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A Theory-Based Study of Factors Explaining General Practitioners' Intention to Use and Participation in Electronic Continuing Medical Education

Hadadgar, Arash MD, MS; Changiz, Tahereh MD, PhD; Dehghani, Zahra MS; Backheden, Magnus MS; Mirshahzadeh, Nahidalsadat MD; Zary, Nabil MD, PhD; Masiello, Italo PhD

Journal of Continuing Education in the Health Professions: Fall 2016 - Volume 36 - Issue 4 - p 290–294
doi: 10.1097/CEH.0000000000000123
Original Research

Introduction: Electronic modes of continuing medical education (eCME) can provide an appropriate and scalable way of updating the knowledge and skills of general practitioners (GPs). To optimize the adoption of eCME and develop efficient and cost-effective eCME programs, factors explaining GPs' intention to use eCME must first be elucidated.

Methods: Using the Theory of Planned Behavior as a framework, we developed a questionnaire and administered it to GPs in seven CME seminars in Isfahan, Iran, in 2014. Three domains of GPs' intention to use eCME were measured: attitudes, perceived behavioral control, and subjective norms. We used linear and logistic regression to identify the main predictors of intention and behavior.

Results: GPs who had high score in perceived behavioral control and a more positive attitude toward e-learning had a higher intention to adopt it for CME. In contrast, subjective norms (eg, social pressures to use eCME) were not a predictor. Attitude toward usefulness of eCME was the main predictor of being an actual eCME user.

Discussion: Perceived behavioral control and attitude constitute the main predictors of the intention to use eCME. Establishing discussions forums and strengthening organizational support for eCME through an increased awareness among clinical superiors and CME managers would be expected to increase GPs' intention to use eCME.

Dr. Hadadgar: PhD Student, Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Stockholm, Sweden, and Researcher, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Dr. Changiz: Professor, Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Mrs. Dehghani: Researcher, Medical Education Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran. Mr. Backheden: Lecturer, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden. Dr. Mirshahzadeh: Director, Continuing Medical Education office, Isfahan University of Medical Sciences, Isfahan, Iran. Dr. Zary: Associate Professor, Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden. Dr. Masiello: Associate Professor, Department of Clinical Science and Education, Södersjukhuset, Karolinska Institute, Stockholm, Sweden.

Correspondence: Arash Hadadgar, MD, MS, Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Tomtebodavägen 18A, 3rd Floor, Solna, Stockholm 17177, Sweden; e-mail: arash.hadadgar@ki.se.

Supported intellectually by IUMS and KI and financially by a grant (#293158) from IUMS. Also, without the great support of IUMS CME office, this study would have not been possible.

Disclosures: The authors declare no conflict of interest.

Dr. Zary and Dr. Masiello contributed equally to this study.

Ethical considerations: The research ethics committee of Isfahan University of Medical Sciences reviewed and approved the research protocol (IRB number = 293158, December 2013).

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (http://www.jcehp.org).

© 2016 Lippincott Williams & Wilkins, Inc.
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