• 1

    Institute of Medicine: Crossing the Quality Chasm: A New Health System for the 21st Century, National Academy Press, Washington, DC. ,2001. .

    • PubMed
    • Export Citation
  • 2

    Association of American Medical Colleges: Medical school objectives project: contemporary issues in medicine, report II: medical informatics and population health. Available at: http://www.aamc.org/meded/msop/msop2.pdf. Accessed October. 2003. .

    • PubMed
    • Export Citation
  • 3

    Accreditation Council for Graduate Medical Education: Institutional requirements. Available at: http://www.acgme.org. Accessed January. 2004. .

    • PubMed
    • Export Citation
  • 4

    Institute of Medicine: Health Professions Education: A Bridge to Quality, National Academies Press, Washington, DC. ,2003. .

    • PubMed
    • Export Citation
  • 5

    Barzansky B, Etzel SI: Educational programs in US medical schools, 2002–2003. .JAMA 290::1190. ,2003. .

  • 6

    Dellavalle RP, Stegner DL, Deas AM, et al: Assessing evidence-based dermatology and evidence-based internal medicine curricula in US residency training programs: a national survey. .Arch Dermatol 139::369. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Chichester SR, Wilder RS, Mann GB, et al: Utilization of evidence-based teaching in U.S. dental hygiene curricula. .J Dent Hyg 75::156. ,2001. .

  • 8

    Forrest JL, Miller SA: Integrating evidence-based decision making into allied health curricula. .J Allied Health 30::215. ,2001. .

  • 9

    Keenan AM, Redmond AC: Integrating research into the clinic: what evidence based practice means to the practising podiatrist. .JAPMA 92::115. ,2002. .

  • 10

    Council on Podiatric Medical Education: Standards and requirements for accrediting colleges of podiatric medicine (CPME 120). Available at: http://www.apma.org/CPME/cpme120.htm. Accessed October. 2003. .

    • PubMed
    • Export Citation
  • 11

    Council on Podiatric Medical Education: Standards and requirements for approval of residencies in podiatric medicine and surgery (CPME 320). Available at: http://www.apma.org/s_apma/bin.asp?CID=393&DID=9471&DOC=FILE.PDF. Accessed August. 2005. .

    • PubMed
    • Export Citation
  • 12

    McNevin AJ, Gill CE, North MG: Podiatric medical education: a view into the next century. .JAPMA 86::354. ,1996. .

  • 13

    Turlik MA, Kushner D: Levels of evidence of articles in podiatric medical journals. .JAPMA 90::300. ,2000. .

  • 14

    Green ML, Ellis PJ: Impact of an evidence-based medicine curriculum based on adult learning theory. .J Gen Intern Med 12::742. ,1997. .

  • 15

    Ramos KD, Schafer S, Tracz SM: Validation of the Fresno test of competence in evidence based medicine. .BMJ 326::319. ,2003. .

  • 16

    Evans EG, Sigurgeirsson B: Double blind, randomised study of continuous terbinafine compared with intermittent itraconazole in treatment of toenail onychomycosis: the LION Study Group. .BMJ 318::1031. ,1999. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Perkins BA, Olaleye D, Zinman B, et al: Simple screening tests for peripheral neuropathy in the diabetes clinic. .Diabetes Care 24::250. ,2001. .

  • 18

    Guyatt GH, Sackett DL, Cook DJ: Users’ guides to the medical literature: II. How to use an article about therapy or prevention: A. Are the results of the study valid?. JAMA 270::2598. ,1993. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Guyatt GH, Sackett DL, Cook DJ: Users’ guides to the medical literature: II. How to use an article about therapy or prevention: B. What were the results and will they help me in caring for my patients?. JAMA 271::59. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Jaeschke R, Guyatt GH, Sackett DL: Users’ guides to the medical literature: III. How to use an article about a diagnostic test: A. Are the results of the study valid?. JAMA 271::389. ,1994. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Mazmanian PE, Mazmanian PM: Commitment to change: theoretical foundations, methods, and outcomes. .J Contin Educ Health Prof 19::200. ,1999. .

  • 22

    Jones DL: Viability of the commitment-for-change evaluation strategy in continuing medical education. .Acad Med 65::S37. ,1990. .

  • 23

    Sackett DL, Straus SE, Richardson WS, et al: Evidence-Based Medicine: How to Practice and Teach EBM, Churchill Livingstone, Edinburgh. ,2000. .

    • PubMed
    • Export Citation
  • 24

    Skeff KM, Stratos GA, Bergen MR: Evaluation of a medical faculty development program: a comparison of traditional pre/post and retrospective pre/post self-assessment ratings. .Eval Health Prof 3::350. ,1992. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25

    Dolcourt JL, Zuckerman G: Unanticipated learning outcomes associated with commitment to change in continuing medical education. .J Contin Educ Health Prof 23::173. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26

    Davis DA, Thomson MA, Oxman AD, et al: Changing physician performance: a systematic review of the effect of continuing medical education strategies. .JAMA 274::700. ,1995. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27

    Davis DA, Thomson MA, Oxman AD, et al: Evidence for the effectiveness of CME: a review of 50 randomized controlled trials. .JAMA 268::1111. ,1992. .

