Requesting a commitment to change: conditions that produce behavioral or attitudinal commitment

There is a lack of clarity in the conceptualization of commitment underlying the commitment to change (CTC) procedure used by organizers of continuing education in the health professions. This article highlights the two distinct conceptualizations of commitment that have emerged in the literature outside health care education and practice. The distinction is important because different antecedent conditions produce different types and dimensions of commitment. This article goes on to explore the antecedents of behavioral and attitudinal commitment and illustrates how different types of commitment may have been produced in previous CTC studies. As a result, the article also demonstrates the need for clarity in the conceptualization of commitment, especially to guide empirical research into the nature and strength of commitment produced by the variety of CTC strategies. Such research is relevant in increasing our understanding of how and why CTCs are able to influence practice change.