Effectiveness of a decision-training aid on referral prioritization capacity

Harries, Priscilla, Tomlinson, Christopher, Notley, Elizabeth, Davies, Miranda and Gilhooly, Kenneth (2012) Effectiveness of a decision-training aid on referral prioritization capacity. Medical Decision Making, 32(6), pp. 779-791. ISSN (print) 0272-989X


BACKGROUND: In the community mental health field, occupational therapy students lack the capacity to prioritize referrals effectively. OBJECTIVE: The purpose of this study was to test the effectiveness of a clinical decision-training aid on referral prioritization capacity. DESIGN: A double-blind, parallel-group, randomized controlled trial was conducted using a judgment analysis approach. SETTING: Each participant used the World Wide Web to prioritize referral sets at baseline, immediate posttest, and 2-wk follow-up. The intervention group was provided with training after baseline testing; control group was purely given instructions to continue with the task. PARTICIPANTS: One hundred sixty-five students were randomly allocated to intervention (n = 87) or control (n = 81). Intervention. Written and graphical descriptions were given of an expert consensus standard explaining how referral information should be used to prioritize referrals. MEASUREMENTS: Participants' prioritization ratings were correlated with the experts' ratings of the same referrals at each stage of testing, as well as to examine the effect on mean group scores, regression weights, and the lens model indices. RESULTS: At baseline, no differences were found between control and intervention on rating capacity or demographic characteristics. Comparison of the difference in mean correlation baseline scores of the control and intervention group compared with immediate posttest showed a statistically significant result that was maintained at 2-wk follow-up. The effect size was classified as large. At immediate posttest and follow-up, the intervention group improved rating capacity, whereas the control group's capacity remained poor. The results of this study indicate that the decision-training aid has a positive effect on referral prioritization capacity. CONCLUSIONS: This freely available, Web-based decision-training aid will be a valuable adjunct to the education of these novice health professionals internationally.

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