Rheumatology algorithms for primary care physicians

Abstract

Primary care physicians were trained on three rheumatology topics to assess the effectiveness of an educational strategy for continuing medical education. Algorithm training was shown to be at least as effective as that based on standard prose monographs. Both training groups improved their knowledge of patient management skills but there were no statistically significant differences between groups in the amount learned. When algorithms were used to design text materials, the designed texts required less study time than did the annotated clinical algorithms alone. That difference was significant for the shoulder pain materials (P < 0.05) but not for the osteoporosis materials. The ratio of knowledge gained to study time was significantly higher for the algorithm group on the low back pain topic (P < 0.05) but not for the other topics. Taped interview problems tests were studied as a method for assessing patient management skills related to problem-specific indicator conditions and were found to produce interrater reliability greater than 0.80 on five of the six tests.Continuing Medical Education (CME) is a critical link in the process of transferring the knowledge gained from arthritis research into the clinic environment where it can benefit patients. Improvements in patient care and outcomes frequently depend upon the education of health care providers on improved techniques, medications, and treatment strategies. This paper presents data obtained from a study sponsored by the National Fund for Medical Education. That study sought to assess the effectiveness of clinical algorithms (i.e., decision-making flow charts) as an instructional methodology in a CME environment for primary care physicians. The specific research question addressed was: "Do practitioners learn more effectively and efficiently from clinical algorithms than from standard prose texts?" In connection with the CME training experiments conducted with three annotated clinical algorithms covering rheumatology topics, this study also provided the opportunity to examine the reliability of a taped interview problems (TIP) test of patient management skills and the impact of clinical algorithms in helping to construct educational materials.

A survey of the management of leg ulcers in primary care settings in Scotland

“…In the medical profession, the use of clinical guidelines has been shown to encourage appropriate care (Delamothe, 1993) and to be a useful education strategy for continuing professional education (Ambrose et al, 1990). Evidence-based practice is now acknowledged to be the optimum basis for clinical decision-making (Sackett et al, 1991), and Grimshaw & Russell (1993) have demonstrated that properly developed guidelines can change clinical practice and may lead to improved patient compliance.…”

Critical appraisal of continuing medical education in the rheumatic diseases for primary care physicians

“…Ambrose et al (39) compared the use of clinical algorithms with standard prose for training primary care physicians and family practice residents in the management of low back pain, osteoporosis, and shoulder pain. An increase in physician knowledge was found after the training (P < 0.001 for low back pain and osteoporosis; P not significant for shoulder pain), but there were no differences between the algorithm and prose groups.…”