Abstract
BackgroundPrevious research has shown that internet education can lead to short-term improvements in clinicians' knowledge, confidence and communication practices. We wished to better understand the duration of these improvements and whether different curriculum delivery strategies differed in affecting these improvements.MethodsAs previously described, we conducted a randomized control trial comparing four different strategies for delivering an e-curriculum about herbs and other dietary supplements (HDS) to clinicians. The four strategies were delivering the curriculum by: a) email over 10 weeks; b) email within one week; c) web-site over 10 weeks; d) web-site within one week. Participants were surveyed at baseline, immediately after the course and 6–10 months after completing the course (long-term). Long-term outcomes focused on clinicians' knowledge, confidence and communication practices.ResultsOf the 780 clinicians who completed the course, 385 (49%) completed the long-term survey. Completers and non-completers of the long-term survey had similar demographics and professional characteristics at baseline. There were statistically significant improvements from baseline to long-term follow-up in knowledge, confidence and communication practices; these improvements did not differ by curriculum delivery strategy. Knowledge scores improved from 67.7 ± 10.3 at baseline to 78.8 ± 12.3 at long-term follow-up (P < 0.001). Confidence scores improved from 53.7 ± 17.8 at baseline to 66.9 ± 12.0 at long term follow-up (P < 0.001); communication scores improved from 2.6 ± 1.9 at baseline to 3.6 ± 2.1 (P < 0.001) at long-term follow-up.ConclusionThis e- curriculum led to significant and sustained improvements in clinicians' expertise about HDS regardless of the delivery strategy. Future studies should compare the impact of required vs. elective courses and self-reported vs. objective measures of behavior change.
Highlights
Previous research has shown that internet education can lead to short-term improvements in clinicians' knowledge, confidence and communication practices
Herbs and dietary supplements (HDS) are the most commonly used complementary medical therapies purchased in the United States [1], leading to concerns about HDS safety and efficacy[2]
Face-to-face Continuing Medical Education (CME) courses often fail to result in sustained changes in physician behaviors [6,7]
Summary
Previous research has shown that internet education can lead to short-term improvements in clinicians' knowledge, confidence and communication practices. Health care professionals have expressed a strong interest in HDS training courses[3,4,5]. Face-to-face Continuing Medical Education (CME) courses often fail to result in sustained changes in physician behaviors [6,7]. Online CME training has shown improved behavior and knowledge [8]. We previously reported the short-term outcomes of our randomized controlled trial (RCT) comparing four different strategies of delivering an on-line course about HDS to diverse clinicians [9]. The short-term results suggested that all four strategies of the e-curriculum and significantly improved clinicians' knowledge, confidence, and communication practices
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