Pre- and post-training changes in the test-ordering behavior of the emergency physicians in the management of adults with acute gastroenteritis

Abstract

Introduction: The aim of this study is to investigate the education-inflicted changes in the test-ordering behavior of the emergency physicians in the management of patients with a presumptive diagnosis of acute gastroenteritis (AGE). Methods: The study was designed as a single-center interventional study and was conducted in a large training hospital over a two-month period. In the first month of the study; physicians’ test ordering behavior in patients with acute AGE was analyzed (Group 1). After one-month period, physicians working in the hospital emergency department (ED) underwent a one-hour focused training on the management of patients with AGE. One month after the training, variations in test order habits were observed and recorded (Group 2). Before and after the training; demographic information, vital signs on admission, complaints, physical examination findings, associated conditions, and the work-up results were analyzed comparatively. Results: Following the education session, there was a decrease of 6% in the rate of tests ordered for the patients and an increase of 11% in the rate of pathological findings on the laboratory work up. The patients’ blood pressure, body temperature and heart rate were the factors without any effect on test-ordering behavior. In the present study, the ratio of patients ordered tests in the management of AGE in the ED was found to be lower and the rate of pathological findings was higher in the post-education period when compared to pre-education period. Conclusions: Future population-based well-designed studies will enlighten the possible effect of education on test-ordering in acute medicine.