Continuing medical education for AIDS: an organizational response

The Management of the Southern California Kaiser-Permanente Medical Group mandated a day-long program of continuing medical education on AIDS for all staff physicians at one facility. Presentations dealt with cognitive (transmission/diagnosis), skills (risk factors, history taking), and affective (discomfort/attitudes) domains. All physicians participated in 2 small-group workshops on sexual history taking and ethical issues. An evaluation compared primary care physicians' attitudes and practices before and after the program at the experimental site (Medical Center), a comparison site (written materials only), and a "no-treatment" facility. A sample of new patients (N = 2,689) seen by study physicians (N = 253) before and after the educational intervention were telephoned to determine if sexual history questions were asked by their physicians. There was a significant increase in the frequency of sexual history questions asked by internists at the experimental site. Over 95% of all patients were accepting of sexual history questions. This program has since been repeated at 11 medical centers involving over 3,500 Kaiser-Permanente physicians throughout Southern California.