Early adoption of new drug treatments: the role of continuing medical education and physician adaptivity.
The influence of continuing medical education (CME) on the adoption of new treatments is widely regarded as self-evident. Less well understood is how the dynamics of dissemination of new healthcare practices are influenced by the intersection of education with the adaptive characteristics of providers. We developed and validated a 43-item online instrument (eSAIL) for measuring adaptive style and used it to investigate the interplay of physician adaptivity with key components of effective medical education. Satisfactory Cronbach alpha and test-retest reliability coefficients were observed for all primary psychometric scales and a composite adaptivity scale. Discriminant, convergent, and predictive validities of eSAIL scales were consistent across all cohorts. Using an online medical education program for which data on physician behavioral change are available, we show that the rate of adoption of new drugs is driven by both psychological (adaptivity) and environmental (educational) inputs. We show for the first time that topic eminence, length of reinforcement period and physician adaptive score in the eSAIL are each proportional to early-adoption-related behavioral change. Using a simple forced-choice question, a cohort of 208 physicians was segmented into "A" (adaptive) and "C" (conservative) segments based on their eSAIL adaptivity z scores (+0.170 versus -0.234 respectively; P < 0.01). Early adoption of new drug treatments by similarly segmented physician cohorts was driven almost entirely by A-segment physicians, but only when those physicians were additionally exposed to effective medical education.
Protigen, Inc., Sunnyvale, CA 94085, USA. desmond@protigen.com
Desmond
D
Mascarenhas
Baljit K
BK
Singh
Amoolya H
AH
Singh
Sally Vander
SV
Veer
D000223:Adaptation, Psychological; D000328:Adult; D002309:Cardiology / Q000193:education*; D004059:Diffusion of Innovation; D004358:Drug Therapy; D004502:Education, Medical, Continuing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011594:Psychometrics