Effects of a Web-based Educational Module on Pediatric Emergency Medicine Physicians’ Knowledge, Attitudes, and Behaviors Regarding Youth Violence

Abstract

Introduction:Youth seen in the emergency department (ED) with injuries from youth violence (YV) have increased risk for future violent injury and death. Pediatric emergency medicine (PEM) physicians rarely receive training in, or perform, YV screening and intervention. Our objective was to examine effects of a web-based educational module on PEM physicians' knowledge, attitudes, and behaviors regarding YV screening and interventions in the ED.Methods:We invited all PEM fellows and attendings at an urban Level I pediatric trauma center to complete an interactive web-based education module (and 1-month booster) with information on YV's public health impact and how to screen, counsel and refer YV-involved patients. Consenting subjects completed electronic assessments of YV prevention knowledge and attitudes (using validated measures when possible) before and after the initial module and after the booster. To measure behavior change, chart review identified use of YV-specific discharge instructions in visits by YV-injured PEM patients (age 12–17; identified by E codes) 6 months before and after the intervention. We analyzed survey data were analyzed with Fisher's exact for binary outcomes and Kruskal-Wallis for Likert responses. Proportion of patients given YV discharge instructions before and after the intervention was compared using chi-square.Results:Eighteen (67%) of 27 PEM physicians participated; 1 was lost at post-module assessment and 5 at 1 month. Module completion time ranged from 15–30 minutes. At baseline, 50% of subjects could identify victims' re-injury rate; 28% were aware of ED YV discharge instructions. After the initial module and at 1 month, there were significant increases in knowledge (p<0.001) and level of confidence speaking with patients about avoiding YV (p=0.01, df=2). Almost all (94%) said the module would change future management. In pre-intervention visits, 1.6% of patients with YV injuries were discharged with YV instructions, versus 15.7% in the post-intervention period (p=0.006, 95%CI for difference 3.6%-24.5%).Conclusion:A brief web-based module influenced PEM physicians' knowledge and attitudes about YV prevention and may have affected behavior changes related to caring for YV victims in the ED. Further research should investigate web-based educational strategies to improve care of YV victims in a larger population of PEM physicians.

Development and Evaluation of a Web-Based Educational Toolkit on the Knowledge, Attitudes, and Practices of Psychiatric Prescribers Regarding Long-Acting Injectable Antipsychotics

“…Development of education to address psychiatric prescribers' knowledge deficits, uninformed attitudes, and poor prescribing practices that prevent LAIs from being utilized as a treatment option in those with schizophrenia is needed. Studies have indicated that the use of toolkits can facilitate translation of evidence into practice (Yamada et al, 2015), and web-based education has shown promise at improving the knowledge, attitudes, and practices of medical professionals (Madsen et al, 2014).…”

Improving Uptake of Emergency Department-initiated Buprenorphine: Barriers and Solutions

“…It has been used to understand and contextualize the relative uptake of computed tomography clinical imaging rules 34 and has also been used to design clinical curriculums that successfully modified the behavioral intentions of EPs. 35 More recently, Samuels et al and Choo et al used TPB as a framework to inform changes in opioid-related clinical behaviors among clinicians in the ED. 36 , 37 …”

A Novel Pediatric Emergency Department Intervention to Improve Adolescent Sexual Health Care

“…While this study had a small sample size and lacked a control group, the literature demonstrates that similar sample sizes and design have been used for initial intervention evaluation. 33,34,35 Data was collected from a single, Midwestern urban pediatric ED, thus findings may not be generalizable to trainees in varied geographic locations. Due to the rotating nature of trainees in the ED, we only obtained immediate post-intervention assessments and do not know if changes will be sustained over time.…”