Validating an instrument for selecting interventions to change physician practice patterns: a Michigan Consortium for Family Practice Research study.
OBJECTIVE
The goal of this study was to develop a psychometric instrument that classified physiciansamprsquo response styles to new information as seekers, receptives, traditionalists, or pragmatists. This classification was based on specific combinations of 3 scales: (a) belief in evidence vs experience as the basis of knowledge, (b) willingness to diverge from common or previous practice, and (c) sensitivity to pragmatic concerns of practice. The instrument will help focus efforts to change practice more accurately.


METHODS
This was a cross-sectional study of physician responses to a psychometric instrument. Paper-and-pencil survey forms were distributed to 3 waves of physicians, with revision for improved internal consistency at each iteration.


METHODS
Participants were 1393 primary care physicians at continuing education events in the Midwest or at primary care clinic sites in the Veteransamprsquo Health Administration system.


METHODS
Internal consistency was measured by factor analysis with orthogonal rotation and Cronbachamprsquos alpha.


RESULTS
A total of 1287 usable instruments were returned (106, 1120, and 61 in the 3 iterations, respectively), representing approximately three fourths of distributed forms. Final scale internal consistencies were a = 0.79, b = 0.74, and c = 0.68. The patterns of scores on the 3 scales were consistent with the predictions of the theoretical scheme of physician types. The "seeker" type was the rarest, at fewer than 3%.


CONCLUSIONS
It is possible to reliably classify physicians into categories that a theoretical framework predicts will respond differently to different interventions for implementing guidelines and translating research findings into practice. The next step is to demonstrate that the classification predicts physician practice behavior.
Green
Lee A
LA
University of Michigan Medical School, Ann Arbor, USA. greenla@umich.edu
Gorenflo
Daniel W
DW
Wyszewianski
Leon
L
D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D004501:Education, Medical; D004502:Education, Medical, Continuing; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000145:classification* / Q000193:education / Q000523:psychology; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000145:classification* / Q000639:trends; D011594:Psychometrics; D012107:Research Design; D012680:Sensitivity and Specificity; D013038:Specialization; D017749:Total Quality Management; D014481:United States; D014493:United States Department of Veterans Affairs