Medical students administering academic detailing

Introduction:

Academic detailing is an approach to inter-professional education utilizing personalized meetings and techniques for exchange of information similar to those employed in pharmaceutical detailing.  This project served as a pilot for connecting medical students with community physicians with the aim of increasing influenza vaccine carrying rates in obstetrics offices.

Methods:

Structured interviews were conducted with 44 obstetricians from different practices, half of which did not carry influenza vaccine.  The encounters included a medical student presentation on vaccination during pregnancy, a questionnaire, and a survey regarding the interaction. 

Results:

Of 45 practices contacted, medical students were able to gain access and detail 44 providers.  Among obstetricians not carrying, 67% did not carry the vaccine because they felt reimbursement does not cover associated costs.  92% indicated they would carry the vaccine if it were cost-neutral.  Of those who already carried the vaccine, 85% cited breaking even on cost as a key factor in their decision. 25% of providers who previously did not carry the vaccine, started to in the months following detailing.  A survey indicated very high provider and student satisfaction with the detailing interactions.

Discussion and conclusion:

Medical students were successful in engaging providers in office based academic detailing.  One quarter of providers changed important practice based on the detailing. Surprisingly, the students found that cost of administration was the major deterrent to carrying vaccine.  Medical student academic detailing should be further explored as a means of educating students and providers in public health topics, and in changing clinical practice.