title: Commitment to change instrument enhances program planning, implementation, and evaluation.
abstract: BACKGROUND
  This study investigates the use of a commitment to change (CTC) instrument as an integral approach to continuing medical education (CME) planning, implementation, and evaluation and as a means of facilitating physician behavior change.
  
  
  METHODS
  Descriptive statistics and grounded theory methods were employed. Data were collected from 20 consecutive CME programs. Physicians were asked to list up to three things they intended to change in their clinical practice as a result of the program. A copy was sent 3 weeks later as a reminder. Six months later, a summary of peer-intended changes was sent to reinforce intended behavior change.
  
  
  RESULTS
  Of 602 participants, 291 (48%) completed CTC forms, resulting in 803 citations. Responses were congruent with the educational objectives and intentions of the program planners. Using the constant comparative method of analysis, a framework was identified for interpreting physician learning strategies. It included change strategies and motivation, learning issues, better doctoring, changes to clinic practice, and diffusion.
  
  
  CONCLUSIONS
  CTC was useful as a multipurpose tool providing planners with meaningful feedback to (1) assess congruence of intended changes in physician behavior with program objectives, (2) document unanticipated learning outcomes, and (3) enable and reinforce intended behavior change.
authors.affiliation: Canadian Institute for the Relief of Pain and Disability, 204-916 West Broadway Avenue, Vancouver.
authors.forename: Marc I
authors.initials: MI
authors.lastname: White
authors.forename: Stefan
authors.initials: S
authors.lastname: Grzybowski
authors.forename: Marc
authors.initials: M
authors.lastname: Broudo
mesh_terms: D001955:British Columbia; D004502:Education, Medical, Continuing / Q000379:methods*; D005194:Family Practice / Q000193:education*; D006284:Health Plan Implementation; D006801:Humans; D033182:Intention; D010934:Planning Techniques; D015397:Program Evaluation; D014911:Whiplash Injuries / Q000628:therapy