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

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  • Antonius Schneider

    (TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
    Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, 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
    Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany)

  • Siona Laverty

    (TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
    Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany)

  • Stefanie Ziehfreund

    (TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
    Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany)

  • Alexander Hapfelmeier

    (TUM School of Medicine, Institute of General Practice and Health Services Research, Technical University of Munich, Munich, Germany
    TUM School of Medicine, Institute of Medical Informatics, Statistics and Epidemiology, Technical University Munich, Munich, Germany)

  • Dagmar Schneider

    (Kompetenzzentrum Weiterbildung Allgemeinmedizin Bayern (KWAB), Erlangen, Germany
    Koordinierungsstelle Allgemeinmedizin, Munich, 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
    Institute of General Practice, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany)

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.

Suggested Citation

  • Antonius Schneider & Markus Bühner & Therese Herzog & Siona Laverty & Stefanie Ziehfreund & Alexander Hapfelmeier & Dagmar Schneider & Pascal O. Berberat & Marco Roos, 2021. "Educational Intervention Reduced Family Medicine Residents’ Intention to Request Diagnostic Tests: Results of a Controlled Trial," Medical Decision Making, , vol. 41(3), pages 329-339, April.
    • Handle: RePEc:sae:medema:v:41:y:2021:i:3:p:329-339
    DOI: 10.1177/0272989X21989692
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    References listed on IDEAS

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    1. Antonius Schneider & Magdalena Wübken & Klaus Linde & Markus Bühner, 2014. "Communicating and Dealing with Uncertainty in General Practice: The Association with Neuroticism," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-7, July.
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