title: Effect of a primary care continuing education program on clinical practice of chronic obstructive pulmonary disease: translating theory into practice.
abstract: OBJECTIVE
  To describe the development and implementation process and assess the effect on self-reported clinical practice changes of a multidisciplinary, collaborative, interactive continuing medical education (CME)/continuing education (CE) program on chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Multidisciplinary subject matter experts and education specialists used a systematic instructional design approach and collaborated with the American College of Chest Physicians and American Academy of Nurse Practitioners to develop, deliver, and reproduce a 1-day interactive COPD CME/CE program for 351 primary care clinicians in 20 US cities from September 23, 2009, through November 13, 2010.
  
  
  RESULTS
  We recorded responses to demographic, self-confidence, and knowledge/comprehension questions by using an audience response system. Before the program, 173 of 320 participants (54.1%) had never used the Global Initiative for Chronic Obstructive Lung Disease recommendations for COPD. After the program, clinician self-confidence improved in all areas measured. In addition, participant knowledge and comprehension significantly improved (mean score, 77.1%-94.7%; P<.001). We implemented the commitment-to-change strategy in courses 6 through 20. A total of 271 of 313 participants (86.6%) completed 971 commitment-to-change statements, and 132 of 271 (48.7%) completed the follow-up survey. Of the follow-up survey respondents, 92 of 132 (69.7%) reported completely implementing at least one clinical practice change, and only 8 of 132 (6.1%) reported inability to make any clinical practice change after the program.
  
  
  CONCLUSIONS
  A carefully designed, interactive, flexible, dynamic, and reproducible COPD CME/CE program tailored to clinicians' needs that involves diverse instructional strategies and media can have short-term and long-term improvements in clinician self-confidence, knowledge/comprehension, and clinical practice.
authors.affiliation: Department of Medicine, University of Texas Health Science Center at San Antonio, USA. adamssg@uthscsa.edu
authors.forename: Sandra G
authors.initials: SG
authors.lastname: Adams
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pitts
authors.forename: JoEllen
authors.initials: J
authors.lastname: Wynne
authors.forename: Barbara P
authors.initials: BP
authors.lastname: Yawn
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Diamond
authors.forename: Shuko
authors.initials: S
authors.lastname: Lee
authors.forename: Ed
authors.initials: E
authors.lastname: Dellert
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Hanania
mesh_terms: D000328:Adult; D000368:Aged; D002983:Clinical Competence; D004502:Education, Medical, Continuing; D004521:Educational Measurement; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000193:education*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000628:therapy*; D014481:United States