MP31: The contrarian effect: how does a Choosing Wisely focused knowledge translation initiative affect emergency physician practice in a high awareness-low investigation environment?

Abstract

following: taking notes, eating, only reading). Both groups showed significant improvements in their test scores (Asthma: 22% improvement, Toxicology: 29%; p < 0.01 for both), with blog posts demonstrating a larger but non-significant difference (RM-ANOVA, Topic*Modality F(1,59) = 0.001, p = 0.973). Conclusion: This study suggests that podcasts and blog posts significantly improve medical student knowledge retention to a similar degree, but differ in usage conditions.

Effectiveness of Interventions to Decrease Image Ordering for Low Back Pain Presentations in the Emergency Department: A Systematic Review

“…A total of 603 unique studies were identified though the electronic and gray literature searches. Figure outlines the study selection process, which resulted in a total of five included studies . Twenty‐one studies were excluded for the following reasons: not a primary research study ( n = 13), ineligible study population (e.g., non‐ED population; n = 4), absence of a control group ( n = 2), or absence of an intervention aimed at reducing imaging ( n = 2).…”

“…All five studies, published between 1987 and 2017, implemented the intervention in the EDs of teaching hospitals in Canada, the United States, or the United Kingdom and employed before–after study designs. Three studies were published in peer‐reviewed journals and two studies were conference abstracts . All studies recruited adult patients presenting to the ED with LBP; however, no study specified how many patients presented with traumatic or nontraumatic LBP.…”

“…Two studies failed to report the number of patients enrolled in the pre‐ and postintervention groups . Reported imaging modality varied across studies and included simple radiography, computed tomography (CT) and myelography, magnetic resonance imaging (MRI), CT, and medical imaging unspecified . While four studies reported the proportion of LBP patients undergoing imaging, one study only reported the number of imaging referrals in the pre‐ and postintervention periods and no additional information was received following author communication …”

“…While all of the studies included representative pre‐ and postintervention groups, two studies did not adequately describe the intervention, and details of the point in time when the intervention was implemented were unclear in two studies . A lack of information on the comparability between groups, and reliable outcome assessment, was common among the studies. One study failed to collect data during a similar time frame for the pre‐ and postintervention periods …”

“…The study did not, however, report whether staff were trained in the use of the new CDS tool. One study assessed an education‐only intervention . Chandra et al implemented a targeted knowledge translation (KT) intervention of the Choosing Wisely Canada recommendation “do not order lumbar x‐rays for non‐traumatic LBP unless red flags exist.” The KT initiative was implemented via a 1‐hour video seminar, departmental posters, and assessing physician knowledge of the recommendation via a before and after awareness survey.…”