Performance improvement CME in psychiatry: implementing black box warning informed consent

Abstract

Objective. Performance improvement continuing medical education (PI CME) is a recent educational methodology designed better to link educational content and outcomes in the context of limitations in the effectiveness of traditional CME. This study examines the ease of use and effectiveness of psychiatric CME in a small hospital. Methods. All staff psychopharmacologists assessed their performance in providing informed consent of black box risks of prescribed psychiatric medications in a 3-month period. Staff were educated regarding black box risks of all commonly prescribed psychiatric medications, and their performance in the following quarter was reassessed. Significance of change following the educational intervention at 3 and 6 months was determined by Chi square analysis. Results. PI CME was clearly successful in supporting behaviour change, χ2(1, N=60) =20.86, p=0.000, far outstripping traditional CME efforts. Changes in behaviour persisted over time, χ2(1, N=61)=4.04, p=0.044. This PI CME event received the highest possible rating by CME participants, and took few staff resources to implement. Conclusions. PI CME is an educational technology that can be carried out, without significant burdens to participants or educators, in psychiatric departments of small hospitals. PI CME can be much more effective than traditional CME in bringing about desired behaviour change in psychiatrist behaviours. Hospital-based PI CME may have other benefits, such as meeting criteria for Maintenance of Certification.