title: A Theory-Based Study of Factors Explaining General Practitioners' Intention to Use and Participation in Electronic Continuing Medical Education.
abstract: Electronic modes of continuing medical education (eCME) can provide an appropriate and scalable way of updating the knowledge and skills of general practitioners (GPs). To optimize the adoption of eCME and develop efficient and cost-effective eCME programs, factors explaining GPs' intention to use eCME must first be elucidated.
  
  
  
  Using the Theory of Planned Behavior as a framework, we developed a questionnaire and administered it to GPs in seven CME seminars in Isfahan, Iran, in 2014. Three domains of GPs' intention to use eCME were measured: attitudes, perceived behavioral control, and subjective norms. We used linear and logistic regression to identify the main predictors of intention and behavior.
  
  
  
  GPs who had high score in perceived behavioral control and a more positive attitude toward e-learning had a higher intention to adopt it for CME. In contrast, subjective norms (eg, social pressures to use eCME) were not a predictor. Attitude toward usefulness of eCME was the main predictor of being an actual eCME user.
  
  
  
  Perceived behavioral control and attitude constitute the main predictors of the intention to use eCME. Establishing discussions forums and strengthening organizational support for eCME through an increased awareness among clinical superiors and CME managers would be expected to increase GPs' intention to use eCME.
authors.affiliation: Dr. Hadadgar: PhD Student, Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden, and Researcher, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Dr. Changiz: Professor, Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Mrs. Dehghani: Researcher, Medical Education Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran. Mr. Backheden: Lecturer, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden. Dr. Mirshahzadeh: Director, Continuing Medical Education office, Isfahan University of Medical Sciences, Isfahan, Iran. Dr. Zary: Associate Professor, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden. Dr. Masiello: Associate Professor, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.
authors.forename: Arash
authors.initials: A
authors.lastname: Hadadgar
authors.forename: Tahereh
authors.initials: T
authors.lastname: Changiz
authors.forename: Zahra
authors.initials: Z
authors.lastname: Dehghani
authors.forename: Magnus
authors.initials: M
authors.lastname: Backheden
authors.forename: Nahidalsadat
authors.initials: N
authors.lastname: Mirshahzadeh
authors.forename: Nabil
authors.initials: N
authors.lastname: Zary
authors.forename: Italo
authors.initials: I
authors.lastname: Masiello
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D034201:Computers, Handheld / Q000706:statistics & numerical data; D004502:Education, Medical, Continuing; D005260:Female; D058005:General Practitioners / Q000523:psychology*; D006801:Humans; D033182:Intention; D020407:Internet; D007492:Iran; D008297:Male; D008875:Middle Aged; D000068997:Smartphone / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires