Integrating clinical practice guidelines into daily practice: Impact of an interactive workshop on drafting of a written action plan for asthma patients
✍ Scribed by Dr. Martin Labelle; Ms. Michèle Beaulieu; Dr. Paolo Renzi; Dr. Elham Rahme; Dr. Robert L. Thivierge
- Publisher
- John Wiley and Sons
- Year
- 2004
- Tongue
- English
- Weight
- 857 KB
- Volume
- 24
- Category
- Article
- ISSN
- 0894-1912
No coin nor oath required. For personal study only.
✦ Synopsis
Introduction: Written action plans ( WAPs) are instructions that enable asthmatics to manage their condition appropriately and are recommended by current asthma clinical practice guidelines (CPGs). However; general practitioners (GPs) rarely draft WAPs for their patients. An interactive, case-based workshop for asthma, combined with an objective structured clinical examination (OSCE), was developed to increase GPs'knowledge and use of WAPs in Qukbec.
Methods:
The study compared 24 GPs receiving an OSCEpreworkshop and 12 monthspostworkshop (group 1) with 16 GPs receiving an OSCE preworkshop and at 6 and 12 months post-workshop (group 2). Participants received no feedback on their OSCE performance. During the workshop, which presented a preformatted tool to aid drafting of the WAPs, all 40 GPs worked individually and in small groups to answer questions on a hypothetical clinical case and then discussed the responses with a facilitator and an asthma specialist.
Results: Only group 2 GPs showed a significant improvement in knowledge of WAPs 12 months post-workshop (p = .01). The likelihood of prescribing WAPs to patients increased in group 2 to a degree approaching statistical significance (p = .070), and there was a borderline nonsignificant trend for prescribing practice to improve more among group 2 GPs than among group 1 GPs (p = .052). There was also a nonsignificant trend for 6-month OSCE to increase attendance at the 12-month OSCE.
Discussion: An interactive workshop employing a preformatted WAP tool and a reinforcing OSCE at 6 months yielded improved knowledge of WAPs at 1 yeal: Although originally developed as a form of evaluation, the OSCE appears to have formative value even when correction is not provided and may increase the effectiveness of continuing medical education intewentions to enhance CPG implementation.