Knowledge, attitudes, and practices of Florida physicians regarding dengue before and after an educational intervention.
BACKGROUND
Failure to recognize and appropriately manage dengue early in the clinical course may result in late initiation of supportive treatment for severe disease. In Florida, travel-related and autochthonous dengue occur and are likely under-recognized. The objective of this study was to evaluate physician knowledge of dengue and its management before and after an educational intervention in Florida.


METHODS
From 2012-13 we conducted 14 grand-rounds style lectures on dengue clinical management attended by 413 physicians, and analyzed data from the pre- and post-tests.


RESULTS
Of those attending, 231 and 220 completed the pre-and post-tests, respectively. Overall, the mean pre-test score for knowledge-based questions was 74.3 and average post-test score was 94.2%, indicating a mean increase of 19.9% (P < 0.0001, 95% CI 17.7-22.4). Reported confidence in dengue recognition and management also increased. Non-US trained physicians and those who had treated more than ten dengue cases performed significantly better in the pre-test. Post-test scores did not differ by subgroup.


CONCLUSIONS
The train-the-trainer approach with grand-rounds style presentations appear to be an effective intervention to improve knowledge of dengue among physicians.
Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, #850 (R-21), Miami, FL, 33155, USA. sdoblecki@med.miami.edu.
Susanne
S
Doblecki-Lewis
Division of General Internal Medicine, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Ave NW Room 5-419, Washington, DC, 20037, USA.
Aileen
A
Chang
Division of Infectious Diseases, Department of Medicine, Oakland University William Beaumont School of Medicine, Beaumont Health Grosse Pointe, 468 Cadieux Rd, Grosse Pointe, MI, 48230, USA.
Renee
R
Jiddou-Yaldoo
Dengue Branch, Division of Vector-borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, United States Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333, USA.
Kay M
KM
Tomashek
Florida Department of Health, Division of Disease Control and Health Protection, Zoonotic and Vectorborne Disease, 4052 Bald Cypress Way, Bin A12, Tallahassee, FL, 32399-1712, USA.
Danielle
D
Stanek
Division of Infectious Disease Epidemiology, Bureau for Public Health, West Virginia Department of Health & Human Resources, 350 Capitol St. Rm. 125, Charleston, WV, 25301, USA.
Leena
L
Anil
Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, #864 (R-21), Miami, FL, 33155, USA.
Paola
P
Lichtenberger
D002983:Clinical Competence; D065187:Controlled Before-After Studies; D003715:Dengue / Q000175:diagnosis / Q000628:therapy; D004502:Education, Medical, Continuing; D005431:Florida; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D000070260:Teacher Training; D056164:Teaching Rounds
Clinical practice; Dengue; Evaluation; Physician training; Survey