Introduction
Methods
Continuing Medical Education Curricula and Time Line
Patient Chart Review
Assessment of Physician Learner Performance and Patient Health Outcomes
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Pre- and post-activity surveys to measure baseline and immediate changes in declarative (level 3A) and procedural knowledge (level 3B)
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30 to 60-day follow-up survey to measure impact on clinical decision making and changes in practice (levels 5)
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Patient chart review to measure impact on clinical decision making and the resultant patient health outcomes (levels 5 and 6)
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Statistical Analysis
Results
Summary of Physician Participation in CME Activities and Patient Chart Review
Live CME program | Live CME attendance
N = 4112 | Number of physicians who completed patient charts | Number of patient charts completed per physician
N = 264 | |
---|---|---|---|---|
Signup
N = 445 | Completion
N = 34 | |||
Feb. 9, 2012 | 658 | 80 | 5 | 1, 1, 9, 12, 4 = 27 |
Mar. 10, 2012 | 523 | 99 | 7 | 9, 5, 6, 11, 3, 4, 5 = 43 |
April 11, 2012 | 918 | 69 | 7 | 4, 13, 3, 10, 7, 15, 17 = 69 |
June 23, 2012 | 548 | 75 | 8 | 1, 2, 10, 1, 5, 10, 13, 15 = 57 |
Sept. 19, 2012 | 510 | 54 | 3 | 15, 2, 5 = 22 |
Nov. 15, 2012 | 492 | 35 | 4 | 5, 7, 1, 33 = 46 |
Dec. 8, 2012 | 463 | 33 | 0 | 0 |
Physician Learner Knowledge, Competence and Performance Scores
Live didactic program | Online case-based interactive activity | All CME | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Fort L. | Houston | Anaheim | New York | Rosemont | Boston | Online | Clara | Bobby | Total | ||
Moore’s Level |
N
| 20 | 46 | 141 | 17 | 110 | 115 | 1270 | 841 | 620 | 3180 |
3 Knowledge | Pre-test | 13.0 (27.0) | 11.0 (22.1) | 16.0 (26.9) | 6.19 (17.9) | 13.3 (24.7) | 21.2 (31.1) | 33.1 (34.7) | 79.2 (22.0) | 62.3 (25.1) | 43.0 (37.6) |
Post-test | 45.7 (42.4) | 22.5 (32.7) | 25.8 (32.9) | 13.3 (29.6) | 25.60 (34.0) | 41.2 (37.5) | 48.1 (38.6) | 86.4 (20.8) | 71.6 (25.6) | 54.8 (39.2) | |
Change | 250.0* | 105.0* | 61.5* | 115.4 | 92.3* | 94.1** | 45.3** | 9.2** | 15.0** | 27.3** | |
4 Competence | Pre-test | 69.6 (47.1) | 56.04 (49.9) | 39.6 (50.0) | 19.1 (39.5) | 46.8 (30.0) | 57.6 (49.6) | 70.4 (45.6) | 69.9 (33.3) | 49.9 (36.0) | 59.9 (44.6) |
Post-test | 91.3 (29.8) | 68.1 (46.9) | 68.0 (46.7) | 22.9 (42.2) | 49.2 (30.1) | 63.1 (48.4) | 75.3 (43.2) | 80.4 (30.0) | 62.3 (33.8) | 69.4 (42.1) | |
Change | 31.3* | 21.6* | 71.9* | 20.0 | 5.1* | 9.7 | 6.7* | 15.0 | 24.8** | 15.9** | |
5 Performance | Pre-test | 3.6 (1.0) | 3.5 (1.2) | 2.8 (1.2) | 3.2 (1.3) | 3.2 (1.3) | 2.9 (1.1) | 3.3 (1.2) | 3.7 (1.2) | 3.5 (1.1) | 3.4 (1.2) |
Post-test | 4.5 (0.8) | 4.4 (0.9) | 4.0 (1.0) | 4.8 (0.4) | 4.5 (0.8) | 4.2 (0.9) | 4.0 (1.0) | 4.2 (1.0) | 3.9 (1.0) | 4.09 (1.0) | |
Change | 23.61* | 25.60* | 41.31* | 47.3** | 40.1* | 44.5** | 22.6** | 13.9** | 11.5** | 19.8** |
Patient Health Baseline Characteristics and Outcomes
Clinical characteristic | Value | |
---|---|---|
N
| % | |
Gender | ||
Female | 127 | 48.11 |
Male | 137 | 51.89 |
Baseline characteristic | ||
HbA1c ≤ 7% | 9 | 3.41 |
Diabetes Duration (years) | ||
Mean | 4.62 | |
SD | 3.21 | |
Age (years) | ||
Mean | 53.98 | |
SD | 13.06 | |
BMI (kg/m2) | ||
Mean | 32.2 | |
SD | 4.97 | |
Weight (lb) | ||
Mean | 203.4 | |
SD | 43.49 | |
Height (in) | ||
Mean | 66.2 | |
SD | 4.34 | |
HbA1c (%) | ||
Mean | 9.37 | |
SD | 1.62 | |
Number of antihyperglycemic drugs | ||
Mean | 1.7 | |
SD | ||
Total patient count | 264 |
Endpoint result | N | % Patients |
---|---|---|
HbA1c reduction ≥0.5% | 170 | 64.4 |
Insulin therapy initiation | 117 | 44.3 |
HbA1c ≤ 7.0% | 50 | 20.3 |
Therapy escalation | 197 | 75 |
Total patient count | 264 |