Malka B. Finkelstein MD, Presenter: Nothing to Disclose

Michel Bochner MD, Abstract Co-Author: Nothing to Disclose

Marjorie Werner Stein MD, Abstract Co-Author: Nothing to Disclose

To determine if a didactic lecture regarding appropriate radiologic work-ups has an effect on the ordering behaviors of physicians.

A one-hour conference based on the American College of Radiology Appropriateness Criteria was given to medical students and medical housestaff. The lecture was given to small groups over the course of several months. A multiple-choice survey concerning the most suitable initial imaging study for nine common clinical scenarios was given to half of the participants before and the other half after the lecture. The results were tallied and compared.

A total of 27 surveys were distributed to third and fourth year medical students, 11 pre- and 16 post-lecture. All surveys were completed and returned. The average pre-lecture score was 4/9 (44%) and post-lecture was 7/9 (78%), with a 34% improvement (p=0.0001). A total of 40 surveys were distributed to medical housestaff, 20 pre- and 20 post-lecture. Twenty-three surveys were completed and returned, 10 pre- and 13 post-lecture. The average pre-lecture score was 6/9 (67%) and post-lecture was 7/9 (78%), with an 11% improvement (p=0.1039).

A one-hour conference significantly improves medical student ordering abilities. The lack of needed significant improvement at the housestaff level may be related to the method of teaching or the receptiveness of the residents. As residents already have preconceived ideas regarding radiologic work-ups, it may be more difficult to effectively change their methods. Intervention at the medical student level is most effective in impacting physicians’ ordering abilities.

Finkelstein, M, Bochner, M, Stein, M, Improving Physician Ordering Behavior: Is a One Hour Lecture Effective?.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4407733.html