title: Improving emergency medicine residents' approach to patients with alcohol problems: a controlled educational trial.
abstract: OBJECTIVE
  We determine whether training using a structured skills-based intervention would improve emergency medicine residents' 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.
  
  
  CONCLUSIONS
  A brief, structured, educational intervention for residents contributed to significant improvement in knowledge and practice with regard to patients with alcohol problems.
authors.affiliation: Section of Emergency Medicine, Yale University School of Medicine, New Haven, CT 06519, USA. gail.donofrio@yale.edu
authors.forename: Gail
authors.initials: G
authors.lastname: D'Onofrio
authors.forename: Eric S
authors.initials: ES
authors.lastname: Nadel
authors.forename: Linda C
authors.initials: LC
authors.lastname: Degutis
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Sullivan
authors.forename: Karen
authors.initials: K
authors.lastname: Casper
authors.forename: Edward
authors.initials: E
authors.lastname: Bernstein
authors.forename: Jeffrey H
authors.initials: JH
authors.lastname: Samet
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000175:diagnosis* / Q000628:therapy; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003237:Connecticut; D004635:Emergency Medicine / Q000193:education*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008404:Massachusetts; D010819:Physician's Role; D011159:Population Surveillance; D020377:Self Efficacy; D013663:Teaching / Q000379:methods