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A Simple Allergist-Led Intervention Improves Resident Training in Anaphylaxis


Affiliations
1 Division of Allergy & Immunology, Hofstra Northwell School of Medicine, 865 Northern Boulevard, Suite 101, Great Neck, NY 11021, United States
2 Pediatric Allergy & Immunology, Stony Brook Children’s Hospital, T-11, Room 080, Stony Brook, NY 11794, United States
3 Division of Allergy & Immunology, Hofstra Northwell School of Medicine, 865 Northern Boulevard, Suite 101, Great Neck, NY 11021,, United States
4 ProHealth Care LLP, 2 Lincoln Avenue,No. 302, Rockville Centre, NY 11570, United States
5 Biostatistics Unit, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, United States
 

Physicians underrecognize and undertreat anaphylaxis. Effective interventions are needed to improve physician knowledge and competency regarding evidence-based anaphylaxis diagnosis and management (ADAM). We designed and evaluated an educational program to improve ADAM in pediatrics, internal medicine, and emergency medicine residents from two academic medical centers. Anonymous questionnaires queried participants' demographics, prior ADAM clinical experience, competency, and comfort. A pretest assessing baseline knowledge preceded a 45-minute allergist-led evidence-based presentation, including practice with epinephrine autoinjectors, immediately followed by a posttest. A follow-up test assessed long-term knowledge retention twelve weeks later. 159 residents participated in the pretest, 152 participated in the posttest, and 86 participated in the follow-up test. There were no significant differences by specialty or site. With a possible score of 10, the mean pretest score (7.31 ± 1.50) was lower than the posttest score (8.79 ± 1.29) and follow-up score (8.17 ± 1.72) (P < 0.001 for both). Although participants' perceived confidence in diagnosing or managing anaphylaxis improved from baseline to follow-up (P < 0.001 for both), participants' self-reported clinical experience with ADAM or autoinjector use was unchanged. Allergist-led face-toface educational intervention improves residents' short-term knowledge and perceived confidence in ADAM. Limited clinical experience or reinforcement contributes to the observed decreased knowledge.
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  • A Simple Allergist-Led Intervention Improves Resident Training in Anaphylaxis

Abstract Views: 106  |  PDF Views: 2

Authors

Artemio M. Jongco
Division of Allergy & Immunology, Hofstra Northwell School of Medicine, 865 Northern Boulevard, Suite 101, Great Neck, NY 11021, United States
Sheila Bina
Pediatric Allergy & Immunology, Stony Brook Children’s Hospital, T-11, Room 080, Stony Brook, NY 11794, United States
Robert J. Sporter
Division of Allergy & Immunology, Hofstra Northwell School of Medicine, 865 Northern Boulevard, Suite 101, Great Neck, NY 11021,, United States
Marie A. Cavuoto Petrizzo
ProHealth Care LLP, 2 Lincoln Avenue,No. 302, Rockville Centre, NY 11570, United States
Blanka Kaplan
Division of Allergy & Immunology, Hofstra Northwell School of Medicine, 865 Northern Boulevard, Suite 101, Great Neck, NY 11021, United States
Myriam Kline
Biostatistics Unit, Feinstein Institute for Medical Research, 350 Community Drive, Manhasset, NY 11030, United States
Susan J. Schuval
Pediatric Allergy & Immunology, Stony Brook Children’s Hospital, T-11, Room 080, Stony Brook, NY 11794, United States

Abstract


Physicians underrecognize and undertreat anaphylaxis. Effective interventions are needed to improve physician knowledge and competency regarding evidence-based anaphylaxis diagnosis and management (ADAM). We designed and evaluated an educational program to improve ADAM in pediatrics, internal medicine, and emergency medicine residents from two academic medical centers. Anonymous questionnaires queried participants' demographics, prior ADAM clinical experience, competency, and comfort. A pretest assessing baseline knowledge preceded a 45-minute allergist-led evidence-based presentation, including practice with epinephrine autoinjectors, immediately followed by a posttest. A follow-up test assessed long-term knowledge retention twelve weeks later. 159 residents participated in the pretest, 152 participated in the posttest, and 86 participated in the follow-up test. There were no significant differences by specialty or site. With a possible score of 10, the mean pretest score (7.31 ± 1.50) was lower than the posttest score (8.79 ± 1.29) and follow-up score (8.17 ± 1.72) (P < 0.001 for both). Although participants' perceived confidence in diagnosing or managing anaphylaxis improved from baseline to follow-up (P < 0.001 for both), participants' self-reported clinical experience with ADAM or autoinjector use was unchanged. Allergist-led face-toface educational intervention improves residents' short-term knowledge and perceived confidence in ADAM. Limited clinical experience or reinforcement contributes to the observed decreased knowledge.