamics that complicated the development of a college-wide consensus on the selection of goals and outcomes, socializing faculty and interns to revised procedures, etc.).