Altering physicians' practice patterns--a nationwide educational experiment: evaluation of the Clinical Education Program of the American Diabetes Association.

A comprehensive evaluation of the Clinical Education Program (CEP) of the American Diabetes Association on type II diabetes was undertaken in a cohort of 5640 primary-care physicians to determine whether practice patterns are affected by such continuing medical education programs. The educational and behavioral objectives were defined and the extent to which these objectives were met was evaluated by use of questionnaires completed by conference attendees both before and after they participated in the program and by in-office interviews 2 mo later with 288 of the primary-care physicians who had attended the conference. Prior to participation, approximately half of the primary-care physicians described diabetes practice patterns consistent with excellent care. The proportion who stated that they intended to improve their practice patterns increased significantly after the conference. Similarly, the majority of these same physicians knew the basic educational objectives before the conference, with a significant increase in the proportion of physicians knowing these objectives after the conference. The office interviews indicated that the changes noted in the proportion of physicians intending to carry out a practice at the end of the conference were sustained or actually increased in this cohort. Exceptions to this trend occurred in the area of use of glucosylated hemoglobin and perhaps in the area of periodic assessment of macrovascular circulation. Two interesting additional findings from the in-office interviews were that physicians prefer the conference format for learning and that distribution of printed material alone is not very effective in influencing knowledge and behavior in primary-care physicians. The CEP met its educational and behavioral objectives.(ABSTRACT TRUNCATED AT 250 WORDS)