Dr. Konnyu: Assistant Professor, Center for Evidence Synthesis in Health, School of Public Health, Brown University, Providence, RI, and Department of Health Services, Policy & Practice, School of Public Health, Brown University, Providence, RI. Dr. McCleary: Postdoctoral Fellow, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, and Postdoctoral Fellow, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada. Dr. Presseau: Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, Associate Professor, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada, and School of Psychology, University of Ottawa, Ottawa, Ontario, Canada. Dr. Ivers: Family Physician, Family Practice Health Centre, Women's College Research Institute, and Institute for Health Systems Solutions and Virtual Care, Women's College Hospital, Toronto, Ontario, Canada, and Associate Professor, Department of Family and Community Medicine, and Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada. Dr. Grimshaw: Senior Scientist, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, Full Professor, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada, and Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
J Contin Educ Health Prof. 2020 Fall;40(4):268-273. doi: 10.1097/CEH.0000000000000319.
Continuing professional development (CPD) is a widely used and evolving set of complex interventions that seeks to update and improve the knowledge, skills, and performance of health care professionals to ultimately improve patient care and outcomes. While synthesized evidence shows CPD in general to be effective, effects vary, in part due to variation in CPD interventions and limited understanding of CPD mechanisms of action. We introduce two behavioral science tools-the Behavior Change Technique Taxonomy version 1 and the Theoretical Domains Framework-that can be used to characterize the content of CPD interventions and the determinants of behaviour potentially targeted by the interventions, respectively. We provide a worked example of the use of these tools in coding the educational content of 43 diabetes quality improvement trials containing clinician education as part of their multicomponent intervention. Fourteen (of a possible 93; 15%) behavior change techniques were identified in the clinician education content of the quality improvement trials, suggesting a focus of addressing the behavioral determinants beliefs about consequences, knowledge, skills, and social influences, of diabetes care providers' behavior. We believe that the Behavior Change Technique Taxonomy version 1 and Theoretical Domains Framework offer a novel lens to analyze the CPD content of existing evidence and inform the design and evaluation of future CPD interventions.
继续职业发展 (CPD) 是一套广泛使用且不断发展的复杂干预措施，旨在更新和提高医疗保健专业人员的知识、技能和绩效，最终改善患者的护理和结果。虽然综合证据表明 CPD 总体上是有效的，但效果各不相同，部分原因是 CPD 干预措施的差异和对 CPD 作用机制的理解有限。我们引入了两种行为科学工具——行为改变技术分类法第 1 版和理论领域框架——可分别用于描述 CPD 干预措施的内容和干预措施可能针对的行为决定因素。我们提供了一个实际示例，说明如何在对包含临床医生教育作为其多组分干预措施一部分的 43 项糖尿病质量改进试验的教育内容进行编码时使用这些工具。在质量改进试验的临床医生教育内容中，确定了 14 种（可能的 93 种中的 14 种；15%）行为改变技术，这表明关注解决行为决定因素的行为，如糖尿病护理提供者行为的后果、知识、技能和社会影响的信念。我们相信，行为改变技术分类法第 1 版和理论领域框架为分析现有证据中的 CPD 内容提供了新的视角，并为未来 CPD 干预措施的设计和评估提供了信息。
