Sunday, January 30, 2011

What Works to Change Practice

What can we do to help physicians improve their practice? There is research that can help guide decisions and priorities. In a 1998 “review of reviews,” looks at methods that have improved practice. The educational message is pretty clear – didactic methods will not work, we need to include education that that helps physicians think about, and practice their new knowledge.




Consistently Effective Interventions

Reminders (manual or computerized)

Multifaceted interventions

Interactive educational meetings that include at least include discussion or practice



Interventions of Variable Effectiveness

Audit and feedback

Local opinion leaders

Local consensus processes

Patient mediated interventions



Interventions with little or no effect

Educational materials, including clinical practice guidelines, recommendations for clinical care, audiovisual materials, and electronic publications

Didactic educational meetings





Bero, L.A., Grilli,R., Grimshaw,J.R., Harvey, E., Oxman, A.D., and M Thomson (1998) Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. BMJ; 317 : 465.

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