Educating community clinicians using principles of academic detailing in an evolving landscape

Abstract

Improving prescribing practices and patient health outcomes requires not just abstract knowledge about evidence-based practices but practical tools to support implementation. Continuing education can promote clinician behavior changes and improvements in patient outcomes more effectively when it includes opportunities for interactivity, use of multiple modalities, repeated exposure to content, longer-duration activities, and emphasis of outcomes that resonate with the target audience.1 Academic detailing involves direct educational outreach,2 including face-to-face interaction with clinicians, to achieve these goals. The educational method incorporates the principles of adult learning theories,3 theory of planned behavior,4 and social marketing5,6 with the goal of improving evidence-based practice behaviors.2,7 The intervention is delivered by trained professionals, typically pharmacists, physicians, nurses, or public health workers. Academic detailing was originally adapted from the communication approach employed by pharmaceutical representatives, which is centered around brief, one-to-one interactions in a clinician’s office. Academic detailing can address situations where there is an opportunity to change clinician behavior with focused and practical educational content. In the area of prescribing, these situations include those in which medications are misused, safer or less expensive medications are underused, or therapies offering marginal benefit are overused.2 Academic detailing involves an interactive discussion with clinicians in their practice setting, with a focus on improving individual clinical performance and recommending practice changes. The individualized focus distinguishes academic detailing from other quality improvement strategies, such as general lecture-based education on a topic, care coordination, practice facilitation, and practice redesign.8

Topics & Concepts