A case-based teaching module combined with audit and feedback to improve the quality of consultations.
BACKGROUND
Medical consultation is an integral part of hospitalist physicians' practice, yet there is no uniform training to achieve competency in this area during residency.


OBJECTIVE
To improve the quality of medical consultations performed by hospitalists in an academic medical center.


METHODS
Single group pre-post study design comparing knowledge and behaviors after exposing physicians to an educational intervention.


METHODS
Johns Hopkins Bayview Medical Center, 2006-2007.


METHODS
Seven hospitalist faculty members, and 12 internal medicine house-staff members, who served on the medical consultation service during the study period.


METHODS
Participants were exposed to an educational intervention consisting of a case-based module teaching the principles of medical consultation, as well as audit and feedback in which they critically reviewed their most recent written consultations.


METHODS
Pretests and posttests were used to assess knowledge. Performance and physician behaviors were assessed following the intervention; consultations done by hospitalists in the months prior to the educational intervention were scored and compared to their postintervention consultations. Wilcoxon signed rank tests and paired t tests were used for the analyses.


RESULTS
Improvement in the median knowledge score (pretest vs. posttest) was significant only for house-staff and not for faculty (10/14 vs. 12/14, P = 0.03 and 11/14 vs. 12/14, P = 0.08, respectively). The quality of consults written by all hospitalists improved after the educational intervention; the mean scores increased from 2.7 to 3.3 (P = 0.0006).


CONCLUSIONS
This curricular intervention including audit and feedback was effective in improving the quality of medical consultations performed by hospitalist physicians.
Wright
Renee
R
Collaborative Inpatient Medicine Service, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, Maryland 21224, USA. rwrigh22@jhmi.edu
Howell
Eric
E
Landis
Regina
R
Wright
Scott
S
Kisuule
Flora
F
Minter Jordan
Myechia
M
D000046:Academic Medical Centers / Q000592:standards; D000328:Adult; D016022:Case-Control Studies; D005246:Feedback; D005260:Female; D020445:Hospitalists / Q000193:education* / Q000592:standards*; D006801:Humans; D008297:Male; D008485:Medical Audit / Q000592:standards*; D011787:Quality of Health Care / Q000592:standards; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D012017:Referral and Consultation / Q000592:standards*