Teaching asthma management: an evidence-based educational approach

Background: Asthma management plans and asthma education have been incorpor ated into recent guidelines, and implementation of these reduces asthma mor bidity. Junior doctors are frequently involved in asthma management, but te aching about asthma in medical school is seldom assessed. We studied asthma knowledge, confidence in practical asthma management, and the effectivenes s of an interactive asthma education workshop in final year medical student s. Thirty-five students attended the workshop, with 26 returning questionna ires on both of the two sessions. Methods: Students attended a two hour asthma workshop comprising interactiv e teaching sessions on management of acute and stable asthma, and a practic al session using asthma devices. Theoretical knowledge was assessed by a 20 item questionnaire, completed immediately prior to the workshop and after two weeks, at a feedback session. Practical knowledge was assessed by confi dence scores in use of asthma devices on a five point scale (not at all con fident to very confident), before, immediately after the workshop, and afte r two weeks. Results: Students scored poorly in questions on: predictors of asthma morta lity, nebuliser and Turbuhaler(R) use, asthma management plans, and physica l signs in acute asthma. Mean (SE) knowledge score increased significantly from 64.4% (6.1) to 74.2% (5.6) (p<0.05; paired t-test) at two weeks. Confi dence scores rose significantly for all practical aspects of asthma managem ent (p<0.01; Wilcoxon matched pairs test), and declined at two weeks, bur s till remained significantly higher than at baseline (p<0.05). Conclusions: Medical students had poor knowledge about several important fe atures of asthma care. The asthma workshop was effective in increasing know ledge and confidence in management of asthma in the short term, and could b e useful in optimising implementation of asthma guidelines in clinical prac tice and potentially later in training of junior medical officers.