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Cited by 141Innovations in Medical EducationHealth Sciences Research and EducationHealth Policy Implementation Science

Commitment to change statements can predict actual change in practice.

Wakefield, Jacqueline, Herbert, Carol P., Maclure, Malcolm, Dormuth, Colin, Wright, James M., Legare, Jeanne, Brett-MacLean, Pamela, Premi, John·2003·Journal of Continuing Education in the Health Professions
DOI 10.1002/chp.1340230205
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Abstract

INTRODUCTION: Statements of commitment to change are advocated both to promote and to assess continuing education interventions. However, most studies of commitment to change have used self-reported outcomes, and self-reports may significantly overestimate actual performance. As part of an educational randomized controlled trial, this study documented changes that family physicians committed to make in their prescribing and then used third-party data to examine actual changes. METHOD: Following participation in a continuing medical education program using interactive small groups, physicians were asked to identify changes that they planned to make in their practices. For prescribing changes related to four conditions, data from a provincial pharmacy registry were analyzed for 6-month periods before and after the educational intervention. RESULTS: A total of 207 physicians participated in the project, which involved monthly meetings of 30 peer learning groups. Ninety-nine physicians received experimental case-based educational modules +/- personal prescribing feedback, and 91 of these indicated that they planned to make at least one change in practice. Of the 209 intended changes, 71% were directly related to the prescribing messages in the materials. DISCUSSION: In three of four indicator conditions, physicians who expressed a commitment to change were significantly more likely to change their actual prescribing for the target medications in the following 6 months. The percentage of physicians who did change their prescribing varied significantly by condition. Further study of the process of translating commitment to change into real practice change is needed.

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  • The authors endeavored to be reflective and reflexive by being attentive to and disclosing personal involvement in and opinions about the R2C2 model and about assessment and feedback.

    “We also endeavored to be reflective and reflexive by being attentive to and disclosing personal involvement in and opinions about the R2C2 model and about assessment and feedback, which may have influenced our analysis.31,32”

    From The R2C2 Model in Residency Education: How Does It Foster Coaching and Promote Feedback Use? (2018) · cites this paper as [31]

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Authors
Wakefield, J., Herbert, C. P., Maclure, M., Dormuth, C., Wright, J. M., Legare, J., Brett-MacLean, P., & Premi, J.
Affiliations
  • McMaster University (CA)
  • Western University (CA)
  • University of Victoria (CA)
  • University of Alberta (CA)
ORCID
Venue
Journal of Continuing Education in the Health Professions
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003
Volume
23
Issue
2
Pages
81-92
ISSN
0894-1912 (ISSN-L)
DOI
10.1002/chp.1340230205
OpenAlex
W2057363268
Cited by
141
References
30
Citations by year
2026: 4 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 10 · 2017: 7 · 2016: 4 · 2015: 7 · 2014: 8 · 2013: 3 · 2012: 10
FWCI
6.09
Type
journal article
Language
en
Open access
closed
Licence
doi.wiley.com/10.1002/tdm_license_1 (tdm, 4626 d)
Locations
  • Journal of Continuing Education in the Health Professions (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
  • Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Keywords
commitment to change, practice change, prescribing patterns, general practitioners, continuing medical education, peer learning groups, case-based teaching, prescribing feedback, self-reported outcomes
MeSH terms
Attitude of Health Personnel, British Columbia, Diabetes Mellitus, Type 2, Drug Utilization, Education, Medical, Continuing, Family Practice, Feedback, Health Services Research, Heart Failure, Humans, Hypertension, Organizational Innovation, Practice Patterns, Physicians', Drug Prescriptions, Problem-Based Learning

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