Differences in preventive health quality by residency year : Is seniority better?

It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively. To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training. Cross-sectional study. One hu...

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Bibliographic Details
Published in:	Journal of general internal medicine : JGIM Vol. 20; no. 9; pp. 825 - 829
Main Authors:	WILLEFF, Lisa L, PALONEN, Kafri, ALLISON, Jeroan J, HEUDEBERT, Gustavo R, KIEFE, Catarina I, MASSIE, F. Stanford, WALL, Terry C, HOUSTON, Thomas K
Format:	Journal Article
Language:	English
Published:	Heidelberg Springer 01-09-2005 Blackwell Science Inc
Subjects:	Adult Biological and medical sciences Colorectal Neoplasms - prevention & control Counseling - statistics & numerical data Cross-Sectional Studies Female Health participants Humans Internal Medicine - education Internship and Residency Male Mass Screening - utilization Medical sciences Original Pediatrics - education Preventive Medicine Public health. Hygiene Public health. Hygiene-occupational medicine Quality of Health Care United States United States Professional experience internship and residency: quality indicators Education level Health service Indicator Care Medicine Prevention Resident(student) preventive health services Cross sectional study Quality Comparative study Public health health care
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Summary:	It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively. To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training. Cross-sectional study. One hundred twenty Internal Medicine residents, postgraduate year (PGY)- 1 and PGY -2, attending a University Internal Medicine teaching clinic between June 2000 and May 2003. We studied 6 preventive health care services offered or received by patients by abstracting data from 1,017 patient records. We examined the differences in performance between PGY-1 and PGY-2 residents. Postgraduate year-2 residents did not statistically outperform PGY-1 residents on any measure. The overall proportion of patients receiving appropriate preventive health services for pneumococcal vaccination, advising tobacco cessation, breast and colon cancer screening, and lipid screening was similar across levels of training. PGY-1s outperformed PGY-2s for tobacco use screening (58%, 51%, P = .03). These results were consistent after accounting for clustering of patients within provider and adjusting for patient age, gender, race and insurance, resident gender, and number of visits during the measurement year. Overall, patients cared for by PGY-2 residents did not receive more outpatient preventive health services than those cared for by PGY-1 residents. Efforts should be made to ensure quality patient care in the outpatient setting for all levels of training.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Portions of this paper were presented as an oral abstract presentation at the Southern Regional meeting of the Society of General Internal Medicine in New Orleans, La, February 12–14, 2004 and the abstract was published in the Journal of Investigative Medicine 2004;Vol 52#1. Portions of this paper were presented as an abstract poster presentation at the national Society of General Internal Medicine in Chicago, Ill, May 12–15, 2004.
ISSN:	0884-8734 1525-1497
DOI:	10.1111/j.1525-1497.2005.0158.x