Provider education to promote implementation of clinical practice guidelines

Study objectives: Although the interest in and promulgation of clinical pra ctice guidelines have significantly increased in the past 2 decades, concer n exists about their actual implementation. This article focuses on one str ategy to encourage guideline implementation at the clinician level: clinici an education. The objectives of the article are to review educational strat egies, to consider them within the context of complementary strategies carr ied out at the organizational and clinic setting levels, and to outline cha llenges and recommendations for clinicians' continuing education. Methods: Experience and data from relevant randomized clinical trials withi n an educational framework are reviewed. Observations: Implementation of clinical practice guidelines requires a var iety of skills, including assessment, appropriate delineation of a treatmen t and monitoring plan, patient tracking, and patient counseling and educati on skills. Continuing education strategies must reflect the content and tea ching methods that best match the learning objectives. The pressures of cur rent-day practices place limits on the resources, particularly clinician ti me, that are available for continuing education. Organizational resources m ust be committed to build the complementary supportive systems necessary fo r improved clinician practice, In addition to physicians, education must be directed at nonphysician clinicians, office staff, and administrators who also are responsible for guideline implementation. Conclusions: To meet the challenges of developing clinician motivation, bal ancing competing demands, and treating patients with complex medical condit ions, all within time constraints, clinical leaders need to design educatio n activities that have leadership support, reflect compelling evidence, use multiple strategies and teaching techniques, and engage learners in skill building and problem solving.