Key Clinical MessageThe loss of ANKRD11 gene confirms the diagnosis of KBG syndrome but does not elucidate the pediatric phenotype providing a counseling challenge. With the expansion of prenatal diagnosis, and the potential to perform whole‐exome sequencing antenatally, we must describe the genetic abnormalities, antenatal ultrasound findings, and phenotype concurrently to facilitate counseling.
This article describes a short-term evaluation of the behavioral and practice-related changes physicians have made as a result of attending one such course. Barriers that interfered with intended changes are described.
PROGRAM DESCRIPTIONThe course's history and contents are described elsewhere. 5,7,8 Course registration is limited to no more than 12 participants. The small-group experience gives participants opportunities to vent anger at being accused of wrongdoing, to learn that they are neither alone nor being singled out by a state medical board, to examine the reasons that might underlie misprescribing, and to learn strategies for preventing recurrence.Consistent with the literature on promoting physician behavior change, the three-day course combines traditional didactic instruction, confrontation, personal examination, practical planning, and problem solving. [9][10][11][12][13] Course objectives aim to help participants: • constructively re-channel anger associated with being remanded to the course
Participants made reasonable plans consistent with course objectives and made progress implementing most intentions. LTC physicians who attended the CME course intended to alter their behaviors, but significant obstacles interfered, at least in the short term. Most thought PPS would not change the quality of care provided in their institutions. Future courses should address implementation barriers.
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