title: Can experiential-didactic training improve clinical STD practices?
abstract: BACKGROUND
  High rates of sexually transmitted diseases (STDs) present an ongoing costly public health challenge. One approach to reduce STD transmission is to increase the number of clinicians adopting the Centers for Disease Control and Prevention's STD Treatment Guidelines. This evaluation assesses the effectiveness of a 3-day experiential and didactic training to translate recommendations into practice by increasing clinician knowledge and skills and helping participants anticipate and overcome barriers to implementation.
  
  
  METHODS
  Between 2001 and 2004, 110 direct care clinicians from 10 states participated in one of 27 standardized 3-day interactive trainings offered by the Denver STD/human immunodeficiency virus (HIV) Prevention Training Center. STD/HIV knowledge and clinical skills were measured before, immediately after, and 6 months after training. Practice patterns were assessed before training and after 6 months. Structural barriers to implementation were identified 6 months post-training.
  
  
  RESULTS
  Trainees demonstrated significant post-training gains in mean knowledge scores immediately post-training (P < 0.001) and 6 months post-training (P = 0.002). After 6 months, self-reported mean skill levels remained significantly improved compared to precourse (P < 0.05) for each of 27 skills including STD risk assessment, clinical examination, diagnosis, and treatment. Self-reported improvement in practice patterns was significant for 23 of 35 practices (P < 0.05) 6 months post-training. Participants indicated that inadequate time (52.9%), facilities/equipment (51.5%), and staffing (47.1%) interfered with implementation of recommended practices.
  
  
  CONCLUSIONS
  Experiential-didactic STD/HIV training can modestly improve knowledge, clinical skills, and implementation of STD recommended practices 6 months after training. Further research is needed to identify the impact of improved clinical practices on STD/HIV transmission.
authors.affiliation: Health and Behavioral Sciences, University of Colorado Denver, Campus Box 188, PO Box 173364, Denver, CO 80217, USA. susan.dreisbach@ucdenver.edu
authors.forename: Susan
authors.initials: S
authors.lastname: Dreisbach
authors.forename: Sharon
authors.initials: S
authors.lastname: Devine
authors.forename: John
authors.initials: J
authors.lastname: Fitch
authors.forename: Teri
authors.initials: T
authors.lastname: Anderson
authors.forename: Terry
authors.initials: T
authors.lastname: Lee
authors.forename: Cornelis
authors.initials: C
authors.lastname: Rietmeijer
authors.forename: Kitty K
authors.initials: KK
authors.lastname: Corbett
mesh_terms: D002487:Centers for Disease Control and Prevention, U.S.; D002983:Clinical Competence; D004502:Education, Medical, Continuing / Q000379:methods*; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010820:Physicians; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012749:Sexually Transmitted Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D014481:United States