Our philosophy to change physician behavior is based upon Prochaska’s transtheoretical model for adult learning, which recognizes that adults are inherently resistant to change. However, through a series of small sequential steps of enlightenment and awareness via unique educational engagement, it is possible to elicit change.

Figure 1.0: Prochaska’s Transtheoretical Model (TTM) integrates stages, processes and levels of change.

In 1977, James O. Prochaska, Ph.D, Professor Emeritus in the department of Psychology and Clinical Psychology at the University of Rhode Island, and Carlo DiClemente, Ph.D., Professor Emeritus in the department of Psychology at the University of Maryland (UMBC, developed the Transtheoretical Model (TTM; Prochaska, 1979) as a theoretical framework of intentional behavior change  (Prochaska & Di Clemente, 1982) that integrates stages, processes and levels of change and helps assess the willingness of an individual to adapt to new and healthier behaviors, including smoke cessation, as well as management of stress, weight, and depression.

A Model for Physicians
At Sunvalley Communication we have adopted Prochaska’s Transtheoretical model, which suggests that behavior evolves through stages from pre-contemplation, to contemplation, to preparation, to action, and to maintenance of change, to include research-based and practice changing understanding of clinical data in the development of customized medical publishing and educational plans. This approach includes carefully designed strategies to help physician’s appraise published (peer reviewed) medical research, improve their information management by synthesizing the available peer reviewed evidence, describing the current evidence base of effectiveness and efficiency of dissemination and implementation strategies, and test and explore the mechanisms leading implementation of change in the clinic.

While traditional medical education programs are designed to affect knowledge and beliefs, they rarely results in the adoption of practice changing behavior.  To help move physicians and medical/health care professionals on a continuum from pre-contemplation towards a maintenance approach, resulting in deeper understanding of the teaching materials leading to a long-term behavioral change, we (custom) develop multistage motivational strategies designed to preparing physicians for change. In our process we focus on change as a result of a better understanding of peer reviewed, evidence-based materials and how each stage of the process strengthens the desired clinical outcomes to benefit patients.

Educational Impact
Measuring the the educational impact of education programs can be challenging. Using Prochaska’s transtheoretical model for adult learning helps to measure change behavior and to asses the readiness of learners’ (i.e physicians, nurses, etc.) to act (i.e. prescribing readiness), as well as measure the efficacy of education approaches designed to improve the performance of practicing physicians. The outcomes from this evaluation help in a better understanding why (and how) some learning activities are more effective than others. It also helps in planning future education programs designed to meet learners’ needs in each stage of the desired behavior change

Evidence-based Medicine
One of the central dogmas in healthcare, evidence-based medicine (also referred to as EBM) has been advocated for decades. Evidence-based medicine not only helps in revolutionizing healthcare practices, but also improve the standard of healthcare for everyone. However, adopting evidence based medicine in their medical practice, physicians may face a difficult challenge. Hence, effective strategies for driving physician behavioral change and adopting evidence-based medicine are necessary.

Improving patient performance
Prochaska’s transtheoretical model for adult learning can be an effective tool to drive physician behavioral change and adopting evidence-based medicine. In turn, physicians can apply Prochaska’s transtheoretical model to solicit behavioral changes among their patients. For example, providing (medical and treatment) information to patients may not necessarily result in a positive outcome. Rather, assessing a patient’s skill and understanding the required treatment, and, where neccessary, simplifying a treatment regimen, helping patients to adhere to their therapy, answering questions, and modifying a patient’s deeply entrenched (often faulty) understanding and beliefs, using ‘treatment contracts’ that involve patients in the (treatment) decision making process, and enlisting family & friends and social support in guiding their patients, may be required to improve patient’s adherence to treatment regimens.

Effective programs
We understand the learning patterns and behaviors of various specialists, ranging from oncologists and hematologists to oncology nurses and primary care physicians. This understanding helps us give our clients the best possible return on their investment and the broadest reach of promotional educational programs

Proven research has shown that our method of applied technology is an effective method in reaching the medical/science and physician communities.


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