Effects of structured encounter forms on pediatric house staff knowledge, parent satisfaction, and quality of care. A randomized, controlled trial.

OBJECTIVE

To evaluate the effects of health supervision structured encounter forms on pediatric house staff knowledge, parent satisfaction, and quality of care.

DESIGN

Randomized, controlled trial.

SETTING

Pediatric house staff continuity clinic in a university-based children's hospital.

PARTICIPANTS

53 pediatric house officers and 153 parents.

INTERVENTIONS

House staff were randomized to use structured encounter forms focused on developmental milestones (group 1) or anticipatory guidance/preventive care (group 2) during health supervision visits.

OUTCOME MEASURES

Changes in house staff knowledge were assessed with pretests and posttests. Parent satisfaction was assessed with surveys. Quality of care, defined as compliance with recommended guidelines for age-specific health supervision, was assessed by audiotaping visits.

RESULTS

Group 1 demonstrated greater but not significantly different improvement in knowledge of developmental milestones than group 2, while group 2 improved more than group 1 in knowledge of anticipatory guidance/ preventive care. Parent satisfaction with developmental screening was significantly greater for group 1 visits than for group 2 visits (P < .001). Group 1 demonstrated significantly greater compliance than group 2 with recommended standards of developmental screening (P = .001).

CONCLUSIONS

The use of structured encounter forms for health supervision in pediatric house staff continuity clinics may increase house staff knowledge of developmental milestones and anticipatory guidance/preventive care, increases parent satisfaction with developmental assessment during health supervision, and improves compliance with recommended guidelines for developmental assessment.