The importance of educating postgraduate pediatric physicians about food allergy

Knowledge, attitude, and practices of medical clinicians regarding food allergy and anaphylaxis in Hyderabad, India

BACKGROUND

Food allergy (FA) is a chronic condition of emerging global concern. Surveys have been conducted in numerous countries to assess physician knowledge, attitude, and practices (KAP) pertaining to FA and anaphylaxis, and substantial deficits in their KAP were identified.

OBJECTIVE

To assess the KAP of medical clinicians in Hyderabad, India, with respect to FA and anaphylaxis.

METHODS

A regionally representative sample of 570 physicians including 113 general practitioners, 123 pediatricians, 110 pulmonologists, 113 dermatologists, and 111 gastroenterologists were recruited from all major institutions in Hyderabad, India. A validated questionnaire was used to assess their KAP.

RESULTS

Overall, 90% of questions were correctly answered and differences emerged with respect to specific items, namely the following: (1) the lateral thigh being the preferred location for epinephrine administration (P = .001); (2) a positive skin prick test or radioallergosorbent test is sufficient for FA diagnosis (P = .04); and (3) the appropriate epinephrine dose for a 27-kg child (P = .006). Approximately 95% of the participants in each group were confident in their ability to care for patients with FA, yet 91% desired additional periodic FA training sessions.

CONCLUSION

Survey findings suggest that although FA knowledge among South Indian clinicians seems high across all major specialties who care for patients with FA, there are differences in the level of knowledge among them, which in turn reflects the differences in attitude and approach toward their patients. These FA care providers still desire to further participate in continuing medical education efforts in the field of food allergy. Efforts to provide periodic training and education for all FA clinical care providers remain vital in South India.

Involving medical students in service improvement: evaluation of a student-led, extracurricular, multidisciplinary quality improvement initiative

BACKGROUND

Quality improvement (QI) is considered a duty of every doctor and, as such, it is fundamental that medical schools nurture QI skills of medical students. At a London medical school, a novel initiative was designed to involve medical students in QI. Such novel aspects include its student leadership, multidisciplinary approach and extra-curricular nature. The aim of this study is to evaluate the effectiveness of the initiative, and thus add to the experiences of existing medical student QI programs, as well as provide guidance to other institutions wishing to involve medical students in QI.

METHODS

The key features of the initiative's design is described. Its effectiveness was evaluated by the collection of retrospective data on the quality of the initiative's QI projects (QIPs), including the proportion which: 1) reached completion; 2) resulted in a significant improvement in their primary outcome; 3) had sustained results at follow-up; 4) achieved publication; and 5) contributed towards a prize or conference presentation.

RESULTS

There were 109 students involved throughout 10 projects from 14 different undergraduate and postgraduate courses from 2015-2019. 50% of the initiative's projects achieved a significant improvement in their primary outcome, and the proportion of projects which sustained these improvements at follow-up was 100%. Furthermore, 20% of projects were published, and 60% contributed towards a prize or conference presentation.

CONCLUSION

The results of this study show that the initiative was effective at involving medical students in QI. As such, other groups establishing medical student QI programs may benefit from replicating positive elements of its design and operation.