A study of the factors that influence physiciansʼ commitments to change their practices using learning diaries

Use of personal digital assistants (PDAs) in reflection on learning and practice

“…Several studies describe the use of paper diaries and desktop computers as tools for creating portfolios of physicians' continuing medical education activities. [41][42][43] The present study used case study methods. Yin 45 defines case study research as an "empirical inquiry that investigates a contemporary phenomenon within its real-life context; when the boundaries between phenomenon and context are not clearly evident"~p.…”

“…assist physicians in recording and reflecting on their learning activities. [41][42][43] Effective January 2002, the Virginia Board of Medicine required by law that physicians complete 60 hours of continuing medical education every 2 years, with 30 hours being reported as type 1 credit. 44 Credit must be offered by an accredited sponsor or organization that is sanctioned by the profession and provides documentation of hours to the practitioner~for example: American Medical Association PRA category 1, American Osteopathic Association category 1, American Academy of Family Physicians Prescribed credit; American Academy of Pediatrics credit hours toward the Pediatrics Review and Education Program~PREP!…”

Teaching and evaluating point of care learning with an Internet-based clinical-question portfolio

“…Physicians are more likely to commit to change their practice after learning episodes stimulated by reviewing the management of a patient or by an audit of their practice compared to episodes stimulated by the general impulse to scan the literature. 4,5 Finally, the POC portfolio facilitates reflection, which is associated with "deeper" learning 16 and appears to play an important role in behavior change and professional development. Participants reflect at 3 different levels in completing the portfolio.…”

“…23 More specific to our study, 3 groups of investigators reported the assessment of point of care learning with electronic portfolios. 4,5,[7][8][9][10]24,25 Differences in the type of data reported for these 3 systems permit few quantitative comparisons.…”

“…1 In addition, they are less likely to produce practice changes, as they represent "predisposing" interventions without "enabling" or "reinforcing" components 2,3 and remain detached from actual patientcare scenarios. 4,5 And finally, although surveys show high levels of satisfaction with the ABIM open-book examination modules, some diplomates find that they fail to reflect that range of clinical questions they encounter in their practices and lament the lack of relevance to their personal professional development.…”