Effect of CD-ROM-based educational intervention on resident knowledge and adherence to deep venous thrombosis prophylaxis guidelines

BACKGROUND: CD-ROM-based educational methods are not new to residency training, yet little is known about how they affect resident knowledge and patient care practices. OBJECTIVE: We evaluated the effects of a CD-ROM-based educational tool on residents' knowledge of anticoagulation and their adherence to anticoagulation guidelines. DESIGN, SETTING AND PARTICIPANTS: Residents in the departments of cardiothoracic surgery, emergency medicine, otolaryngology, internal medicine, neurosurgery, dental medicine, neurology, obstetrics and gynecology, orthopedics, surgery, and urology at a university hospital participated in the study. INTERVENTION: Residents were provided with CD-ROM-based training on the proper use of anticoagulation based on the sixth ACCP guidelines for antithromboric therapy. Multiple choice testing was carried out before and after the CD-ROM intervention to assess resident knowledge, and resident compliance with venous thromboembolism prophylaxis guidelines was assessed via inpatient chart review by an independent committee. MAIN OUTCOME MEASURES: Changes in knowledge were measured via test scores and the rate of compliance with anticoagulation guidelines. RESULTS: Multiple choice test scores of 117 residents increased significantly after reviewing the CD-ROM (from 46.7% +/- 15.1% to 77.8%+/- 15.1%, P <.005). As a control, we administered the same test at the same 2 times at a comparable institution but without the CD-ROM intervention and found that test scores did not significantly increase. Chart review revealed a rate of compliance with anticoagulation guidelines for prophylaxis of venous thromboembolism of 75% before the CD-ROM intervention, which increased to 95% after the intervention, an increase that was sustained for at least 7 months. CONCLUSIONS: These findings suggest that CD-ROM-based interventions might be useful not only in enhancing resident knowledge but also in improving the quality of care by favorably affecting clinical practice.