CME and change in practice: An alternative perspective

A two-year study was undertaken by the American College of Cardiology (ACC) to assess the effects of its continuing medical education (CME) programs on physician practice behavior. The principal method of evaluation was a telephone interview conducted by fellow cardiologists. Participants were interviewed before and after the CME conferences; control groups were drawn from program cancellations and/or attendees at contiguous courses. Data abstracted from patient charts were also collected from a subsample of participants. Specific course-related behavior change reported ranged from 53–74% of the participants, and 7-29% of the controls. Results revealed that the CME courses contained relatively little information that was new to the audience; that numerous other influences on practice interacted with CME content; and that change attributable to CME was generally subtle and often delayed. Theoretical implications for perspectives on physician behavior change and CME programming are presented and discussed.