Rationale: A chief problem identified by all in the SCD community is the difficulty of accessing and utilizing knowledgeable providers. The primary reason for this dearth of trained primary and specialty care providers with the adequate cognitive and skill-based competencies to care for this population. There is anecdotal evidence to support the assumption that current training and education of house staff may be inadequate to provide them with competency in addressing the health care needs unique to persons with SCD. This project will incorporate multiple elements including Children's, Cooper Green and UAB hospitals, and the Division of Social, Health Services and Community Research (DSHSCR). It seeks to define barriers to effective treatment and the development of a positive physician :patient relationship that may exist among physicians, and to assess the outcome of specific educational interventions on physician's attitudes and patient perception of quality of care. This will be pursued through the following specific aims: 1) To develop, implement and test a randomized, intensive education intervention designed to enhance the functional outcome features of the medical as administered by residents of the UAB, Cooper Green and Children's Hospitals over a four year period. 2) To address the following outcome questions: a) What is the impact of an intensive educational intervention on improving the cognitive and skill based competencies of house staff at three urban medical centers serving children, adolescents and adults with SCD in Alabama over a four year period? b) What are the longitudinal effects of the intensive educational intervention on the in patient management and rate of utilization of persons with SCD? C) What is the effect of attending physician bias on length of stay-readmission rate and patient satisfaction? and d) From the perspective of the persons with SCD: does an intensive educational intervention make a difference in their opinions of, and satisfaction with, the quality of care they receive? We hypothesize that intensive education will alter the beliefs and attitudes and competency in incoming house staff. Methodology: It is proposed that interns will be randomized by site with half receiving the intensive education intervention and the other half receiving knowledge about SCD based on existing teaching formats. Each group will be administered the Physician Questionnaire. