158850 Instrument Development for Continuing Medical Education Evaluation

Tuesday, November 6, 2007

Jing Tian, MD , Department of Public and Community Health, Public Health Informatics Research Laboratory, University of Maryland, College Park, College Park, MD
Nancy L. Atkinson, PhD , Office of Communication and Education, Consultant, National Cancer Institute, Rockville, MD
Barry Portnoy, PhD , Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD
Barnett S. Kramer, MD, MPH , Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, MD
Sylvia K. Scherr, MS, RN , Office of Continuing Health Education, Uniformed Services University of the Health Sciences (USUHS), Silver Spring, MD
Robert S. Gold, Dean, PhD, DrPH , School of Public Health, University of Maryland, College Park, College Park, MD
The ultimate goal of continuing medical education (CME) programs is to enhance the quality of patient care available in the United States as well as other regional areas through professional education. According to State Medical Licensure Requirements and Statistics (2006), forty-seven of fifty-four state and territorial medical licensing boards require completion of 12 to 50 hours of CME per year. While physicians report spending a considerable amount of time in CME to maintain their medical licenses, little research exists to document its effectiveness.

Reviews have been published during the last decade summarizing CME evaluation studies to assess their effectiveness. These reviews showed that the questionnaires used in CME evaluation studies have generally lacked a theoretical background, which may have resulted in misleading interpretations of study results. Standards for CME evaluation and tools for measurement are needed to improve the assessment of factors influencing CME effectiveness. A review of the CME evaluation literature was conducted by the Office of Disease Prevention and the Office of Continuing Medical Education at the National Institutes of Health in 2006. A major finding of this review was the lack of existing validated and reliable instruments to measure the effects of CME. This finding is also confirmed by an evidence review of the effectiveness of CME conducted by the Agency for Healthcare Research and Quality.

The purpose of this research is to develop a standardized theory-based, valid and reliable CME evaluation instrument for clinicians. This instrument includes core items assessing the constructs addressed in the second evaluation level of the Kirkpatrick's model, namely, attitudes, behavioral beliefs, evaluation for behavioral beliefs (outcome expectancies), perceived behavioral control (self-efficacy), and behavioral intention. This newly developed 25-item instrument was based on the Theory of Planned Behavior. It could serve as a model for CME evaluation and be adapted for different CME programs according to their specific clinical domains. This will enable the comparison of effectiveness across different CME interventions and also help researchers understand factors influencing the effectiveness of different CME programs. Additionally, these findings could help to guide future CME intervention design.

Data collected through a conference entitled, Preoperative Therapy in Invasive Breast Cancer, sponsored by the National Cancer Institute were used to examine the psychometric characteristics of this instrument. During this presentation, the Theory of Planned Behavior and the major steps completed for instrument development and validation will be discussed. Instrument validity and reliability information will be provided.

Learning Objectives:
Name the cognitive constructs being addressed in this standard CME instrument. Adapt this standard CME instrument to specific clinical domains as appropriate. Utilize the adapted CME instrument to evaluate the effectiveness of CME interventions.

Keywords: Professional Training, Evaluation

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.