Collaboration and Curriculums: Changing Healthcare Professional Behavior

Background:  HCPs are critical influencers of individual health behavior – 78% of people cited their HCP as an important source of health information and 35% go to their physician as their first resource for health questions (second only to the internet).  With this impact on consumers, they are a vital channel to behavior change.  Reaching HCPs can be challenge.  They are pressed for time and overloaded with information.  One of the most influential periods in HCP professional development is their residency training.  To meet this opportunity, CDC’s “Learn the Signs. Act Early.” campaign took on a new initiative: development of a pediatric residency curriculum.  This product, in conjunction with other offerings of this social marketing campaign, provides a new avenue of changing HCP behavior, thereby decreasing the average age of diagnosis for autism spectrum disorders (ASDs) and improving care for children with autism.

Program background:  ASDs have an estimated prevalence of approximately 1:110.  Pediatricians are increasingly expected to screen and diagnose children, and manage their educational, behavioral, and developmental needs. The “Learn the Signs. Act Early.” team identified a need for a pediatric residency curriculum through assessment with partners, including the Association of University Centers on Disabilities, the Maternal and Child Health Bureau (MCHB), and the Society for Developmental and Behavioral Pediatrics. The CDC and MCHB-Developmental-Behavioral Pediatrics programs took an innovative approach to curriculum creation.  Teams of developmental-behavioral pediatric fellows and faculty at some of the nation’s most prominent medical schools developed case content.  These teams are uniquely positioned to know important medical content through their specialist experience as well as the learning process and needs of residents.  The resulting curriculum addresses fundamental components of identifying, diagnosing, and managing ASDs.

Evaluation Methods and Results:  Pilot testing with 48 facilitators validated the content and approach and showed self-reported improvement in learning objectives. 

• Early Warning Signs: 89%
• Screening: 87%
• Communicating Abnormal Results from a Screening Tool: 61%
• Making an Autism Diagnosis: 94%
• Early Intervention and Education: 90%
• Treatments for Autism: 83%
• Autism-Specific Anticipatory Guidance: 87%

Pre/post testing currently underway will measure achievement of learning objectives.  Preliminary results suggest strong knowledge gain; full results will be available during the presentation.

Conclusions:  Though requiring significant time investment and true collaboration, a pediatric residency program can help improve the knowledge of HCPs, an important step in changing practice behaviors.

Implications for research and/or practice: Health organizations can apply the approach and findings of this process to improve their own outreach to HCPs.

• Expert and audience-developed: Using teams of leading faculty and fellows to develop the curriculum lent twofold benefits – high quality content ensured through inclusion of field leaders, while fellows confirmed it meets practical needs of future facilitators.
• Collaboration leads to success: Residency education can be a difficult goal; however, collaboration with experts in the field and key decision makers throughout the process improves results and implementation.
• Use effective learning methods: Case-based learning is the preferred method of learning among HCPs.
• Facilitator flexibility:  HCP educators utilize a variety of teaching techniques.  Providing multiple resources and information on a variety of topics allows facilitators to customize sessions.