A continuing medical education lecture and workshop, physician behavior, and barriers to change
Bibliographic record
Abstract
BACKGROUND: Continuing medical education (CME) is undertaken with the intention that it will affect the practice of medicine at the level of choices made by individual physicians. Inherent in this effort is the assumption that CME is sufficient to effect a change in physician behavior. METHODS: To further examine the relationship between a CME activity and physician behavior, we conducted a study of behavior and barriers to change associated with a CME lecture and workshop on breast cancer risk assessment and treatment. Using the assessment of learning outcomes model of the International Association of Continuing Education and Training, we developed an instrument for assessing physician behavior and barriers to change. RESULTS: Throughout the United States and Canada, the instrument was administered on-site immediately after a CME activity implemented at 79 hospitals and cancer centers. It was administered again 6 months after the CME activity. There were 1,244 responses collected from 4,537 participants. This study reports the survey findings of 176 physician-paired responses to both the first and second waves of surveys. Some physicians changed their behavior with regard to performing risk assessments on all of their eligible patients. Ninety-two of the 176 physicians indicated that they had changed their practice regarding the use of tamoxifen therapy. Twenty-one physicians indicated that they were already using tamoxifen in their practice setting. Three influential barriers to change were identified: a lack of consensus among colleagues and peers, lack of time for assessment and patient counseling, and lack of reimbursement by the patient's insurance companies. FINDINGS: The CME activity was effective in changing the self-reported behavior of some physicians. Others attended the CME activity to obtain more information or to become more skilled about a procedure they had already implemented. Because of formidable barriers, it is unlikely that a single educational intervention will be sufficient to effect a change in the clinical practices of all physicians who participate in a CME activity.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".