Assessment of Faculty Development Needs of Primary Care Physicians Regarding Adrenal Insufficiency

Presentation Number: SUN 276
Date of Presentation: April 2nd, 2017

Vinni Makin*1, Amy Nowacki2 and Colleen Colbert3
1Cleveland Clinic Foundation, Cleveland, OH, 2Cleveland Clinic, Cleveland, OH, 3Cleveland Clinic, Cleveland

Abstract

Background

There are numerous pitfalls associated with the diagnosis and management of adrenal insufficiency(AI).ACTH and cortisol follow a diurnal rhythum, limiting the diagnostic usefullness of random samples.None of the widely available expensive tests classify all patients correctly.. Recent use of various medications can interfere and invalidate the test, making the diagnosis very tricky. Further complicating this is the widespread use of steroids by PCPs. Continuing education for PCPs on this topic is critical.

Objectives

  • Utilize survey methodology to assess both PCPs’ knowledge of AI diagnosis and management and faculty development preferences for AI education

  • Assess whether needs and preferences differ based on whether or not PCPs work regularly with trainees

Methods

A draft needs assessment questionnaire was designed based upon existing clinical and survey methodology literature and then edited based upon feedback from an expert panel comprised of eight endocrinologists and hospitalists. A pretest (pre-pilot) was conducted with 15 PCPs, who also provided feedback. The final questionnaire was administered in paper-and-pen format to the intended respondents.

Results

Of 100 questionnaires distributed, a total of 51 were returned, where 38 (75%) were considered complete. The majority of respondents believed their knowledge of AI diagnosis and management was average when compared with peers. There were four AI knowledge questions; results indicated that PCPs were comfortable diagnosing, but not managing AI patients. Only 2/51 respondents correctly answered all four clinical knowledge questions. There was no difference in the clinical knowledge among physicians with or without trainees

Twenty-seven (54%) respondents said they utilized online resources to enhance current knowledge of AI, while 42% relied on CME programs. 88.2% of respondents felt they would use a new AI resource if made available to them.

The modality question was intended to guide development of a new educational module. Twenty-five respondents preferred UpToDate, with 8/25 ranking it as their first choice. 20/51 respondents ranked a lecture in their first 3 choices, with 11/20 ranking it number one. 19 subjects ranked case discussion among their top 3 choices, but only 7/19 ranked it number one.

Interpretation and conclusion

Answers from clinical questions indicated that diagnosing AI was easier to do than patient management. Thus, the latter may be an area of focus for developing educational resources. The preferred modality for AI education is the lecture.

 

Nothing to Disclose: VM, AN, CC