Continuing Medical Education

Macleod, G.K.

doi:10.1001/jama.1970.03170200037005

JAMA

1970

DOI: 10.1001/jama.1970.03170200037005

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Continuing Medical Education

G.K. Macleod¹

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1993

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Changing clinical practice: Which interventions work?

Tamblyn

Battista

1993

Journal of Continuing Education in the Health Professions

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Changing clinical practice is a complex challenge. A framework is presented for integrating the perspectives of continuing education, technology assessment, and quality assurance. The effectiveness of cwrent interventions is reviewed. We describe what is known about practice determinants, the most important of which are physician age, clinical training, knowledge, skill, personal characteristics, practice setting, arid reimbursement policies. The rehtive importance of these factors varies and seems to be condition-specif c, an important point to be considered in the selection of pi-actice interventions.Interventions aimed at having an impact on the practice setting (e.g., practice aids or audit programs), 01-on reimbursement policy (e.g., the fee allowed for a service) are more likely to bring about a change in practice than are interventions aimed at changing physician knowledge or skill. This is attributed to the greater relevance of these interventionsfor the individual physician, and to the opportunities provided for practicing them and for feedback. The cost and .feasibility of using the various types cf interventions to bring about practice change hmte to be carefully Haighed against the expected benefit f o r patients. Those seeking to select strategies that will optimize the effectiveness of interventions will need to consider the relative importance of physician abilities and attitudes, pi-actice harriers, and economic disincentives to practice change.

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Changing clinical practice: Which interventions work?

Tamblyn

Battista

1993

Journal of Continuing Education in the Health Professions

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Continuing Medical Education

Cited by 1 publication

References 4 publications

Changing clinical practice: Which interventions work?

Changing clinical practice: Which interventions work?

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