PURPOSE: Evidence based medicine has demonstrated that when prophylactic measures are not routinely administered in a hospital setting, the incidence of hospital acquired DVT is estimated to range from 10 to 40% in medical or general surgery patients. VTE prophylaxis directly targets pulmonary embolism, the most common complication of DVT and the leading cause of hospital-associated death. We sought to evaluate the medical students’ and medical residents’ knowledge of VTE prophylaxis at a 476 bed community teaching hospital in Brooklyn, NY.
METHODS: This was a cross-sectional study of medical students and medical residents based on a question set that analyzed various clinical scenarios. We used current evidence based guidelines to design 40 questions which were extensively reviewed by a pulmonary critical care attending, and redefined to create a 14-question set that addressed the most pronounced clinical situations and avoided redundancy. The final 14-question set was presented in a live session using a real time audience response system to answer each question, followed by an educational component that addressed the key teaching point of each question. Each individual was given a score (1-14) based upon the number of questions answered correctly.
RESULTS: The highest score was 8 of 14 correctly answered questions. 6 PGY-2 residents scored highest, followed closely by 32 medical students, 8 PGY-3s, and 12 PGY-1s, respectively. ANOVA analysis indicated that the difference in scores was on the threshold of significance (p = 0.057). When analyzed in pairs, medical students did significantly better than PGY-1s (p = 0.007). There was a trend towards significance between PGY-1s and PGY-2s (p = 0.67).
CONCLUSION: Our results showed a disparity in knowledge among those prescribing VTE prophylaxis for inpatients. This study demonstrated the need for enhanced education for PGY-1 Medical Residents, who often have the responsibility of prescribing VTE prophylaxis.
CLINICAL IMPLICATIONS: The low scores observed among the medical residents demonstrated a need to monitor and emphasize VTE prophylaxis guidelines for them. The implementation and education of DVT prophylaxis has a nationwide urgency.
DISCLOSURE: Babak Deyhimpanah, No Financial Disclosure Information; No Product/Research Disclosure Information