Effects of structured encounter forms on pediatric house staff knowledge, parent satisfaction, and quality of care. A randomized, controlled trial

Abstract

Objective: To evaluate the effects of health supervision structured encounter forms on pediatric house staff knowledge, parent satisfaction, and quality of care.

Design: Randomized, controlled trial.

Setting: Pediatric house staff continuity clinic in a university-based children's hospital.

Participants: 53 pediatric house officers and 153 parents.

Interventions: House staff were randomized to use structured encounter forms focused on developmental milestones (group 1) or anticipatory guidance/preventive care (group 2) during health supervision visits.

Outcome measures: Changes in house staff knowledge were assessed with pretests and posttests. Parent satisfaction was assessed with surveys. Quality of care, defined as compliance with recommended guidelines for age-specific health supervision, was assessed by audiotaping visits.

Results: Group 1 demonstrated greater but not significantly different improvement in knowledge of developmental milestones than group 2, while group 2 improved more than group 1 in knowledge of anticipatory guidance/ preventive care. Parent satisfaction with developmental screening was significantly greater for group 1 visits than for group 2 visits (P < .001). Group 1 demonstrated significantly greater compliance than group 2 with recommended standards of developmental screening (P = .001).

Conclusions: The use of structured encounter forms for health supervision in pediatric house staff continuity clinics may increase house staff knowledge of developmental milestones and anticipatory guidance/preventive care, increases parent satisfaction with developmental assessment during health supervision, and improves compliance with recommended guidelines for developmental assessment.