Beno Luke, Hinchman Josephine, Kibbe Debra, Trowbridge Frederick
Department of Pediatrics, Kaiser Permanente of Georgia, Atlanta, GA, USA.
J Contin Educ Health Prof. 2005 Fall;25(4):248-58. doi: 10.1002/chp.38.
Clinicians report a low proficiency in treating overweight children and using behavioral management strategies. This paper documents the design and implementation of a training program to improve clinicians' skills in the assessment and behavioral management of pediatric overweight.
Two one-hour CME trainings were designed using published guidelines, research findings, and expert committee recommendations. The trainings were provided to clinicians of a managed care pediatric department, utilizing novel screening and counseling tools, and interactive exercises. Surveys and focus groups were conducted 3 and 6 months post intervention to examine clinician attitudes and practices regarding the screening and counseling tools.
Post intervention, the majority of clinicians agreed that the clinical practice guidelines (Pediatric Obesity Practice Resource) and BMI-for-age percentile provided useful information for clinical practice. Clinicians reported an increased utilization of the recommended screening tools and changes in office practices to implement these tools. They offered suggestions to improve the ease of use of the tools and to overcome perceived clinician and/or patient barriers.
A brief, cost effective, multi-faceted training and provision of counseling tools were perceived as helpful to clinical practice. Useful lessons were learned about tool design and ways to fit tools into practice. Training the entire health care team is advantageous to the adoption of new tools and practices.
临床医生表示在治疗超重儿童和运用行为管理策略方面能力欠佳。本文记录了一项培训项目的设计与实施情况,该项目旨在提高临床医生对小儿超重进行评估和行为管理的技能。
利用已发表的指南、研究结果和专家委员会的建议,设计了两次为时一小时的继续医学教育培训。培训面向一家管理式医疗儿科部门的临床医生,采用了新颖的筛查和咨询工具以及互动练习。在干预后的3个月和6个月进行了调查和焦点小组访谈,以考察临床医生对筛查和咨询工具的态度及实践情况。
干预后,大多数临床医生认为临床实践指南(《儿童肥胖症实践资源》)和年龄别体重指数百分位数为临床实践提供了有用信息。临床医生报告称,推荐的筛查工具的使用有所增加,并且在办公室实践中为实施这些工具做出了改变。他们提出了改进工具易用性以及克服临床医生和/或患者方面的感知障碍的建议。
简短、经济高效且多方面的培训以及提供咨询工具被认为对临床实践有帮助。在工具设计以及将工具融入实践的方法方面获得了有益经验。培训整个医疗团队有利于采用新工具和新实践。