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Using Administrative Data in Primary Care to Evaluate the Effectiveness of a Continuing Professional Development
Boris Zevin1, Rachael Morkem, Eleftherios Soleas
1Dr. Zevin: Associate Professor, Department of Surgery, Queen's University, Kingston, Ontario. Ms. Morkem: Research Associate, Centre for Studies in Primary Care, Queen's University, Kingston, Ontario. Dr. Soleas: Director of Continuing Professional Development and Adjunct Assistant Professor, Office of Professional Development and Educational Scholarship, Queen's University, Kingston, Ontario. Dr. Dalgarno: Director of Education Research and Adjunct Assistant Professor, Office of Professional Development and Educational Scholarship, Queen's University, Kingston, Ontario. Dr. Barber: Network Director and Assistant Professor, Centre for Studies in Primary Care, Queen's University, Kingston, Ontario.
Introduction:
There are guidelines for referral to medical and/or surgical weight loss interventions (MSWLI) in Ontario; however, only about one-third of eligible patients in our region are being referred for consideration of MSWLI.
Methods:
A planning committee, including a registered dietician, psychiatrist, endocrinologist, bariatric surgeon, family physician, and educationalists, developed an interdisciplinary continuing professional development (CPD) program focused on practical approaches to the management of patients living with obesity. The Kirkpatrick model was used to evaluate the educational outcomes of the CPD program specifically focusing on Level-2, -3, and -4 outcomes based on self-reported questionnaire and health administrative data.
Results:
Eighteen primary care providers from the CPD program agreed to participate in this study, and 16 primary care providers (89%) completed the postintervention questionnaire and granted us access to their MSWLI referral data; 94% of study participants reported changes to their knowledge, comfort, and confidence (Level 2), as well as expected change in their future behaviour (Level 3) following the CPD program. However, there was no change in Kirkpatrick Level-4 outcomes, despite more than 90% of participants indicating that they will be making changes to their practice after the program.
Discussion:
The CPD program in our study was overwhelmingly well received and participants reported knowledge (Level 2) and behavioural (Level 3) changes following participation; however, there was no detectable change in their clinical practice (Level 4). The methodology described in our proof-of-concept study can be modified and adopted to evaluate Level-4 outcomes in other studies of effectiveness of CPD interventions.
Insights
A continuing professional development (CPD) program improved primary care providers' knowledge and confidence in managing obesity, but did not significantly change patient referral rates for weight loss interventions.
Area of Science:
- Obesity Medicine
- Medical Education
- Healthcare Management
Background:
- Referral rates for medical and/or surgical weight loss interventions (MSWLI) in Ontario are suboptimal, with only about one-third of eligible patients being referred.
- A gap exists in the practical management of patients with obesity within primary care settings.
Purpose of the Study:
- To evaluate the effectiveness of an interdisciplinary continuing professional development (CPD) program designed to enhance primary care providers' (PCPs) management of patients with obesity.
- To assess educational outcomes using the Kirkpatrick model, focusing on knowledge, behavior, and practice changes.
Main Methods:
- An interdisciplinary CPD program was developed by experts in obesity management.
- The program's outcomes were evaluated using the Kirkpatrick model (Levels 2, 3, and 4) via self-reported questionnaires and health administrative data.
- 16 primary care providers completed the study, providing pre- and post-intervention data.
Main Results:
- 94% of participants reported increased knowledge, comfort, and confidence (Kirkpatrick Level 2) after the CPD program.
- Over 90% of participants anticipated changes in their future practice behavior (Kirkpatrick Level 3).
- No significant change in actual clinical practice or referral rates (Kirkpatrick Level 4) was observed.
Conclusions:
- The CPD program effectively enhanced PCPs' knowledge and confidence regarding obesity management.
- While the program influenced self-reported knowledge and intended behavior, it did not translate into measurable changes in clinical practice or patient referrals.
- The study highlights the need for further research and refined methodologies to evaluate and improve the impact of CPD on clinical practice outcomes in obesity care.
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