Klein L E, Charache P, Johannes R S
J Med Educ. 1981 Jun;56(6):504-11. doi: 10.1097/00001888-198106000-00007.
Pessimism has been expressed in the medical literature as to the efficacy of educational interventions in modifying practice patterns of graduate physicians. As a result, a prospective controlled trial of a specific form of educational intervention, the physician tutorial, was designed to test this belief. Physicians in the experimental group were surveyed to assess their knowledge of the effectiveness, cost and side effects of antibiotics used in the treatment of a preselected index condition, and a tutorial was developed to modify suboptimal prescribing patterns. Antibiotic usage patterns were initially similar for the experimental and control physicians. Prescribing patterns afterwards were statistically different, with the experimental physicians increasing their prescription of the encouraged antibiotics and decreasing that of the discouraged antibiotics. This was accompanied by a statistically significant decrease in direct drug charges. These results suggest that educational programs can be effective in modifying graduate physician prescribing practices.
医学文献中曾对教育干预在改变住院医师执业模式方面的效果表示悲观。因此,设计了一项针对特定教育干预形式——医师辅导教程——的前瞻性对照试验,以检验这一观点。对实验组的医师进行调查,以评估他们对用于治疗预先选定的索引病症的抗生素的有效性、成本和副作用的了解情况,并编写了一份教程以改变不理想的处方模式。实验组和对照组医师最初的抗生素使用模式相似。之后的处方模式在统计学上存在差异,实验组医师增加了推荐使用的抗生素的处方量,减少了不推荐使用的抗生素的处方量。同时,直接药物费用有统计学意义的下降。这些结果表明,教育项目在改变住院医师的处方行为方面可能是有效的。