Marchisio Paola, Mira Eugenio, Klersy Catherine, Pagella Fabio, Esposito Susanna, Bianchini Sonia, Di Mauro Giuseppe, Fusi Michela, Nazzari Erica, Tagliabue Marta, Bellussi Luisa, Principi Nicola
Department of Pediatrics, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy.
Pediatr Infect Dis J. 2009 Jan;28(1):1-4. doi: 10.1097/INF.0b013e318184ef02.
Medical education and guidelines have been advocated as major means of improving the management of otitis media. Limited data are available concerning medical education in acute otitis media (AOM), and the association between medical education and attitudes about AOM guidelines has never been explored.
To assess the prevalence of medical education concerning AOM, of a positive attitude toward AOM guidelines and of appropriate diagnostic methods in a large sample of Italian pediatricians (PEDs) and otolaryngologist (ENTs) and to look for possible associations between them.
This cross-sectional survey was based on the responses of 2012 physicians (1160 PEDs and 852 ENTs) to a mailed anonymous questionnaire.
Very few (9%) of the responders had received any AOM medical education during medical school, but the number increased during residency (38%) and peaked in the postresidency period (53%) with slight differences between PEDs and ENTs. Forty percent reported a positive attitude toward AOM guidelines, with PEDs having a better attitude than ENTs (46% vs. 32%, P < 0.001). An appropriate diagnostic method for AOM was reported by only 21% of the physicians (PEDs 11% vs. ENTs 35%, P < 0.001). AOM medical education during postresidency and reporting the use of appropriate diagnostic methods were significantly associated with a positive attitude about AOM guidelines.
Specific educational programs concerning AOM should be implemented and rigorously evaluated, before physicians become fully trained PEDs and ENTs, and maintained during postresidency. Evidence-based guidelines should be further incorporated into everyday practice of both PEDs and ENTs.
医学教育和指南已被倡导为改善中耳炎管理的主要手段。关于急性中耳炎(AOM)医学教育的数据有限,且医学教育与对AOM指南的态度之间的关联从未被探讨过。
在大量意大利儿科医生(PEDs)和耳鼻喉科医生(ENTs)样本中评估关于AOM的医学教育、对AOM指南的积极态度以及适当诊断方法的普及率,并寻找它们之间可能的关联。
这项横断面调查基于2012名医生(1160名PEDs和852名ENTs)对一份邮寄的匿名问卷的回复。
在医学院期间,很少有应答者(9%)接受过任何AOM医学教育,但在住院医师培训期间这一数字有所增加(38%),并在住院医师培训后阶段达到峰值(53%),PEDs和ENTs之间存在细微差异。40%的人报告对AOM指南持积极态度,PEDs的态度比ENTs更好(46%对32%,P<0.001)。只有21%的医生报告了AOM的适当诊断方法(PEDs为11%,ENTs为35%,P<0.001)。住院医师培训后阶段的AOM医学教育以及报告使用适当的诊断方法与对AOM指南的积极态度显著相关。
在医生成为完全培训合格的PEDs和ENTs之前,应实施并严格评估关于AOM的特定教育项目,并在住院医师培训后阶段持续进行。循证指南应进一步纳入PEDs和ENTs的日常实践中。