Pinkerton R E, Tinanoff N, Willms J L, Tapp J T
JAMA. 1980 Nov 14;244(19):2183-5.
As part of an educational program in preventive dentistry for family medicine residents, we evaluated changes in systemic fluoride prescribing habits related to newly acquired knowledge. Residents, unaware of the study, were randomly assigned to one of two groups and shown a videotape describing preventive dental techniques. We supplemented the tape viewed by one group with specific instructions explaining the implementation of the information in patient care. Residents in both groups demonstrated the ability to learn and maintain their level of knowledge during a three-month period. Daily chart audits, however, revealed no substantial increase in correct prescribing of systemic fluoride to pediatric patients for either group. Only subsequent individual monitoring and reinforcement achieved the desired behavior. The acquisition of new knowledge by resident physicians under these circumstances did not lead to its application in daily patient care. This result parallels reported difficulties in altering physician behavior by continuing medical education, and suggests that residency programs are an appropriate setting to initiate improved physician performance in response to acquired knowledge.
作为针对家庭医学住院医师的预防牙科教育项目的一部分，我们评估了与新获得的知识相关的全身用氟处方习惯的变化。住院医师在不知情的情况下被随机分为两组，并观看了一盘描述预防牙科技术的录像带。我们对其中一组观看的录像带补充了具体说明，解释如何在患者护理中运用这些信息。两组住院医师在三个月期间均表现出学习并维持知识水平的能力。然而，每日图表审计显示，两组对儿科患者正确开具全身用氟处方的情况均未大幅增加。只有随后的个体监测和强化措施才实现了预期行为。在这种情况下，住院医师获取新知识后并未将其应用于日常患者护理。这一结果与报道的通过继续医学教育改变医生行为的困难情况相似，并表明住院医师培训项目是促使医生根据所学知识提高表现的合适场所。
