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Volume 29 (4)

Volume 29, Issue 4, Fall 2009line
J Contin Educ Health Prof 2009; 29(4): 246
ORIGINAL RESEARCH

Characteristics that predict physician participation in a Web-based CME activity: The MI-Plus study
Michael J. Schoen, Edmond F. Tipton, Thomas K. Houston, Ellen Funkhouser, Deborah A. Levine, Carlos A. Estrada, Jeroan J. Allison, O. Dale Williams, Catarina I. Kiefe

A b s t r a c t

Introduction: Physician use of the Internet for practice improvement has increased dramatically over the last decade, but research shows that many physicians choose not to participate. The current study investigated the association of specific physician characteristics with enrollment rates and intensity of participation in a specific Internet-delivered educational intervention to improve care to post–myocardial infarction (MI) patients.
Methods: Primary-care physicians were recruited for participation in a randomized controlled trial designed to compare effectiveness of an intervention Web site versus a control Web site in the management of adult chronic disease. Physicians were informed that the intervention focused on ambulatory post–myocardial infarction patients. Physician characteristics were obtained from a commercial vendor with data merged from the American Medical Association and Alabama State Licensing Board. Enrollment and Web use were tracked electronically.
Results: Out of a sample of 1337 eligible physicians, 177 (13.2%) enrolled in the study. Enrollment was higher for physicians with more post-MI patients (≤ 20 vs < 20 patients, 15.3% vs 9.3%, p = .002) and for those practicing in rural compared to urban areas (16.3% vs 12.1%, p = .046). Intensity of use of the Internet courses after initial enrollment was not predicted by physician characteristics in the current sample.
Discussion: Physicians with more post-MI patients and rural practice location were found to predict enrollment in an Internet-delivered continuing medical education (CME) intervention designed to improve care for post-MI patients. These factors predicted program interest but not program use. More research is needed to replicate these findings to investigate variables that determine physician engagement in Internet CME.

Lessons For Practice
  • Clinical relevance was a strong predictor of enrollment in Web-delivered CME, as with all CME.
  • Rural practices were more likely to enroll in Web-delivered CME.
  • Participants may be viewed as innovators and early adopters from a diffusion of innovation perspective.
  • On-line CME may be seen as a type of disruptive technology.
  • Future research is needed to identify the educational needs of rural providers, and strategies for increasing participation in Internet CME more clearly.

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