Predicting Clinical Practice Change: An Evaluation of Trainings on STD Knowledge, Diagnosis, and Treatment.

BACKGROUND STD clinical training for working professionals requires substantial time and resources. Understanding the predictors of change in worksite practices and barriers to change will allow educators, learners, and clinical leadership to aid in ensuring learned practices are implemented and barriers are addressed. METHODS Data for this analysis comes from the first standardized national evaluation of a CDC-funded clinical prevention training network, including pre-course registration and responses to immediate post (1 to 3 days)- and 90-day post-course evaluations from 187 courses. Univariate statistics describe the trainees and their workplace. Bivariate statistics describe their intention to change and actual change stratified by functional role and employment setting. Logistic regression identified predictors of self-reported changes in practice. RESULTS The strongest predictors for practice change included an intention to change and attendance at a training lasting four hours or more. Functional role was a weaker predictor of change in practice; employment setting did not predict change. Over half of the trainees (65.9%, n = 912) stated their intention to make a change in their practice immediately after training. At 90 days post-course, 62.4% (n = 863) reported making a practice change. Trainees that took courses lasting four hours or more reported making a change more often (70%) than trainees from shorter courses (53%). We also report on trainees' barriers to practice change. CONCLUSIONS Results suggest that longer trainings may result in more practice change than shorter trainings, recruitment of trainees should focus on those more likely to make a change in their practice, and future trainings should focus on organizational capacity building and assessing change at the organizational level.