Teaching Residents Established Guidelines And Standards of Care To Strengthen Their Cost-Containment Practices

A program that outlined the concepts of evidence-based medicine improved residents’ knowledge about treatment costs


Purpose: This small-scale, preliminary study was intended to evaluate the effectiveness of a structured educational intervention designed to enhance cost-awareness in medicine residents.

Design: The study took place at a large tertiary care children’s hospital between March 2007 and December 2008. Participants randomly participated in the intervention group and were enrolled during resident noon conference time slots; the control group participated one by one as schedules allowed.

Methodology: The educational intervention, a one-hour PowerPoint tutorial based on current published practice guidelines from the American Academy of Pediatrics (AAP), was given only to the intervention group. Both control and intervention groups were evaluated pre- and post-intervention using a self-administered questionnaire that utilized clinical case vignettes to assess their understanding of practice guidelines as a proxy for cost awareness.

Principal findings: Eighty pediatric residents participated in the study, 40 in each group. The average number of correct answers on pre- and post-intervention questionnaires increased from 8.32 to 13.62 of 19 questions for the intervention group, compared to an increase from 8.35 to 9.85 for the control group. The increase in the intervention group was significantly higher than the increase in the control group (P<.001).

Conclusions: Following structured teaching that outlined the concepts of evidence-based medicine, an increase was seen in residents’ knowledge of strategies for containing costs.