在继续医学教育讲座后做出改变的承诺对医疗实践的影响：一项随机对照试验。

The impact on medical practice of commitments to change following CME lectures: a randomized controlled trial.

机构信息

University of Massachusetts Medical School, Worcester, MA 01655, USA.

出版信息

Med Teach. 2011;33(9):e495-500. doi: 10.3109/0142159X.2011.599452.

DOI:10.3109/0142159X.2011.599452

PMID:21854144

Abstract

BACKGROUND

Self-reported commitment to change (CTC) could be a potentially valuable method to address the need for continuing medical education (CME) to demonstrate clinical outcomes.

AIM

This study determines: (1) are clinicians who make CTCs more likely to report changes in their medical practices and (2) do these changes persist over time?

METHODS

Intervention participants (N = 80) selected up to three commitments from a predefined list following the lecture, while control participants (N = 64) generated up to three commitments at 7 days post-lecture. At 7 and 30 days post-lecture, participants were queried if any practice change occurred as a result of attending the lecture.

RESULTS

About 91% of the intervention group reported practice changes consistent with their commitments at 7 days. Only 32% in the control group reported changes (z = 7.32, p < 0.001). At 30 days, more participants in the intervention group relative to the control group reported change (58% vs. 22%, z = 3.74, p < 0.01). Once a participant from either group made a commitment, there were no differences in reported changes (63% vs. 67%, z = <0.00, p = 0.38).

CONCLUSION

Integration of CTC is an effective method of reinforcing learning and measuring outcomes.

摘要

背景

自我报告的改变承诺（CTC）可能是一种有价值的方法，可以满足继续医学教育（CME）展示临床结果的需求。

目的

本研究旨在确定：（1）做出 CTC 的临床医生是否更有可能报告其医疗实践的改变；（2）这些改变是否会随着时间的推移而持续？

方法

干预组参与者（N=80）在讲座后从预定义列表中选择最多三个承诺，而对照组参与者（N=64）在讲座后 7 天内生成最多三个承诺。在讲座后 7 天和 30 天，询问参与者是否因参加讲座而导致任何实践改变。

结果

约 91%的干预组在 7 天内报告与承诺一致的实践改变。对照组中只有 32%的人报告有改变（z=7.32，p<0.001）。在 30 天，与对照组相比，干预组报告改变的参与者更多（58% vs. 22%，z=3.74，p<0.01）。一旦参与者做出承诺，无论来自哪个组，报告的改变都没有差异（63% vs. 67%，z=<0.00，p=0.38）。