Implementing achievable benchmarks in preventive health: a controlled trial in residency education.
OBJECTIVE
To evaluate the Preventive Health Achievable Benchmarks Curriculum, a multifaceted improvement intervention that included an objective, practice-based performance evaluation of internal medicine and pediatric residents' delivery of preventive services.


METHODS
The authors conducted a nonrandomized experiment of intervention versus control group residents with baseline and follow-up of performance audited for 2001-2004. All 130 internal medicine and 78 pediatric residents at two continuity clinics at the University of Alabama School of Medicine, Birmingham, participated. Performance of preventive care was assessed by structured chart review. The multifaceted feedback curriculum included individualized performance feedback, academic detailing by faculty, and collective didactic sessions. The main outcome was difference in receipt of preventive care for patients seen by intervention and control residents, comparing baseline and follow-up.


RESULTS
Charts were reviewed for 3,958 patients. Receipt of preventive care increased for patients of intervention residents, but not for patients of control residents. For the intervention group, significant increases occurred for five of six indicators in internal medicine: smoking screening, quit smoking advice, colon cancer screening, pneumonia vaccine, and lipid screening; and four of six in pediatrics: parental quit smoking advice, car seats, car restraints, and eye alignment (p < .05 for all). For control residents, no consistent improvements were seen. There was greater improvement for intervention than for control residents for four of six indicators in internal medicine, and two of six in pediatrics.


CONCLUSIONS
Using a multifaceted feedback curriculum, the authors taught residents about the care they provide and improved documented patient care.
Houston
Thomas K
TK
Division of General Internal Medicine, University of Alabama at Birmingham School of Medicine, 35294, USA. thouston@uab.edu
Wall
Terry
T
Allison
Jeroan J
JJ
Palonen
Katri
K
Willett
Lisa L
LL
Keife
Catarina I
CI
Massie
F Stanford
FS
Benton
E Cason
EC
Heudebert
Gustavo R
GR
D000328:Adult; D000407:Alabama; D019985:Benchmarking; D004521:Educational Measurement; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D010372:Pediatrics / Q000193:education; D011315:Preventive Medicine / Q000193:education* / Q000706:statistics & numerical data