title: Randomized controlled trial comparing four strategies for delivering e-curriculum to health care professionals [ISRCTN88148532].
abstract: BACKGROUND
  Internet education is increasingly provided to health professionals, but little is known about the most effective strategies for delivering the content. The purpose of this study is to compare four strategies for delivering an Internet-based (e-) curriculum on clinicians' knowledge (K), confidence (CONF), and communication (COMM) about herbs and other dietary supplements (HDS).
  
  
  METHODS
  This national randomized 2 x 2 factorial trial included physicians, pharmacists, nurses, nutritionists and trainees in these fields. Participants were randomly assigned to one of four curriculum delivery strategies for 40 brief modules about HDS: a) delivering four (4) modules weekly over ten (10) weeks by email (drip-push); b) modules accessible on web site with 4 reminders weekly for 10 weeks (drip-pull); c) 40 modules delivered within 4 days by email (bolus-push); and d) 40 modules available on the Internet with one email informing participants of availability (bolus-pull).
  
  
  RESULTS
  Of the 1,267 enrollees, 25% were male; the average age was 40 years. The completion rate was 62%, without significant differences between delivery groups. There were statistically significant improvements in K, CONF and COMM scores after the course (P<0.001 for all), although the difference in COMM was small. There were no significant differences in any of the three outcomes by delivery strategy, but outcomes were better for those who paid for continuing education credit.
  
  
  CONCLUSIONS
  All delivery strategies tested similarly improved K, CONF, COMM scores about HDS. Educators can use the strategy that is most convenient without diminishing effectiveness. Additional curricula may be necessary to make substantial changes in clinicians' communication practices.
authors.affiliation: Pediatrics and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA. kkemper@wfubmc.edu
authors.forename: Kathi J
authors.initials: KJ
authors.lastname: Kemper
authors.forename: Paula
authors.initials: P
authors.lastname: Gardiner
authors.forename: Jessica
authors.initials: J
authors.lastname: Gobble
authors.forename: Ananda
authors.initials: A
authors.lastname: Mitra
authors.forename: Charles
authors.initials: C
authors.lastname: Woods
mesh_terms: D000328:Adult; D003142:Communication; D003479:Curriculum; D019587:Dietary Supplements; D004496:Education, Continuing / Q000458:organization & administration*; D034742:Electronic Mail; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D029001:Herbal Medicine; D006801:Humans; D020407:Internet; D008297:Male; D017145:Models, Educational; D009726:Nurses; D010595:Pharmacists; D010820:Physicians