Effects of a short educational intervention on interns' professional confidence regarding drug treatment management in clinical practice: Randomized controlled study

[Speaker] Johan Lonnbro:1,2
[Co-author] Karin Nylen:3, Susanna Wallerstedt:3
1:Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden, 2:Sahlgrenska Academy, University of Gothenburg, Sweden, 3:Sahlgrenska Academy, Dept. of Pharmacology, University of Gothenburg, Sweden

Prescribing of drugs is a core skill for a physician. Consequently, it is essential that practicing physicians are confident in drug treatment management. However, in an unpublished questionnaire study (2013; n=47), we found that 60% of the interns were not confident in performing basic medication reviews, that is, to reconcile the drug treatment and ascertain that it is reasonable given the patient's current health status. Therefore, this study was performed to evaluate if an educational intervention could increase the interns' professional confidence in drug treatment management in clinical practice.

A randomized controlled trial was performed in Sahlgrenska University Hospital, Gothenburg, Sweden. Interns, recruited in 2014 to 2016, were randomly allocated to intervention or control group (1:1). The intervention consisted of two three hour seminars, led by an internist and a clinical pharmacologist, focused on collegial discussions on fictive and authentic cases, including tips on practical handling of the electronic medical records system with integrated decision-support tools. The effects of the intervention were evaluated with a questionnaire, distributed at baseline and six month follow-up, in which the interns were to grade their agreement to statements from 1 (completely disagree) to 5 (completely agree). In bivariate analyses, those rating 4 or 5 were categorized as agreeing.

A total of 69 interns were included, 57 of whom (83%) completed the questionnaire at baseline and follow-up (54% female; median age: 29 years; 28% with research-oriented internship). The intervention group increased their agreement to statements reflecting confidence in drug treatment matters to a greater extent than did the control group (Table). At follow-up, 23 (89%) of 26 evaluable interns in the intervention group, compared with 18 (58%) of 31 in the control group, stated that they were confident in performing basic medication reviews. The odds for being confident were 8.4 times greater in the intervention group (95% confidence interval: 1.8; 40), after adjustments for age, sex, research experience, work experience, and baseline confidence.

A limited educational intervention, based on collegial discussions on cases, can improve junior physicians' confidence in drug treatment management in clinical practice.

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