CRITICAL ANALYSIS

Critical Analysis

Interprofessional Groups

Executive Summary

In Canada, it is assumed that continuing professional development (CPD), which encompasses continuing medical education (CME), plays a crucial role in maintaining and improving the quality and efficiency of the healthcare system by translating evidence into clinical practice. In other words, CPD serves as a significant knowledge-translation strategy and is one potential approach that could be incorporated into the Knowledge to Action Process (KTA) framework. The KTA framework, which explains how knowledge is produced and implemented in healthcare, contains two parts: the knowledge creation cycle and the action cycle. While the first cycle comprises the process of creating knowledge, the second one constitutes the process of applying the knowledge thus created. By translating knowledge and evidence into practice, CPD pertains to the action cycle. Designed to improve performance in healthcare practices and ultimately health outcomes, CPD strategies follow the dynamic and iterative process for knowledge translation. As in other educational disciplines, most evaluation frameworks used in CPD are derived from Kirkpatrick's model. This model assesses training effectiveness by measuring participants' reactions to an educational activity. Changes in participants' knowledge, skills, or attitudes, transfer of learning to practice observed changes in behaviour and finally, the results of the newly acquired behaviour on organizational outcomes such as productivity and quality. (Ovretveit, 1993, 137)

According to this model, the effects of current approaches to the assessment of the impact of accredited CPD activities should ideally be evaluated focusing on participants' participation, satisfaction, and changes in knowledge, behaviour, and patient outcomes. In practice, however, most CPD providers only assess the outcomes using pre- and post activity self-administered questionnaires. Although the impacts of levels have been measured in the context of research projects using health services methods, CPD providers are still struggling to find reliable ways to measure these impacts on a routine basis. Godin and colleagues proposed an integrated conceptual model to predict behaviour change in healthcare professionals that offer a clear basis for developing a valid and reliable measurement instrument to assess CPD impacts on clinical practice. Since individual decisions are often central to the adoption of clinically related behaviours, theories providing information about cognitive mechanisms underlying behaviours help provide direction to behaviour-change interventions targeting healthcare professionals. (Ovretveit, Mathias & Thompson, 1997, 218)

The results of a systematic review of several studies suggested that a number of constructs originating from social cognitive theories were the most promising for assessing behaviour change in health professionals. Our study aims to:

(a) Meet CPD providers' needs for high-quality evaluation methods that are based on well established theories for predicting clinical behaviour and intentions to change of healthcare professionals.

(b) Establish guidelines for reliability and validity of those methods.

The integrated model proposed by Godin and colleagues has identified key constructs likely related to behaviour, and we now want to develop an instrument that assesses the constructs in this framework as a proxy for predicting changes in behaviour in CPD activities.

With the rapid development of technology within diagnostic imaging and radiotherapy, it is vital that CPD is ...