Statements of commitment to change are advocated both to promote physician change and to assess interventions designed to promote change. Although commitment to change is only one part of a complex process of change, recent progress has established a solid theoretical and research base to support this approach. Studies have demonstrated that it can be used effectively with many different types of educational activities and that statements of "plans to change " practice can predict actual changes. The importance of follow-up as part of the commitment to change model is becoming clearer, although questions remain about the most effective process to accomplish this and the optimal timing. Further research is needed to establish the effectiveness of the commitment-to-change approach itself as well as to better understand the functions (and thus the forms) of the different components of the commitment-to-change model.