Improving emergency medicine residents' approach to patients with alcohol problems: a controlled educational trial

Ann Emerg Med. 2002 Jul;40(1):50-62. doi: 10.1067/mem.2002.123693.


Study objective: We determine whether training using a structured skills-based intervention would improve emergency medicine residents' knowledge and practice in screening and intervening with patients presenting to the emergency department with alcohol problems.

Methods: In a controlled trial conducted at 2 similar emergency medicine residency programs associated with urban, Level I trauma centers, a 4-hour didactic, video, and skills-based workshop was conducted. Main outcome measures included (1) scores on changes in self-reported knowledge, current practice, self-efficacy, role-responsibility, attitudes and beliefs, and provider readiness to change from baseline to 1 year after intervention and (2) change in practice as measured by record review before and after intervention.

Results: The intervention group (n=17) had a significant increase in knowledge scores (P <.001) and practice with regard to percent of medical records with evidence of screening and intervention (17% before versus 58% after; 95% confidence interval [CI] 31 to 50; P <.001); no change was observed in the control group (n=19). These increases were significantly different between groups (95% CI 30 to 54; P <.001). There were no significant differences within or between groups for composite scores derived for current practice, self-efficacy, role responsibility, or readiness to change.

Conclusion: A brief, structured, educational intervention for residents contributed to significant improvement in knowledge and practice with regard to patients with alcohol problems.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alcoholism / diagnosis*
  • Alcoholism / therapy
  • Attitude of Health Personnel*
  • Clinical Competence
  • Connecticut
  • Emergency Medicine / education*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Internship and Residency / methods*
  • Internship and Residency / statistics & numerical data
  • Male
  • Massachusetts
  • Physician's Role
  • Population Surveillance
  • Self Efficacy
  • Teaching / methods