Short 2006b.

Study characteristics
Methods	Design: cluster‐RCT Unit of randomisation: all physicians in an office assigned to the same study or control group
Participants	Healthcare provider: physicians Other: N/A Location/Setting: community practice settings in Arizona and Missouri, USA Sample size cluster: n = 65 offices (intervention group n = 34, control group n = 31) physicians: n = 81 (intervention group n = 44, control group n = 37) Number of withdrawals/dropouts cluster: n = 16 (intervention group n = 15, control group n = 1) physicians:  n = 31 (intervention group n = 22, control group n = 9) Sex: 52% ‐ 56% men Mean age: 47 years Inclusion criteria: community physician specialists in internal medicine, family medicine, paediatrics, obstetrics and gynaecology, and psychiatry in Kansas City and Phoenix, USA; physicians in private (non‐university, non government) practice in the medical specialty, in a group of 7 or fewer physicians, and who have internet access Exclusion criteria: not reported
Interventions	Intervention (n = 44): 4 ‐ 16 hours of asynchronous interactive online IPV e‐teaching; content included 17 case studies that simulated typical presentations; to receive 4 hours of continuing medical education credit, physicians had to complete minimum cases for their specialty (3 ‐ 4) and the ‘readiness to change’ case Control (n = 37): no online IPV training
Outcomes	Primary outcomes: measured on paper‐based PREMIS survey tool Attitudes (actual attitudes and beliefs) Knowledge (actual knowledge) Readiness to manage, respond or perceived efficacy to manage or respond Perceived referrals (i.e. readiness to refer; e.g. practices were assessed via a checklist that recorded the presence or absence of overall office practices such as referral relationships) Perceived identification or readiness to identify or screen for IPV (e.g. practice checklist to assess identification, documentation, and risk assessment) Secondary outcomes: not reported Timing of outcome assessment: 6 and 12 months post‐training
Notes	Study start date: 2003 Study end date: 2006 Funding source: The development of the online continuing medical education programme and the research study were supported by a small business innovation and research grant (R44‐MH62233) from the National Institute of Mental Health Conflicts of interest: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Comment: incomplete information provided Quote: "Physicians were randomly assigned to the CME (study) or to the control group, stratified by city, after completing the initial KABB survey and site visit" (p 182)
Allocation concealment (selection bias)	Unclear risk	Comment: the authors do not report sufficient information for an assessment to be made
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Comment: the authors do not report sufficient information for an assessment to be made
Blinding of outcome assessment (detection bias) All outcomes	Low risk	Comment: self‐reported outcomes and therefore risk of bias from lack of blinding of assessors is low Quote: "Physician IPV KABB was measured via a self‐administered, paper‐based survey tool, physician readiness to manage intimate partner violence survey (PREMIS)" (p 183)
Incomplete outcome data (attrition bias) All outcomes	High risk	Comment: > 20% attrition Quote:"85 physicians initially agreed to participate in the study; however, only 81 physicians completed the first PREMIS surveys. Forty‐four of these physicians were randomly assigned to take the online CME. When the study ended approximately 12 months later, 61% of the physicians had been retained through all three phases" (p 183)
Selective reporting (reporting bias)	Unclear risk	Comment: results for the primary outcomes mentioned in the Methods section were briefly reported in the paper. Adequate data were not provided and some extra results were obtained from the author
Other bias	Unclear risk	Comment: power calculations and analyses do not appear to account for intra‐cluster correlation Quote:"Power calculations were conducted for a two‐group repeated measures design with three time points and an unbalanced design with 52 cases (29 control and 23 study cases). Considering means ranging from 3.5 to 4.5 in the intervention group, and remaining consistent at 3.5 in the comparison group, standard deviations of 1 in both groups, and correlations of 0.5 between levels of the repeated measures, the power to detect moderate effects of 0.20 was 0.88" (p 183)