  • 28

    Mazmanian PE, Johnson RE, Zhang A, et al: Effects of a signature on rates of change: a randomized controlled trial involving continuing education and the commitment-to-change model. .Acad Med 76::642. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29

    Mazmanian PE, Daffron SR, Johnson RE, et al: Information about barriers to planned change: a randomized controlled trial involving continuing medical education lectures and commitment to change. .Acad Med 73::882. ,1998. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30

    Pereles L, Gondocz T, Lockyer JM, et al: Effectiveness of commitment contracts in facilitating change in continuing medical education intervention. .J Contin Educ Health Prof 17::27. ,1997. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31

    D’Eon MF, AuYeung D: Follow-up in train-the-trainer continuing medical education events. .J Contin Educ Health Prof 21::33. ,2001. .

  • 32

    Skeff KM, Stratos GA, Berman J, et al: Improving clinical teaching: evaluation of a national dissemination program. .Arch Intern Med 152::1156. ,1992. .

  • 33

    Leipzig RM, Wallace EZ, Smith LG, et al: Teaching evidence-based medicine: a regional dissemination model. .Teach Learn Med 15::204. ,2003. .

  • 34

    Dolcourt JL: Commitment to change: a strategy for promoting educational effectiveness. .J Contin Educ Health Prof 20::156. ,2000. .

  • 35

    Lockyer JM, Fidler H, Ward R, et al: Commitment to change statements: a way of understanding how participants use information and skills taught in an educational session. .J Contin Educ Health Prof 21::82. ,2001. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 36

    Purkis IE: Commitment for changes: an instrument for evaluating CME courses. .J Med Educ 57::61. ,1982. .

  • 37

    Green ML, Gross CP, Kernan WN, et al: Integrating teaching skills and clinical content in a faculty development workshop. .J Gen Intern Med 18::468. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38

    Curry L, Purkis IE: Validity of self-reports of behavior changes by participants after a CME course. .J Med Educ 61::579. ,1986. .

  • 39

    Wakefield J, Herbert CP, Maclure M, et al: Commitment to change statements can predict actual change in practice. .J Contin Educ Health Prof 23::81. ,2003. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 40

    Green ML: Identifying, appraising, and implementing medical education curricula: a guide for medical educators. .Ann Intern Med 135::889. ,2001. .

  • 41

    Howard GS, Dailey PR: Response-shift bias: a source of contamination of self-report measures. .J Appl Psychol 64::144. ,1979. .

  • 42

    Howard GS, Ralph KM, Gulanick NA, et al: Internal invalidity in pretest-posttest self-report evaluations and the re-evaluation of retrospective pretests. .Appl Psychol Meas 3::1. ,1979. .

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 43

    Bray JH, Howard GS: Methodological considerations in the evaluation of a teacher-training program. .J Educ Psychol 72::62. ,1980. .

  • 44

    Hoogstraten J: Influence of objective measures on self-reports in a retrospective pretest-posttest design. .J Exp Educ 53::207. ,1985. .

A Train-the-Trainer Model for Integrating Evidence-Based Medicine Training into Podiatric Medical Education

Michael L. Green Department of Internal Medicine, Yale University School of Medicine, New Haven, CT; Waterbury and St Mary’s Hospitals, Waterbury, CT.
 Mailing address:Michael L. Green, MD, MSc, Yale University School of Medicine, Waterbury Hospital, 64 Robbins St, Waterbury, CT 06721.

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 MD, MSc

This article presents the development, implementation, and evaluation of a national evidence-based medicine faculty-development program for podiatric medical educators. Ten faculty members representing six accredited colleges of podiatric medicine, one podiatric medical residency program, and a Veterans Affairs podiatry service participated in a 2-day workshop, which included facilitated discussions, minilectures, hands-on exercises, implementation planning, and support after the workshop. Participants’ evidence-based medicine skills were measured by retrospective self-reported ratings before and after the workshop. Participants also reported their implementation of “commitments to change” on follow-up surveys at 3 and 12 months. Participants’ evidence-based medicine practice and teaching skills improved after the intervention. They listed a total of 84 commitments to change, most of which related to the program objectives. By 12 months after the workshop, participants as a group had fully implemented 24 commitments (32%), partially implemented 36 (48%), and failed to implement 15 (20%) of a total of 75 commitments with follow-up data. The most common barriers to change at 12 months were insufficient resources, systems problems, and short patient visit times. A train-the-trainer faculty-development program can improve self-reported evidence-based medicine skills and behaviors and affect curriculum reform at podiatric medical educational institutions. (J Am Podiatr Med Assoc 95(5): 497–504, 2005)

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