Evaluation of the effectiveness of an educational intervention for general practitioners in adolescent health care: randomised controlled trial Commentary: Applying the BMJ's guidelines on educational interventions

Abstract

OBJECTIVE: To evaluate the effectiveness of an educational intervention in adolescent health designed for general practitioners in accordance with evidence based practice in continuing medical education. DESIGN: Randomised controlled trial with baseline testing and follow up at seven and 13 months. SETTING: Local communities in metropolitan Melbourne, Australia. PARTICIPANTS: 108 self selected general practitioners. INTERVENTION: A multifaceted educational programme for 2.5 hours a week over six weeks on the principles of adolescent health care followed six weeks later by a two hour session of case discussion and debriefing. OUTCOME MEASURES: Objective ratings of consultations with standardised adolescent patients recorded on videotape. Questionnaires completed by the general practitioners were used to measure their knowledge, skill, and self perceived competency, satisfaction with the programme, and self reported change in practice. RESULTS: 103 of 108 (95%) doctors completed all phases of the intervention and evaluation protocol. The intervention group showed significantly greater improvements in all outcomes than the control group at the seven month follow up except for the rapport and satisfaction rating by the standardised patients. 104 (96%) participants found the programme appropriate and relevant. At the 13 month follow up most improvements were sustained, the confidentiality rating by the standardised patients decreased slightly, and the objective assessment of competence further improved. 106 (98%) participants reported a change in practice attributable to the intervention. CONCLUSIONS: General practitioners were willing to complete continuing medical education in adolescent health care and its evaluation. The design of the intervention using evidence based educational strategies proved an effective and quick way to achieve sustainable and large improvements in knowledge, skill, and self perceived competency.