title: Impact of a Clinical Educational Effort in Driving Transformation in Health Care.
abstract: OBJECTIVE
  The purpose of this study was to assess whether a 2.5 day clinical education course focused on integrative medicine (IM), complementary health (CH), and patient-centered care strategies delivered to staff at Veteran Health Administration (VHA) facilities resulted in changes in attitudes, self-efficacy, preparedness, intentions, and self-reported use of IM strategies. The study also assessed whether there were differential impacts by participant characteristics.
  
  
  METHODS
  The study used a pre-post intervention group-only design with participants who completed self-report pre, post, and 2-month follow-up surveys. The course was delivered to 15 VHA facilities, reaching a total of 655 participants with 407 participants completing the 2-month follow-up survey (65% response rate).
  
  
  RESULTS
  Findings suggest that the clinical course was associated with changes in all outcomes at the 2-month follow-up, including attitudes, self-efficacy to engage in IM strategies, institutional support, perceived preparedness to discuss non-pharmaceutical approaches to care, intentions to engage in IM strategies, and greater engagement in IM behaviors during clinical encounters. Differential impacts were found for younger participants, longer tenured staff, non-nursing compared to nursing staff, and among those who volunteered as opposed to those who were required to attend.
  
  
  CONCLUSIONS
  The study found significant positive changes in all outcomes measured at the 2-month follow-up. Positive impacts were found across a variety of participant characteristics. Findings suggest that this brief experiential course, designed to be a foundational strategy in driving transformation is effective in shifting attitudes, self-efficacy, preparedness, intentions, and self-reported use of IM strategies.
authors.affiliation: Pacific Institute for Research and Evaluation.
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Atwood
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Shamblen
authors.forename: Tracy
authors.initials: T
authors.lastname: Gaudet
authors.forename: Adam
authors.initials: A
authors.lastname: Rindfleisch
authors.forename: David A
authors.initials: DA
authors.lastname: Collins
authors.forename: Christine
authors.initials: C
authors.lastname: Milovani
authors.forename: Russell
authors.initials: R
authors.lastname: Greenfield
authors.forename: David
authors.initials: D
authors.lastname: Kiefer
authors.forename: David
authors.initials: D
authors.lastname: Rakel
mesh_terms: D001294:Attitude to Health; D004496:Education, Continuing / Q000379:methods*; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D055048:Integrative Medicine; D033182:Intention; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care; D012648:Self Care; D020377:Self Efficacy; D066269:Social Theory; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration