Effects of a depression education program on residents' knowledge, attitudes, and clinical skills

To determine whether an interactive educational program would improve obstetrics and gynecology residents' knowledge, attitudes, confidence, and skills in caring for depressed patients.

We recruited 74 residents from eight residency programs to attend the Depression Education Program, which consists of a 1-hour lecture and two 2-hour workshops combining discussion, diagnosis and treatment tools, critique of a videotape, practice with feedback, and audiotape self-assessment. Before and after the program, participants 1) completed a questionnaire measuring knowledge, attitudes, and reported actions taken with a recent depressed patient; 2) received a standardized patient visit; and 3) kept lists of patients they suspected were depressed. Clinic patients completed a depression screening questionnaire. To assess improvement, we used paired t tests, McNemar chi2 tests, and multivariate models adjusting for training site.

The education program led to 3-month improvements in participants' reported use of formal diagnostic criteria (38% before, 66% after; P =.004), clinical actions documented for suspected depression (P =.035), and perceived self-efficacy in depression care (P <.001). Perceived preparedness to diagnose depression, treat with medications, and comanage with a mental health practitioner improved (P <.05 for each). Small improvements in clinical behaviors with standardized patients and clinic-based depression detection rates were not statistically significant.

The Depression Education Program improved residents' knowledge, confidence, and reported clinical actions with depressed patients, but did not improve most objectively assessed outcomes.