CAN A SPECIALTY SOCIETY EDUCATE ITS MEMBERS TO THINK DIFFERENTLY ABOUT CLINICAL DECISIONS - RESULTS OF A RANDOMIZED TRIAL

OBJECTIVE: Measure the effect of specialty society-developed continuin g medical education (CME) on clinical decision making. DESIGN: Randomi zed controlled trial. SETTING: National sample of neurologists. PARTIC IPANTS: Of 492 neurologists randomly selected from an ongoing American Academy of Neurology CME program, 248 were randomized to receive a ma iled CME course, and 244 did not receive it. INTERVENTION: A mailed ed ucational course on movement disorders, developed by the specialty soc iety, containing information on diseases and practice recommendations with illustrative case presentations. MEASUREMENTS AND MAIN RESULTS: W e assessed adherence to 16 practice recommendations on disease detecti on, diagnostic test use, and treatments by mailed survey sent to all s ubjects 4.5 months after the intervention group received the course (7 3% response rate). The survey contained detailed clinical scenarios to measure self-reported clinical decision making and short open-ended q uestions to measure factual knowledge. More intervention participants (up to 2.6 times more) than control subjects reported clinical decisio n making adherent to 9 of the 16 recommendations (p < .05), For 4 of t he other 7 recommendations, adherence exceeded 85% in both groups. Wit hin the intervention group, neurologists who read the educational cour se were 2 to 6 times more likely to be adherent than neurologists who did not. The intervention group had better factual knowledge than cont rol subjects in six of seven areas (p < .01). CONCLUSIONS: This educat ional course improved neurologists' reported decision making. Specialt y society-developed CME that utilizes a similar format may enhance the effectiveness of mailed CME information to improve physicians' approa ch to clinical decisions.