Abstract
Introduction: Cardiac rehabilitation (CR) remains underutilized despite known benefits. Residency training may be an opportunity to address barriers to CR referrals, including physician knowledge gaps and unfamiliarity with referral processes. We sought to investigate the impact of resident education on knowledge and attitudes towards CR in a pilot study. Methods: Voluntary CR survey was sent to 20 internal medicine residents in a primary care clinic using an online-based platform. Following survey completion, residents received a scripted educational lecture and handout on CR. Surveys were redistributed 2 months post-education. Mean aggregate knowledge scores and attitude ratings on a 5-point Likert scale pre- and post-education were analyzed using paired t-tests. Referral rates of eligible patients 2 months pre- and post- education were analyzed using Fisher’s exact test. Results: Sixteen (80%) residents responded to both pre- and post-education surveys. Thirteen residents (81%) reported no education on CR within the past year. There was a significant increase in aggregate knowledge scores on CR components (5.1 ± 2.1 vs 7.0 ± 1.4, p = 0.001), insurance coverage (2.4 ± 1.8 vs 5.6 ± 0.7, p < 0.0001), and eligible diagnoses (7.1 ± 4.8 vs 9.9 ± 3.4, p = 0.03) following education (figure). Resident attitude ratings also improved after education, particularly in comfort level explaining CR (3.69 ± 1.30 vs. 2.06 ± 1.06, p < 0.0001) and familiarity with the referral process (4.00 ± 1.15 vs. 2.18 ± 1.11, p < 0.0001). CR referrals increased from 0% (0 out of 10 eligible patients) to 33% (3 out of 9 eligible patients) post-education ( p = 0.09). Conclusions: Internal medicine resident knowledge and attitudes towards CR significantly improved after education and may play an important role in facilitating CR referrals. Future studies on optimizing strategies for incorporation of CR education into the residency curriculum is needed.
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