Anticipated and encountered barriers to change in CME: Tools for planning and evaluation

Authors:
  • KMKathleen O'Kane Martin
    Kathleen O'Kane Martin
  • PMPaul E. Mazmanian
    Paul E. Mazmanian
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Abstract
The body of research on successful change as a result of participation in formal continuing medical education (CME) is growing, but there has been little research on instances of unsuccessful change. This study of 51 physicians who planned a total of 78 changes as a result of a CME program revealed three groups of physicians: 1) those who anticipated barriers and reported successfully making the planned change, 2) those who did not anticipate barriers, and did not make the planned change, and 3) those who anticipated barriers but did not make the planned change. Of those who anticipated barriers but did make the planned change, the anticipated barriers included time, habit, lack of appropriate patients, and patients and co-workers in the work setting who might function to oppose change in one way or another. Anticipated and encountered barriers were not related to a lack of clinical information, but involved skills and strategies needed to implement planned changes. Those responsible for planning and implementing CME may consider adjusting their programs to help physicians anticipate barriers and to manage the process of change in the office or other work setting.

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