Evaluating effectiveness of educational intervention on syphilis screening and interpretation in a Family Medicine Residency

<h3>Context:</h3> multiple episodes of inappropriate interpretation and subsequent management of abnormal syphilis screening results were noted in our Family Medicine Residency Clinic (FMRC) <h3>Objective:</h3> develop an educational intervention to inform about appropriate interpretation of syphilis screening and subsequent management with an assessment of understanding and confidence in interpreting, managing, and teaching this content <h3>Study Design and Analysis:</h3> a 6-month pre-intervention review of syphilis screening results in the FMRC to assess interpretation and management of abnormal results. A lecture was given to residents and faculty with a pre and post-intervention survey including a brief quiz about interpretation and management of syphilis results as well as assessment of confidence in performing same as well as teaching this content. A copy of the presentation was provided for those unable to attend to enhance participation in the survey. Post-intervention data was queried from the FMRC and reviewed for any change in pattern in interpretation and management. A t-test and discrimination index was performed to evaluate responses to the survey with descriptive statistics, Chi-square and Fisher Exact test performed on chart review data. <h3>Setting:</h3> Urban Family Medicine residency clinic <h3>Population Studied:</h3> residents and faculty of a Family Medicine residency, patients in the Family Medicine residency clinic where residents and faculty evaluated practice <h3>Intervention:</h3> educational lecture on syphilis testing interpretation and management <h3>Outcome Measures:</h3> responses to knowledge assessment and confidence pre and post-intervention. Improved interpretation and management of syphilis screening results after intervention <h3>Results:</h3> Survey questions assessing knowledge had variable performance with net poor discrimination after the educational intervention. Confidence in all measures improved post-intervention but were not statistically significant. There were no significant differences in appropriate versus inappropriate evaluation and management and comparing reactive versus nonreactive results pre versus post-intervention. Post-hoc power analysis for appropriate versus inappropriate diagnosis and management was very low (2.7% and 31.8% respectively). <h3>Conclusions:</h3> While a non-significant incidence in reactive syphilis screening may reflect better understanding and application of screening this intervention performed poorly likely due to small sample size.