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The impact of education on care practices: an exploratory study of the influence of “action plans” on the behavior of health professionals

Published online by Cambridge University Press:  01 July 2010

Eunice Rodriguez*
Affiliation:
Stanford Geriatric Education Center, Department of Pediatrics, and Center for Education in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA, U.S.A.
Renee Marquett
Affiliation:
Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, U.S.A.
Ladson Hinton
Affiliation:
Department of Psychiatry, University of California, Davis School of Medicine, Sacramento, CA, U.S.A.
Melen McBride
Affiliation:
Stanford Geriatric Education Center, Center for Education in Family and Community Medicine, Stanford University School of Medicine, Stanford, CA, U.S.A.
Dolores Gallagher-Thompson
Affiliation:
Stanford Geriatric Education Center and Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, U.S.A.
*
Correspondence should be addressed to: Eunice Rodriguez, Department of Pediatrics, and Center for Education in Family and Community Medicine, Stanford University School of Medicine 1215 Welch Rd., Modular G, Stanford, CA 94305, U.S.A. Fax: +1 650-723-9692. Email: er23@stanford.edu.

Abstract

Background: There has been limited focus on evaluation of continuing education (CEU) and continuing medical education (CME) in the fields of gerontology and geriatrics. The increasing elderly population combined with the limited clinical workforce highlights the need for more effective methods of continuing education. Traditionally, outcomes of CEU and CME programs relied on self-report measures of satisfaction with the scope and quality of the training, but more recent efforts in this area have focused on outcomes indicating level of improved skills and attitudinal changes of medical and allied health professionals towards working with elderly patients in need of assistance.

Methods: This study focused on the use of “Action Plans” as a tool to stimulate changes in clinical programs following training, along with attempting to determine typical barriers to change and how to deal with them. More than 600 action plans were obtained from participants attending various continuing education classes providing training on care of patients with dementia (PWD) and their families. Both qualitative and quantitative methods, including logistic regression models were used to analyze the data.

Results: Three months following training 366 participants reported whether they were successful in implementing their action plans and identified factors that either facilitated or hindered their goal to make changes outlined in their action plans. Despite the low response rate of program participants, the “action plan” (with follow up to determine degree of completion) appeared to stimulate effective behavioral changes in clinicians working with dementia patients and their family members. Seventy three percent of the respondents reported at least some level of success in implementing specific changes. Specific details about barriers to change and how to overcome them are discussed.

Conclusions: Our results support that developing and writing action plans can be a useful tool to self- monitor behavioral change among trainees over time.

Type
Special Issue Articles
Copyright
Copyright © International Psychogeriatric Association 2010

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References

Bloom, B. S. (2005). Effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews. International Journal of Technology Assessment in Health Care, 21, 380385.CrossRefGoogle Scholar
Center for Health Workforce Studies (2005). The Impact of the Aging Population on the Health Workforce in the United States. Rensselaer, NY: University of Albany, School of Public Health.Google Scholar
Davis, D. et al. (1999). Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA, 282, 867874.CrossRefGoogle ScholarPubMed
Gamel, N. and Yeo, G. (1993). The impact of an educational approach on provision of services to ethnically diverse elders. Journal of Applied Gerontology, 12, 3443.CrossRefGoogle Scholar
Hasnain, M., Onishi, H. and Elstein, A. S. (2004). Inter-rater agreement in judging errors in diagnostic reasoning. Medical Education, 38, 609619.CrossRefGoogle ScholarPubMed
Institute of Medicine (2008). Retooling for an Aging America: Building the Healthcare Workforce. Washington, DC: National Academies Press.Google Scholar
Mazmanian, P. E. and Davis, D. A. (2002). Continuing medical education and the physician as a learner: guide to the evidence. JAMA, 288, 10571060.CrossRefGoogle ScholarPubMed
Mazmanian, P. E., Mazmanian, P. M., and Waugh, J. L. (1997). Commitment to change: ideational roots, empirical evidence, and ethical implications. Journal of Continuing Education in the Health Professions, 17, 133140.CrossRefGoogle Scholar
Mazmanian, P. E., Davis, D. A. and Galbraith, R. (2009). Continuing medical education effect on clinical outcomes. Chest Journal, 135, 49s55s.CrossRefGoogle ScholarPubMed
Memoona, H., Onishi, H. and Elstein, A. S. (2004). Inter-rater agreement in judging errors in diagnostic reasoning. Medical Education, 38, 609616.Google Scholar
Miller, S. H. et al. (2008). Continuing medical education, professional development, and requirements for medical licensure: a white paper of the Conjoint Committee on Continuing Medical Education. Journal of Continuing Education in the Health Professions, 28, 9598.CrossRefGoogle Scholar
Murphy-Southwick, C. and McBride, M. (2006). Geriatric education across 94 million acres: adapting conference programming in a rural state. Gerontology and Geriatric Education, 26, 2536.CrossRefGoogle Scholar
Plassman, B. L. et al. (2007). Prevalence of dementia in the United States: the aging, demographics, and memory study. Neuroepidemiology, 29, 125132.CrossRefGoogle ScholarPubMed
Ratanawongsa, N. et al. (2008). The reported validity and reliability of methods for evaluating continuing medical education: a systemic review. Academic Medicine, 83, 274283.CrossRefGoogle Scholar
Skeff, K. M., Stratos, G. A., Bergen, M. R., Sampson, K. and Deutsch, S. L. (1999). Regional teaching improvement programs for community-based teachers. American Journal of Medicine, 106, 7680.CrossRefGoogle ScholarPubMed
Tian, J., Atkinson, N. L., Portnoy, B. and Gold, R. S. (2007). A systemic review of evaluation in formal continuing medical education. Journal of Continuing Education in the Health Professions, 27, 1627.CrossRefGoogle Scholar
Tonnesen, H. et al. (2007). An evaluation of a model for the systematic documentation of hospital based health promotion activities: results from a multicentre study. BMC Health Services Research, 7. doi:10.1186/1472-6963-7-145.CrossRefGoogle Scholar