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By: University of Southern California-Keck School of Medicine
Primary Investigator: Allan V. Abbot, MD, Professor of Medicine, Associate Dean for Curriculum and Continuing Medical Education, Keck School of Medicine
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Project Description
The Decreasing Disparities in the Diagnosis and Treatment of Depression: An Innovative CME Project proposes to develop, implement, and assess a CME activity that will improve physicians' ability to provide quality of care for patients with depression and decrease disparities in the diagnosis and treatment of depression. The intervention will allow physicians to:
1) compare his/her own attitudes with those of peer and expert physicians regarding diversity and depression;
2) demonstrate knowledge of evidence-based guidelines for the diagnosis and management of depression;
3) demonstrate improvement in clinical judgment regarding the recognition of depression;
4) improve his/her skills in assessing depression in patients from diverse cultural backgrounds;
5) improve his/her ability to assess each patient as an individual rather than according to stereotypical norms; and
6) describe the treatment options and the cost-effective management of the depressed patient.
The project is targeted to 800 logal (multi-ethnic) physicians working in community health centers, public and private community clinics, and in the LAC+USC Medical Center with whom Keck School of Medicine has developed relationships. The two-hour activity will engage physicians with virtual office visits with four patients presenting with symptoms suggesting depression facilitated by an expert and an audience/personal response system for immediate feedback and discussion.
Progress Report: July 2007
The University of Southern California (USC) is developing an innovative CME curriculum that includes video vignettes of patient cases illustrating dilemmas of diagnosis and management of depression in ethnically and racially diverse individuals, eg, 1) an Iranian 35-year-old female complaining of chronic fatigue, but who has underlying depression, 2) an overweight 50-year-old African-American male presenting with snoring, insomnia, and underlying depression, 3) a 40-year-old Asian female who presents with hypothyroidism and seems depressed, but is not, and 4) a 30-year-old Hispanic female who presents with fibromyalgia and depression.
The scenarios were portrayed by experienced patient actors and recorded digitally. In March, the vignettes were presented as a formal CME activity for primary care physicians at the USC School of Medicine. At various points throughout the program, the physician presenter paused the vignettes to question the audience on points related to the cases. Audience response technology was used to facilitate the discussions and to capture participants’ responses. The responses were displayed, allowing the participants to compare their judgment to that of their peers, and subsequently to the responses of experts in psychiatry to the same questions (gathered in the development phase of the activity).
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