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Effectiveness of Education

Carl C. Awh, MD; Howard P. Cupples, MD; Jonathan C. Javitt, MD, MPH

Arch Intern Med. 1991;151(7):1405-1408.

Abstract
We studied the effect of a 4-hour course in recognition and management of diabetic retinopathy on the ability of nonophthalmologist physicians to detect and to appropriately refer patients with sight-threatening diabetic retinopathy. Participants completed a written examination covering case management and performed a total of 340 dilated ophthalmoscopic examinations on selected patients before and 2 weeks following the teaching session. Accuracy of ophthalmoscopy was assessed by comparison with standardized grading of fundus photographs. Scores on the written examination increased from a mean of 49% to 78% correct. The likelihood of failing to detect and appropriately refer patients with proliferative or preproliferative retinopathy decreased from 60% to 15%. Similarly, for patients with maculopathy, the likelihood of failure to detect and to appropriately refer decreased from 83% to 15.6%. These data suggest that education may significantly improve the ability of nonophthalmologists to detect and to appropriately refer patients who are at risk for vision loss.

(Arch Intern Med. 1991;151:1405-1408)

Author Affiliations
From the Worthen Center for Eye Care Research, Center for Sight, Georgetown University Medical Center (Drs Awh, Cupples, and Javitt) and the Department of Community and Family Medicine, Georgetown Medical Center (Dr Javitt), Washington, DC. Dr Awh is now with the Department of Ophthalmology, Duke University Medical Center, Durham, NC.

Footnotes
Accepted for publication October 12, 1990.

Reprint requests to the Center for Sight, Georgetown University Medical Center, 3800 Reservoir Rd NW, Washington, DC 20007 (Dr Javitt).

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