Peering inside the clock: using success case method to determine how and why practice-based educational interventions succeed.

Introduction: No educational method or combination of methods will facilitate implementation of clinical practice guidelines in all clinical contexts. To develop an empirical basis for aligning methods to contexts, we need to move beyond "Does it work?" to also ask "What works for whom and under what conditions?" This study employed Success Case Method to understand how 3 performance improvement CME activities contributed to implementation of tobacco cessation practice guidelines in 9 outpatient practices.

Methods: Success criteria were applied to clinical data from 93 practices, generating a pool of 14 success cases; 9 were recruited into the study.