Learning outcomes and practice changes after a postgraduate course in office orthopedics.

Although many of studies of continuing medical education have demonstrated information transfer and some have resulted in practice changes, little is known about the relationships between physician knowledge, intentions, and actual changes in clinical behavior. This paper presents the results of a study of immediate and delayed learning outcomes, including a parallel exploration of physician intentions and practice changes for three tracer procedures, among 83 physicians attending a post-graduate course in office orthopedics. A high level of knowledge gain and retention was found, and considerable change in practice behavior occurred in self-reported use of torsional profiles, ordering of shoulder arthrograms, and discontinued use of corrective shoes. Discrepancies between physicians' cognitive knowledge, their intentions to apply that knowledge, and reported clinical behavior were consistent with a conservative approach to orthopedic management among the primary care physicians studied.