OBJECTIVE:To determine whether a multimedia computer program could effectively teach patients about fecal occult blood testing (FOBT) and increase screening rates. DESIGN: Randomized trial.SETTING: University-affiliated, community-based Internal Medicine outpatient practice.PARTICIPANTS: All English-speaking patients aged 50 years and older who were offered FOBT screening by their providers were invited to participate. Two hundred and four patients enrolled in the study. Ten patients were later determined to be ineligible. INTERVENTIONS:Patients were randomized to either the educational multimedia computer program or usual nurse counseling about FOBT screening. Screening instructions were based on the material pre-printed on each test kit. Educational sessions were held in a private setting immediately after each patient's office visit. MEASUREMENTS AND MAIN RESULTS:A knowledge-assessment questionnaire was administered in a blinded fashion by telephone the following day. Successful screening was defined as return of the test kits within 30 d. Completion of the FOBT kits was similar in both groups: 62% (58/93) in the computer group and 63% (64/101) in the nurse group (P =.89). Mean knowledge scores were also similar, but there was a trend toward increased knowledge mastery in the computer group (56% vs 41%, P =.09). CONCLUSIONS:A multimedia educational computer program was as effective as usual nurse counseling in educating patients and achieving adherence to FOBT screening. Future studies are needed to determine whether computer-assisted instruction can improve health outcomes. Despite the proven ability of screening to reduce CRC mortality, fewer than 25% of Americans over age 50 have undergone FOBT screening within the past year, and half are not currently screened for CRC by any modality.2,7 According to patients, 2 barriers to screening are lack of knowledge about CRC and confusion about the FOBT screening procedure. 8,9 At the same time, physicians report difficulty finding the time to educate their patients about preventive medicine interventions. 10-12Computer-assisted instruction (CAI), the use of a computer program to deliver an educational message, offers the potential to overcome knowledge barriers and therefore improve screening rates. In contrast to usual office-based counseling or printed materials, CAI can combine graphics, video clips, and audio segments to reinforce the educational message. In addition, CAI standardizes the material being presented and allows patients to proceed at their own pace. Several randomized trials have demonstrated that CAI can increase patients' knowledge about health topics. [13][14][15][16][17][18] We are aware of no studies examining whether CAI can improve CRC screening rates. We hypothesized that CAI could educate patients about FOBT screening more effectively than individual counseling sessions and thereby increase the likelihood that patients will complete the screening procedure. To test this hypothesis, we conducted a randomized-controlled trial comparing a mu...

Internal medicine residents and faculty reported low levels of knowledge about physician-pharmaceutical industry relationships. Some consensus about educational components existed, but optimal educational formats remain uncertain. A six-hour curriculum to address this complex, emotionally charged topic was developed, implemented, and evaluated.

The cost of the evaluation of extra-colonic findings following virtual colonoscopy may be much higher in actual practice than is suggested by prior studies. This will impact the cost-effectiveness of using virtual colonoscopy for asymptomatic colorectal cancer screening and underscores the importance of standardizing the reporting of extra-colonic findings to encourage appropriate follow-up.

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