title: The majority of accredited continuing professional development activities do not target clinical behavior change.
abstract: OBJECTIVE
  Continually improving patient outcomes requires that physicians start new behaviors, stop old behaviors, or adjust how they practice medicine. Continuing professional development (CPD) is the method most commonly used by physicians to improve their knowledge and skills. However, despite regular physician attendance at these activities, change in clinical behavior is rarely observed. The authors sought to identify which of Bloom's domains (cognitive, affective, or psychomotor) are targeted by the learning objectives of CPD activities offered by medical associations, regulatory bodies, and academic institutions in the province of Quebec, Canada.
  
  
  METHODS
  The authors evaluated the objectives of 110 accredited CPD activities offered to physicians and other health professionals from November 2012 to March 2013. The objectives of each activity were extracted and classified into learning domains using Bloom's taxonomy.
  
  
  RESULTS
  Ninety-six percent of the learning objectives analyzed targeted the cognitive domain, which consists of six levels of increasing complexity: knowledge, comprehension, application, analysis, synthesis, and evaluation. Half (47%) targeted knowledge and comprehension, whereas only 26% aimed to improve skills in analysis, synthesis, and evaluation.
  
  
  CONCLUSIONS
  Most accredited CPD activities within this sample were generally not designed to promote clinical behavior change because the focus of these activities was on remembering and understanding information instead of preparing physicians to put knowledge into practice by analyzing information, evaluating new evidence, and planning operations that lead to behavior change. Educators and CPD providers should take advantage of well-established theories of health professional behavior change, such as sociocognitive theories, to develop their activities.
authors.affiliation: Dr. Légaré is full professor, Department of Family Medicine, Université Laval, and clinical investigator, Public Health and Practice-Changing Research Group, Centre Hospitalier Universitaire de Québec (CHU de Québec) Research Centre, Quebec City, Quebec, Canada. Dr. Freitas is project coordinator, Public Health and Practice-Changing Research Group, CHU de Québec Research Centre, Quebec City, Quebec, Canada. Mr. Thompson-Leduc is an epidemiology student, Université Laval, Quebec City, Quebec, Canada. Dr. Borduas is associate professor, Office of the Vice-Dean of Education and Continuing Professional Development, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada. Dr. Luconi is assistant dean of continuing health professional education, Faculty of Medicine, McGill University, Montreal, Quebec, Canada. Dr. Boucher is vice dean of continuing professional education, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada. Dr. Witteman is assistant professor, Department of Family and Emergency Medicine, director of research, Office of Education and Continuing Professional Development, Université Laval, and research scientist, Public Health and Practice-Changing Research Group, CHU de Québec Research Centre, Quebec City, Quebec, Canada. Dr. Jacques is advisor to the president, and executive director, Collège des Médecins du Québec, Montreal, Quebec, Canada.
authors.forename: France
authors.initials: F
authors.lastname: Légaré
authors.forename: Adriana
authors.initials: A
authors.lastname: Freitas
authors.forename: Philippe
authors.initials: P
authors.lastname: Thompson-Leduc
authors.forename: Francine
authors.initials: F
authors.lastname: Borduas
authors.forename: Francesca
authors.initials: F
authors.lastname: Luconi
authors.forename: Andrée
authors.initials: A
authors.lastname: Boucher
authors.forename: Holly O
authors.initials: HO
authors.lastname: Witteman
authors.forename: André
authors.initials: A
authors.lastname: Jacques
mesh_terms: D000068:Accreditation; D000339:Affect; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003071:Cognition; D004502:Education, Medical, Continuing / Q000458:organization & administration*; D006801:Humans; D007858:Learning; D010818:Practice Patterns, Physicians'; D011597:Psychomotor Performance; D011792:Quebec