Abstract
Traditionally, continuing medical education (CME) programs do not address the changes in the organization of a practice necessary to implement new care strategies. We developed a continuing medical education program that included a structured method, termed environmental optimizing, to help primary care physicians implement intensified management strategies for insulin-requiring patients with diabetes mellitus. To evaluate this approach, 88 physicians and 126 of their non-obese, insulin-requiring patients were surveyed and interviewed pre-program and at six and twelve months post-program. The results suggest that this approach to CME resulted in a significant number of physicians adopting the program recommendations. Specifically, there was a significant increase in the use of: 1) multiple daily insulin regimens (p=.01), 2) a program-specific “tracer” insulin regimen (p=.001), 3) the use of HbAl assays to adjust insulin (p<.05), diet and exercise regimens (p<.05), and 4) patients' self monitoring behavior (p<.01). The results of this study suggest that incorporating environmental optimizing into CME curricula may enhance the adoption of program recommendations.
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