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Interactive Seminar with Physicians

Article Citation:
Clark NM, Gong M, Schork MA, Evans D, Roloff D, Hurwitz M, Maiman L, Mellins RB. Impact of Education for Physicians on Patient Outcome. Pediatrics 1998;101(5)831-836

Intervention Setting:
The intervention was conducted in Ann Arbor, Michigan and New York City, New York. The meeting space was not further described.

Target Population:
The intervention targeted general practice pediatricians licensed no earlier than 1960 who provided direct patient care and, through them, their patients aged 1-12 years who had asthma.

Program Description:
The objective of this study was to assess the impact of an interactive seminar based on self-regulation theory on treatment, communication, and education behavior of physicians, the impact on the physician’s patients, and the satisfaction of the patient’s parents. Physicians completed a self-administered survey and parents were interviewed by telephone for baseline data collection. The seminar comprised two group meetings of the physicians, each lasting approximately 2½ hours, which were held over a 2- to 3-week period. Group size was limited to 12 physicians. The seminars were offered three times in each location. The seminar had two components: 1) optimal clinical practice and 2) patient teaching and communication. A total of 69 (93%) program and control group physicians completed a follow-up survey within approximately 5 months of the seminar (or, for controls, their assigned corresponding date). Parent follow-up occurred within a 22-month timeframe.

Evaluation Design:
Randomized controlled study

Sample Size:
The study participants included 74 general practice pediatricians assigned to program or control group and 637 of their patients.

Outcome Measures/Results:
Outcome measures included items related to clinical practice, including the use of particular medicines, procedures for encouraging self-management by patients, and aspects of patient teaching and communication behavior. Outcomes from parents included physician behavior, child’s symptoms, medicines prescribed, use of health care services, observations of the physicians’ teaching and communication behavior, and other aspects of physician-patient interaction. Following the seminar, physicians were significantly more likely than controls to treat newly diagnosed patients with inhaled corticosteroids, more likely to address patients fears about medicines, provide written instructions for medications, provide a sequence of educational messages, and spend less time with their patients. Parents of children treated by program physicians were significantly more likely than controls group parents to report that the physician had been reassuring, urged full activity for the child, and relieved worries, and the parents knew how to make disease management decisions at home. The children treated by program physicians were more likely to have received a prescription for inhaled anti-inflammatory medicine, have been observed using a metered-dose inhaler, and had fewer non-emergency office visits and visits for follow-up after symptoms. There were no differences in emergency department visits or hospitalizations.

Availability of Protocol/Materials:
The protocol and materials are not available for widespread distribution.

Case Study: None

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Data & Surveillance

Percents by Age, Sex, and Race, United States, 2012. Age: Child = 9.3%, Adult =  8.0%, Sex: Male = 7.0%, Female =  9.5%, Race/Ethnicity: White =  8.1%, Black =  11.9%, Hispanic =  7%. Source: National Health Interview Survey, National Center for Health Statistics, Centers for Disease Control and Prevention.

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