Abstract
Purpose Prostate cancer screening with prostate-specific antigen (PSA) is a controversial issue. The present study aimed to explore physician behaviors during an unannounced standardized patient encounter that was part of a randomized controlled trial to educate physicians using a prostate cancer screening, interactive, Web-based module. Methods Participants included 118 internal medicine and family medicine physicians from 5 health systems in California, in 2007-2008. Control physicians received usual education about prostate cancer screening (brochures from the Center for Disease Control and Prevention). Intervention physicians participated in the prostate cancer screening module. Within 3 months, all physicians saw unannounced standardized patients who prompted prostate cancer screening discussions in clinic. The encounter was audio-recorded, and the recordings were transcribed. Authors analyzed physician behaviors around screening: (1) engagement after prompting, (2) degree of shared decision making, and (3) final recommendations for prostate cancer screening. Results After prompting, 90% of physicians discussed prostate cancer screening. In comparison with control physicians, intervention physicians showed somewhat more shared decision making behaviors (intervention 14 items vs control 11 items, P <.05), were more likely to mention no screening as an option (intervention 63% vs control 26%, P <.05), to encourage patients to consider different screening options (intervention 62% vs control 39%, P <.05) and seeking input from others (intervention 25% vs control 7%, P <.05). Conclusions A brief Web-based interactive educational intervention can improve shared decision making, neutrality in recommendation, and reduce PSA test ordering. Engaging patients in discussion of the uses and limitations of tests with uncertain value can decrease utilization of the tests.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 315-323 |
| Number of pages | 9 |
| Journal | Annals of Family Medicine |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jul 2013 |
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Keywords
- Health communication
- Medical education
- Patient-centered care
- Primary care
- Prostate cancer
- Prostate cancer screening
- Qualitative analysis
- Randomized controlled trial
- Risk-benefit assessment
- Shared decision making
- Unannounced standardized patients
ASJC Scopus subject areas
- Family Practice
Cite this
Physician communication regarding prostate cancer screening : Analysis of unannounced standardized patient visits. / Feng, Bo; Srinivasan, Malathi; Hoffman, Jerome R.; Rainwater, Julie A.; Griffin, Erin; Dragojevic, Marko; Day, Frank C.; Wilkes, Michael S.
In: Annals of Family Medicine, Vol. 11, No. 4, 07.2013, p. 315-323.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Physician communication regarding prostate cancer screening
T2 - Analysis of unannounced standardized patient visits
AU - Feng, Bo
AU - Srinivasan, Malathi
AU - Hoffman, Jerome R.
AU - Rainwater, Julie A.
AU - Griffin, Erin
AU - Dragojevic, Marko
AU - Day, Frank C.
AU - Wilkes, Michael S
PY - 2013/7
Y1 - 2013/7
N2 - Purpose Prostate cancer screening with prostate-specific antigen (PSA) is a controversial issue. The present study aimed to explore physician behaviors during an unannounced standardized patient encounter that was part of a randomized controlled trial to educate physicians using a prostate cancer screening, interactive, Web-based module. Methods Participants included 118 internal medicine and family medicine physicians from 5 health systems in California, in 2007-2008. Control physicians received usual education about prostate cancer screening (brochures from the Center for Disease Control and Prevention). Intervention physicians participated in the prostate cancer screening module. Within 3 months, all physicians saw unannounced standardized patients who prompted prostate cancer screening discussions in clinic. The encounter was audio-recorded, and the recordings were transcribed. Authors analyzed physician behaviors around screening: (1) engagement after prompting, (2) degree of shared decision making, and (3) final recommendations for prostate cancer screening. Results After prompting, 90% of physicians discussed prostate cancer screening. In comparison with control physicians, intervention physicians showed somewhat more shared decision making behaviors (intervention 14 items vs control 11 items, P <.05), were more likely to mention no screening as an option (intervention 63% vs control 26%, P <.05), to encourage patients to consider different screening options (intervention 62% vs control 39%, P <.05) and seeking input from others (intervention 25% vs control 7%, P <.05). Conclusions A brief Web-based interactive educational intervention can improve shared decision making, neutrality in recommendation, and reduce PSA test ordering. Engaging patients in discussion of the uses and limitations of tests with uncertain value can decrease utilization of the tests.
AB - Purpose Prostate cancer screening with prostate-specific antigen (PSA) is a controversial issue. The present study aimed to explore physician behaviors during an unannounced standardized patient encounter that was part of a randomized controlled trial to educate physicians using a prostate cancer screening, interactive, Web-based module. Methods Participants included 118 internal medicine and family medicine physicians from 5 health systems in California, in 2007-2008. Control physicians received usual education about prostate cancer screening (brochures from the Center for Disease Control and Prevention). Intervention physicians participated in the prostate cancer screening module. Within 3 months, all physicians saw unannounced standardized patients who prompted prostate cancer screening discussions in clinic. The encounter was audio-recorded, and the recordings were transcribed. Authors analyzed physician behaviors around screening: (1) engagement after prompting, (2) degree of shared decision making, and (3) final recommendations for prostate cancer screening. Results After prompting, 90% of physicians discussed prostate cancer screening. In comparison with control physicians, intervention physicians showed somewhat more shared decision making behaviors (intervention 14 items vs control 11 items, P <.05), were more likely to mention no screening as an option (intervention 63% vs control 26%, P <.05), to encourage patients to consider different screening options (intervention 62% vs control 39%, P <.05) and seeking input from others (intervention 25% vs control 7%, P <.05). Conclusions A brief Web-based interactive educational intervention can improve shared decision making, neutrality in recommendation, and reduce PSA test ordering. Engaging patients in discussion of the uses and limitations of tests with uncertain value can decrease utilization of the tests.
KW - Health communication
KW - Medical education
KW - Patient-centered care
KW - Primary care
KW - Prostate cancer
KW - Prostate cancer screening
KW - Qualitative analysis
KW - Randomized controlled trial
KW - Risk-benefit assessment
KW - Shared decision making
KW - Unannounced standardized patients
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UR - http://www.scopus.com/inward/citedby.url?scp=84880061714&partnerID=8YFLogxK
U2 - 10.1370/afm.1509
DO - 10.1370/afm.1509
M3 - Article
VL - 11
SP - 315
EP - 323
JO - Annals of Family Medicine
JF - Annals of Family Medicine
SN - 1544-1709
IS - 4
ER -