Improved Follow-up of Breast Abnormalities Through Comprehensive Breast Care in Women 40 to 70 Years of Age
Annual rept. 1 Mar 2000-28 Feb 2001
MICHIGAN STATE UNIV EAST LANSING
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In 1999, we began a randomized study of 8 Family Practice residencies, to address previously documented inconsistencies regarding breast cancer screening and management of identified breast abnormalities. Residencies randomized to the intervention arm received a multi-component intervention addressing knowledge and management of breast cancer related issues and clinical breast exam CBE skills. Chart reminder systems included guidelines for appropriate follow-up of breast abnormalities. Physicians performance in clinical settings was assessed through chart audits for women 40 to 70 year old, for the pre- and post- intervention years. Physicians cognitive and clinical skills were assessed pre- and post-intervention, through knowledge test, CBE skills using live simulated models, and lump detection skills in silicone breast models. Results of the pre-intervention chart audit revealed screening rates for the 11 sites to range between 36-6l for CBE, 27-61 for mammography, and l3-45 for both. Physicians performance on the knowledge test improved immediately following the workshop. Follow-up assessment one year later demonstrated improvement in pre-intervention scores, but decrease relative to scores immediately post-intervention. This was also true of the evaluations of CBE skills. Translatability of this project has already begun. The curriculum was revised for Nurse Practitioners and presented in five workshops during the Spring 2001.
- Anatomy and Physiology
- Medicine and Medical Research