Description (provided by the applicant): My long-term career goal is to develop, implement and rigorously evaluate online educational interventions which facilitate the translation of clinical guidelines into evidence-based clinical practice and which improve the quality of healthcare delivery. To accomplish this, my short-term goal is to develop a strong background in health outcomes research techniques and expertise in health services research. With the support of this K08 award, I also hope to demonstrate that a novel form of online educational intervention can substantially impact clinical practice and healthcare quality. I am applying to the AHRQ K08 program to complement a non-renewable VA Research Career Development Award which will soon end. That three year award has afforded me the opportunity to develop my knowledge base in clinical trial design and statistics. However, in spite of my hard work and high productivity, I realize that I need additional protected time to establish myself as an independent health services research investigator. Since I am a urologist, I have designed a research project that utilizes prostate-specific antigen (PSA) screening for prostate cancer as an experimental system to assess the efficacy of an online spaced education program which, in our preliminary studies, has been shown to increase the acquisition and retention of clinical knowledge. None of the major clinical practice guidelines recommend that PSA screening be routinely performed in asymptomatic males over age 76, but in spite of this consensus, age inappropriate PSA screening is performed frequently. My central hypothesis is that implementation of an online spaced education intervention focused on the PSA screening clinical practice guidelines (CPGs) will optimize primary care providers' long-term CPG knowledge and reduce their age-inappropriate prostate cancer screening of their male patients. To test this hypothesis, I will conduct a multi-institutional randomized controlled trial involving VA primary care providers to measure how the spaced education intervention impacts their PSA utilization patterns over 18 months. With support of the K08 award I will also undertake mentored study and coursework in epidemiology, clinical trials, and assessment methodology.