What Do Reinforcement and Confidence Have to Do with It? A Systematic Pathway Analysis of Knowledge, Competence, Confidence, and Intention to Change

The outcomes model most applied in continuing education for the health professions evaluation is Moore and colleagues' conceptual framework. Examination of how the levels interact and the role of confidence and intention to change can help outcomes professionals understand better how to impact clinician practice and conductand report outcomes studies. The current study examined the relationships among knowledge and competence change, confidence change, and intention to change across 57 online oncology certified education programmes published from 2018 to 2020 on Medscape.org. Findings indicate that not only improvement in knowledge and competence but also reinforcement of knowledge and competence are significant predictors of changes in confidence. They also indicate that knowledge and competence influence intention to change through confidence.