Impact of education on physician attitudes toward computed tomography utilization and consent

There are risks to ordering computed tomography (CT) scans.

We set out to determine whether emergency physician attitudes and their predictions of CT ordering behaviors could be influenced by education.

We surveyed emergency physicians at a Level I trauma center with a yearly census of 74,000. Physicians were given a baseline survey that encompassed demographics, attitudes toward CT informed consent, and ordering behaviors. After receiving an education session regarding CT risks, each participant received a follow-up survey. Data analysis was performed using frequencies and chi-squared.

Seventy-five physicians participated; 69% residents and 31% attendings; 34% were female and 66% male. Thirteen percent reported they did not know if informed consent was required for CT scans obtained in the Emergency Department. Pre-education, 89% reported sometimes ordering a CT scan due to a consultant request that they felt was not indicated, and 92% reported that they sometimes ordered a CT scan to appease a patient or family. Eighty-five percent reported that they sometimes ordered a CT scan defensively due to malpractice risk. After education, physicians were more likely to believe a patient should give informed consent before CT (p<0.01) and predicted that they would be more likely to discuss the risks/benefits of CT with their patients all of the time (p=0.001).

After education about the risks of CT utilization, emergency physicians were more likely to believe that patients should give informed consent before CT scan and predicted that they would be more likely to discuss the risks and benefits of CT with their patients.