Educational Intervention Reduced Family Medicine Residents’ Intention to Request Diagnostic Tests: Results of a Controlled Trial

Antonius Schneider, Markus Bühner, Therese Herzog, Siona Laverty, Stefanie Ziehfreund, Alexander Hapfelmeier, Dagmar Schneider, Pascal O. Berberat and Marco Roos
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Antonius Schneider: TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
Markus Bühner: Institute of Psychological Methods and Diagnostics, Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
Therese Herzog: TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
Siona Laverty: TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
Stefanie Ziehfreund: TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
Alexander Hapfelmeier: TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
Dagmar Schneider: Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
Pascal O. Berberat: TUM Medical Education Center, School of Medicine, Technical University of Munich, Munich, Germany
Marco Roos: Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany

Medical Decision Making, 2021, vol. 41, issue 3, 329-339

Abstract: Objective Dealing with uncertainty is a core competence for physicians. To evaluate the impact of an educational intervention on family medicine residents’ (FMRs’) intention to request diagnostic tests and their attitudes toward uncertainty. Methods Nonrandomized controlled trial. Intervention group (IG) FMRs participated in interactive “dealing with uncertainty†seminars comprising statistical lessons and diagnostic reasoning. Control group (CG) FMRs participated in seminars without in-depth diagnostic lessons. FMRs completed the Dealing with Uncertainty Questionnaire (DUQ), comprising the Diagnostic Action and Diagnostic Reasoning scales. The Physicians’ Reaction to Uncertainty (PRU) questionnaire, comprising 4 scales (Anxiety Due to Uncertainty, Concern about Bad Outcomes, Reluctance to Disclose Uncertainty to Patients, and Reluctance to Disclose Mistakes to Physicians) was also completed. Follow-up was performed 3 months later. Differences were calculated with repeated-measures analysis of variance. Results In total, 107 FMRs of the IG and 102 FMRs of the CG participated at baseline and follow-up. The mean (SD) Diagnostic Action scale score decreased from 24.0 (4.8) to 22.9 (5.1) in the IG and increased in the CG from 23.7 (5.4) to 24.1 (5.4), showing significant group difference ( P = 0.006). The Diagnostic Reasoning scale increased significantly ( P = 0.025) without a significant group difference ( P = 0.616), from 19.2 (2.6) to 19.7 (2.4) in the IG and from 18.1 (3.3) to 18.8 (3.2) in the CG. The PRU scale Anxiety Due to Uncertainty decreased significantly ( P = 0.029) without a significant group difference ( P = 0.116), from 20.5 (4.8) to 18.5 (5.5) in the IG and from 19.9 (5.5) to 19.0 (6.0) in the CG. Conclusion The structured seminar reduced self-rated diagnostic test requisition. The change in Anxiety Due to Uncertainty and Diagnostic Reasoning might be due to an unspecific accompanying effect of the extra-occupational seminars for residents.

Keywords: diagnostic reasoning; diagnostic test; family medicine; residency; uncertainty (search for similar items in EconPapers)
Date: 2021
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:41:y:2021:i:3:p:329-339

DOI: 10.1177/0272989X21989692

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