Applying Prochaska's model of change to needs assessment, programme planning and outcome measurement

A major goal of continuing medical education (CME) is to enhance the perfor mance of the learner. In order to accomplish this goal, careful considerati on and expertise must be applied to the three primary ingredients of CME pl anning: assessing learner needs, programme design and outcome measurement. Traditional methods used to address these three components seldom result in CME initiatives that change performance, even in the presence of sophistic ated CME formats and capable learners. In part, performance may not change because the learner is not 'ready to change'. Planners of CME are aware of this concept but have been unable to measure 'readiness to change' or emplo y it in assessing learner needs, and planning and evaluating CME. One theor y that focuses on an individual's readiness to change is Prochaska's model, which postulates that change is a gradual process proceeding through speci fic stages, each of which has key characteristics. This paper examines the applicability of this model to all components of CME planning. To illustrat e the importance of this model, this paper provides examples of these three components conducted both with and without implementation of this model.