People often ask me what is a good indicator of impact…I usually answer world peace…then I get serious.

I won’t get into language today.  Impact–long term outcome.  For purposes of today, they are both the same:  CHANGE in the person or change in the person’s behavior.

Paul Mazmanian, a medical educator at Virginia Commonwealth University School of Medicine, wanted to determine whether practicing physicians who received only clinical information at a traditional continuing medical education lecture would alter their clinical behavior at the same rate as physicians who received clinical information AND information about barriers to behavioral change.  What he found is profound.  Information about barriers to change did not change the physician’s clinical behavior.  That is important.  Sometimes research yields information that is very useful.  This is the case here.  Mazmanian, etal. (see complete citation below) found (drum roll, please) that both groups of physicians were statistically significantly MORE likely to change their clinical behavior if they indicated their INTENT TO CHANGE their behavior immediately following the lecture they received.

The authors concluded that stated intention to change was important in changing behavior.

We as evaluators can ask the same question: Do you intend to make a behavior change and if so, what specific change.

Albert Bandura talks about self-efficacy.  That is often measured by an individual’s confidence to be able to implement a change.  By pairing the two questions (How confident are you that…and Do you intend to make a change…) evaluators can often capture an indicator of behavior change; that indicator of behavior change is often the best case for long-term outcome.


I’ll be at AEA this week.  Next week, I’m moving offices.  I won’t be blogging.


Mazmanian, P. E., Daffron, S. R., Johnson, R. E., Davis, D. A., & Kantrowitz, M. P. (1998). Information about barriers to planned  change: A randomized controlled trial involving continuing medical education lectures and commitment to change. Academic Medicine, 73(8), 882-886.

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One thought on “Intention to change

  1. Hey Englem,

    I believe that intention to change indicated by both groups of physicians was a kind of first little step that obliged them for further steps.

    It has something in common with a little trick performed by agents asking for donation. They first give you a free book or something which is a gift from them (or their organization) that you take (in most cases unintentionally). And then after this “gift” the agent kind of has a right to ask you for some favour – a little donation for their organization.

    There is a big chance that you will give them some money because the agent had given you the gift before. And you have expressed “intention to change” your ignorance and you come to a dialogue when you accepted the gift.

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