Over the past decade, medical education has shifted to the outpatient setting. This shift, accompanied by imperatives to produce more primary care physicians, has resulted in more outpatient primary care being delivered by resident physicians. While studies have demonstrated a variety of educational interventions to improve professional practice, no published studies have attempted to improve residents' primary care practice in the managed care setting. In this project we intend to evaluate the impact of an innovative internet-based intervention on the quality of care residents deliver to over 400 diabetic and hypertensive patients in an HMO. Using a powerful randomized controlled design, we will measure the effect of delivering practice profile information, by way of a credible messenger and the internet, on the quality of residents' primary care. By demonstrating the feasibility of involving physicians-in-training in quality improvement, this project will serve as a model for future educational and quality improvement efforts for residents in managed care settings. Increased resident exposure to this type of intervention may increase their future acceptance of and participation in quality improvement innovations as practicing physicians.
