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Resident physicians' competencies and attitudes in delivering a postnatal diagnosis of Down syndrome.

Ferguson JE, Kleinert HL, Lunney CA, Campbell LR

Department of Obstetrics and Gynecology, Interdisciplinary Human Development Institute, University of Kentucky and Chandler Medical Center, Lexington, Kentucky 40536-0293, USA. jef@uky.edu

OBJECTIVE: This study responded to the need expressed by physicians and parents alike for improved medical information and support to families upon the initial diagnosis of Down syndrome at birth. The purpose was to assess obstetrics and gynecology and pediatrics residents' cognitive knowledge about Down syndrome and comfort in counseling parents with a newborn child with Down syndrome before and after intervention (resident viewing and interaction with the educational material). METHODS: A team of physicians, parents, and educational specialists developed an interactive CD-ROM that asked resident physicians to read and view virtual patient-doctor sessions, and provide their own responses to critical situations related to Down syndrome diagnoses. The research tested both knowledge and attitude change, as well as the effectiveness of an interactive CD-ROM as a pedagogical tool. RESULTS: Our effectiveness study yielded positive and significant improvement in knowledge and level of comfort changes with both obstetrics and gynecology and pediatric physicians in residence at the University of Kentucky. Residents also found the technologically based interactive type of instruction to be usable and valuable. CONCLUSION: Teaching physicians to impart accurate and balanced information about Down syndrome at the initial point of diagnosis can be achieved, in part, through training with the CD-ROM. From a broader perspective, this effectiveness study suggests the potential applications of these communication strategies not only to families who have a child with Down syndrome, but also to those with other life-altering disabilities. LEVEL OF EVIDENCE: II-3.

Published 2 October 2006 in Obstet Gynecol, 108(4): 898-905.
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