Using a Commitment to Change Tool for Evaluation and Planning of a Global Competency-Based Curriculum in Orthogeriatrics

Introduction Measuring the outcomes of educational activities at the performance level is a challenge for all medical educators. This study reports retrospective outcomes data from the administration of a commitment to change (CTC) at orthogeriatrics courses and how the findings were used for curriculum improvement. Methods During 2010-2012, a CTC questionnaire was administered at 8 educational courses attended by 513 orthopedic and trauma surgeons and medicine physicians in 5 countries. The CTC asked if physicians intended to change anything in their clinical practice as a result of participating and to list their specific changes. A 3-month follow-up was conducted to assess the status of intended changes and identify barriers to implementation. Results Two hundred seventy-six (54%) of the 513 course participants and faculty reported at least 1 intended change in their clinical practice (485 specific changes overall). The intended changes were quantified and analyzed further based on 10 competencies for orthogeriatrics. Follow-up responses were received for N = 150 (31%) of the intended changes. Of these changes, 24% were fully implemented, 51% were partially implemented, and 25% were not implemented. The main barriers to implementation were categorized as ongoing process (needs more time) and requires more discussion, collaboration, or support. Discussion CTC is an effective tool for self-reported measurement of outcomes of educational activities at the performance level with orthopedic surgeons and an interprofessional audience. Analysis based on a framework of competencies enables curriculum improvement by identifying content that could be adjusted and new materials to address the issues and barriers that were reported.