Integrating continuous medical education with quality improvement (QI) activities was difficult. Therefore, for a study, researchers sought to evaluate one technique, Interactive Spaced Education (ISE/QI), with conventional (STD/Qi) education as part of a Qi project for constipation control. Randomized, controlled research was done to compare ISE/QI with STD/QI education. A network of local private practices was used to recruit pediatric primary care practitioners (PCPs). Prior to teaching interventions, the QI program was undertaken with all providers. Over 4 months, ISE/QI participants received questions via email weekly, gave responses, got comments, and repeated questions. The STD/QI group was given a PowerPoint presentation with the same teaching content. Pre- and post-surveys examined usability, confidence, and practice improvements, while quizzes tested knowledge. Process control charts are recorded following gastroenterologist (GI) visits. 

About 101 (48%) of the 212 eligible PCPs registered, with 49 in the ISE/QI arm and 52 in the STD/QI education arm. A large effect size improved quiz results in the ISE/QI arm (Cohen d 1.76). The ISE/QI group had a larger mean improvement in confidence while dealing with tough instances (1.84 vs. 1.21, P=0.030). ISE/QI participants were more likely than other online education participants to judge the activity positively (odds ratio [OR] 18.1, P = 0.0001) and to implement practice modifications (OR 3.35, P=0.0152). Overall, GI visits were reduced, but the effect on GI visits within each education arm was mixed. ISE/QI increased expertise and confidence in dealing with complex problems. Participants in the ISE/QI indicated a higher chance of changing practice, but no changes were observed in GI referrals.