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Using a Commitment to Change Tool for Evaluation and Planning of a Global Competency-Based Curriculum in Orthogeriatrics

Cunningham, Michael PhD; Kates, Stephen MD; Blauth, Michael MD

Journal of Continuing Education in the Health Professions: April 2014 - Volume 34 - Issue 2 - p 123–130
doi: 10.1002/chp.21219
Original Research

Introduction: Measuring the outcomes of educational activities at the performance level is a challenge for all medical educators. This study reports retrospective outcomes data from the administration of a commitment to change (CTC) at orthogeriatrics courses and how the findings were used for curriculum improvement.

Methods: During 2010–2012, a CTC questionnaire was administered at 8 educational courses attended by 513 orthopedic and trauma surgeons and medicine physicians in 5 countries. The CTC asked if physicians intended to change anything in their clinical practice as a result of participating and to list their specific changes. A 3-month follow-up was conducted to assess the status of intended changes and identify barriers to implementation.

Results: Two hundred seventy-six (54%) of the 513 course participants and faculty reported at least 1 intended change in their clinical practice (485 specific changes overall). The intended changes were quantified and analyzed further based on 10 competencies for orthogeriatrics. Follow-up responses were received for N = 150 (31%) of the intended changes. Of these changes, 24% were fully implemented, 51% were partially implemented, and 25% were not implemented. The main barriers to implementation were categorized as “ongoing process (needs more time)” and “requires more discussion, collaboration, or support.”

Discussion: CTC is an effective tool for self-reported measurement of outcomes of educational activities at the performance level with orthopedic surgeons and an interprofessional audience. Analysis based on a framework of competencies enables curriculum improvement by identifying content that could be adjusted and new materials to address the issues and barriers that were reported.

Dr. Cunningham: Curriculum Developer for the AOTrauma Orthogeriatrics Education Taskforce, AO Foundation-AO Education Institute, Dubendorf, Switzerland; Dr. Kates: Professor, Department of Orthopaedics, University of Rochester, United States; Dr. Blauth: Professor and Director, Department of Trauma Surgery, Medical University of Innsbruck, Austria.

Disclosures: The courses described in this article were developed from the AOTrauma orthogeriatrics curriculum. Either Dr. Kates or Dr. Blauth was a chairperson or a member of the faculty at each course. Dr Cunningham is an employee of the AO Education Institute and supported the design and development of the curriculum.

Correspondence: Michael Cunningham, AO Foundation-AO Education Institute, Stettbachstrasse 6, 8600 Duebendorf, Switzerland; e-mail:

• Published online in Wiley Online Library (

Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company
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