Best Practices / Research Oral Abstract

An Innovation in Continuing Professional Development to Improve Doctors’ Clinical Performance by the Use of Unannounced Standardized Patients (O016)

Mandana Shirazi (Assistant Professor of Tehran University and Karolinska Institutet); Sagar Parikh (University of Toronto)


The activating educational intervention, based on a three-stage modified Prochaska model of readiness-to-change was successful in improving both knowledge and practice performance of GPs’ and can be recommended for educational interventions within a CPD context in other countries.


The aim is to assess the effects of a tailored educational model based on the modified stages of change on the performance of General Physicians (GPs) in primary care for management of Depressive Disorders (DDs).


A stratified randomized controlled trial was conducted with 192 GPs in primary care in Tehran.

Intervention group

GPs in the attitude stage were included in a large education group and those in the intention stage were in a small group in a workshop setting. The emphasis of the former group was on diagnosis of DDs while the latter stressed treatment and differential diagnosis.

Control group

The GPs were divided into a large and small group, with the number tallying the numbers in the corresponding intervention groups. However, diagnosis and treatment of DDs were emphasized in both groups, where current CME methods for small and large groups were applied.

Assessments were made both before and after two months of intervention by the use of unannounced standardized patients whose total number of their assessments was the largest sample for the studies of this kind (365).


GPs in the intervention group improved their overall mean scores significantly for performances regarding diagnosis, with an intervention effect of 14 %, and treatment with an intervention effect of 20 %.

Applications and future directions: In intervention group an intervention effect of diagnosis was 14% and an intervention effect of treatment was 20%. The result was promising in improving both knowledge and practice of GPs and is recommended for educational interventions within a CPD context.