Ask around and see what people say when you pose the question, “What are the goals of medical education?” Responses will most likely vary from “to impart information to physicians” to “to improve outcomes for patients,” and many others in between. While none of these responses is likely to be wrong in itself, it is rare to hear discussion about the goals being depen dent on the desired outcomes of the educational intervention such as enhancing knowledge, chang ing attitudes, developing skills, or altering behav ior. One way to view this may be that there remains a substantial gap in knowledge about which educational activities truly affect the above parameters. This lack of knowledge hampers the ability to design and implement programs that can effect change in any one or all of these parame ters. For example, the inability of a single, oneoff intervention, such as a didactic lecture, to affect physician behavior by itself has been well docu mented. Multiple interventions using a variety of formats over a period of time have been shown to more consistently produce behavior change. By carefully deciding on the desired outcome, educa tion providers can more consistently deliver inter ventions that are truly designed to meet prede fined goals. The study of adult learning provides a frame work that can help advance the approach to designing effective medicaleducation interven tions. The core principles describe how adults learn best. Included are the fact that adults gen erally prefer learning activities that are problem centered rather than subjectcentered; they need to see benefit in the new knowledge by being able to apply it quickly through its relevance to realworld problems; they benefit from teaching techniques that build on previous knowledge and experience; they have a deep need for their learn ing to be selfdirected; and they want involve ment in the learning activity, which enhances knowledge retention. Designing educational activ ities that meet these needs creates an environ ment that moves adult learning from a passive activity — where only 50% of information that is seen and heard is retained — to an active learn ing activity — where 90% of what is seen, heard, said, and done is assimilated. Of course, to employ such principles, the edu cational outcomes need to be well defined before an effective intervention can be deployed. A valid outcome may very well be to impart product knowledge — particularly for a new product. But it should also be considered whether this improve ment in knowledge is really enough to effect behavior change if that is really the desired out come. Other parameters that may need to be consid ered include how to affect physicians’ attitudes toward a disease, a diagnosis, or a therapeutic regimen; how to enhance their skills in delivering patient care; or how to change their behavior. It is drawing a long bow to assume that imparting knowledge alone has the ability to affect all other parameters. Understanding the barriers to change provides additional insight into the design of educational interventions. The barriers may often not be a result of a lack of knowledge or information. A careful and thoughtful needs assessment should obviously help uncover these barriers, but skillful interpretation of latent (or unstated) needs may provide the greatest opportunity to design motivating and effective educational interven tions. This means understanding those needs that are stated in terms of the learner’s difficulty with solving particular problems, rather than stated as, Cathy Davies Strategic Planner/ Program Director INDUSTRY ISSUES PRECEPT MEDICAL COMMUNICATIONS, a Young & Rubicam company located in Berkeley Heights, NJ, focuses on medicaleducation initiatives and is part of the healthcare network that includes Sudler & Hennessey and IntraMed. For more information, please contact Donna Michalizysen, Managing Director, at 9082880101. How Far Have We Come? The study of adult learning provides a framework that can help advance our approach to designing effective medicaleducation interventions. If it were possible to consistently develop programs by defining the outcomes required and engaging the physician as learner, this surely would bode well for maximizing the return from any medicaleducation intervention. Educational Interventions for Changing Physician Behavior

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