JMIR Publications

ABSTRACT

Background:

Web-based continuing professional development (CPD) is a convenient and low-cost way for physicians to update their knowledge. However, little is known about the factors that influence their intention to put this new knowledge into practice.

Objective:

We aimed to identify socio-cognitive factors associated with physicians’ intention to adopt new behaviors as well as indications of Bloom’s learning levels following their participation in five web-based CPD courses.

Methods:

We performed a cross-sectional study of medical specialists who had completed one of five web-based CPD courses offered by the Federation of Medical Specialists of Quebec. Participants then completed CPD-Reaction, a questionnaire based on Godin’s integrated model for health professional behavior change and with evidence of validity that measures behavioral intention (dependent variable) and psychosocial factors influencing intention (n=4). We also assessed variables related to sociodemographics (n=5), course content (n=9) and course format (e.g. graphic features, duration) (n=8). Content variables were derived from CanMEDS competencies, Bloom’s learning levels and Godin’s integrated model. We conducted ANOVA single-factor analysis, calculated the intra-class correlation coefficient (ICC) and performed bivariate and multivariate analyses.

Results:

A total of 259 physicians participated (range: 38-63 physicians per course). Average age was 50±12 years old and 56% were female. Behavioral intention scores ranged from 5.1 (SD=1.17) to 6.4 (SD=0.88) out of 7 and differed significantly from one course to another (p<0.01). The ICC indicated that 17% of the total variation in the outcome of interest, the behavioral intention of physicians, could be explained at the level of the CPD course (ICC=0.17). In bivariate analyses, social influences (p<0.01), beliefs about capabilities (p<0.01), moral norm (p<0.01), beliefs about consequences (p<0.01) and psychomotor learning (p=0.04) were significantly correlated with physicians’ intention to adopt new behaviors. Multivariate analysis showed the same factors, except for social influences and psychomotor learning, as significantly correlated with intention.

Conclusions:

We observed average to high behavioral intention scores after all five web-based courses, with some variation by course taken. Factors affecting physicians’ intention were beliefs about their capabilities, about the consequences of adopting new clinical behaviors, and doubts about whether the new behavior aligned with their moral values. Our results will inform design of future web-based CPD courses to ensure they contribute to clinical behavior change.