Effect of a CD‐ROM‐based educational intervention on resident knowledge and adherence to deep venous thrombosis prophylaxis guidelines

Abstract

CD-ROM-based educational methods are not new to residency training, yet little is known about how they affect resident knowledge and patient care practices. We evaluated the effects of a CD-ROM-based educational tool on residents' knowledge of anticoagulation and their adherence to anticoagulation guidelines. Residents in the departments of cardiothoracic surgery, emergency medicine, otolaryngology, internal medicine, neurosurgery, dental medicine, neurology, obstetrics and gynecology, orthopedics, surgery, and urology at a university hospital participated in the study. Residents were provided with CD-ROM-based training on the proper use of anticoagulation based on the sixth ACCP guidelines for antithrombotic therapy. Multiple choice testing was carried out before and after the CD-ROM intervention to assess resident knowledge, and resident compliance with venous thromboembolism prophylaxis guidelines was assessed via inpatient chart review by an independent committee. Changes in knowledge were measured via test scores and the rate of compliance with anticoagulation guidelines. Multiple choice test scores of 117 residents increased significantly after reviewing the CD-ROM (from 46.7% +/- 15.1% to 77.8% +/- 15.1%, P < .005). As a control, we administered the same test at the same 2 times at a comparable institution but without the CD-ROM intervention and found that test scores did not significantly increase. Chart review revealed a rate of compliance with anticoagulation guidelines for prophylaxis of venous thromboembolism of 75% before the CD-ROM intervention, which increased to 95% after the intervention, an increase that was sustained for at least 7 months. These findings suggest that CD-ROM-based interventions might be useful not only in enhancing resident knowledge but also in improving the quality of care by favorably affecting clinical practice.