To evaluate objective 1, the dependent variable is the number of continuing education hours in which a CEO had participated in the past 12 months. continuing education was defined as instructional programs or processes that would bring the participants up to date in a particular area of knowledge or skills that may be obtained through in person seminars at participant's facility or offsite; the use of electronic media, such as CDs or DVDs; online seminars; webinars; conferences with platform presentations; self study manuals/ guides; and books or journals discussion group.