Improving emergency medicine residentsʹ approach to patients with alcohol problems: A controlled educational trial

Study objective: We determine whether training using a structured skills-based intervention would improve emergency medicine residentsʹ knowledge and practice in screening and intervening with patients presenting to the emergency department with alcohol problems. Methods: In a controlled trial conducted at 2 similar emergency medicine residency programs associated with urban, Level I trauma centers, a 4-hour didactic, video, and skills-based workshop was conducted. Main outcome measures included (1) scores on changes in self-reported knowledge, current practice, self-efficacy, role-responsibility, attitudes and beliefs, and provider readiness to change from baseline to 1 year after intervention and (2) change in practice as measured by record review before and after intervention. Results: The intervention group (n=17) had a significant increase in knowledge scores (P<.001) and practice with regard to percent of medical records with evidence of screening and intervention (17% before versus 58% after; 95% confidence interval [CI] 31 to 50; P<.001); no change was observed in the control group (n=19). These increases were significantly different between groups (95% CI 30 to 54; P<.001). There were no significant differences within or between groups for composite scores derived for current practice, self-efficacy, role responsibility, or readiness to change. Conclusion: A brief, structured, educational intervention for residents contributed to significant improvement in knowledge and practice with regard to patients with alcohol problems. [DʹOnofrio G, Nadel ES, Degutis LC, Sullivan LM, Casper K, Bernstein E, Samet JH. Improving emergency medicine residentsʹ approach to patients with alcohol problems: a controlled educational trial. Ann Emerg Med. July 2002;40:50-62.]