Comparing 2 Training Modalities Supporting the Adoption of the Safe Environment for Every Kid Approach in Pediatric Primary Care

Objective: To compare the impact of 2 common continuing medical education training modalities—independent online training (IND) and a Maintenance of Certification-4 (MOC) activity—on primary care professionals’ (PCPs’) thinking and practice behavior regarding the Safe Environment for Every Kid (SEEK) approach. This was part of an implementation science study scaling up the evidence-based practice, SEEK. Methods: This is a longitudinal, multisite, mixed methods, cluster randomized controlled trial comparing 21 pediatric primary care practices across the United States randomized to 1 of 2 training modalities. Two hundred ten PCPs completed surveys up to 4 times over a 2-year period to assess their thinking and practice regarding SEEK; a subset was interviewed up to 3 times. Results: Training led to significant and sustained improvements in PCPs’ thinking and behavior related to SEEK, with no significant differences between the IND and MOC groups. PCPs mostly viewed their training positively, but several described shortcomings. PCP characteristics, such as age and sex, did not moderate the impact of the training, nor did the presence of a behavioral health professional. Conclusions: The lack of significant differences between the training modalities favors the simpler IND modality. This was despite the MOC training employing key principles of adult education. Of note, MOC-4 credits are required for pediatric board certification. More research is needed to optimize continuing medical education and tailor approaches for different learners. Clinical Trial Registry and Data Sharing Statement: SEEK: Dissemination and Implementation, NCT03642327: https://clinicaltrials.gov/ct2/show/NCT03642327.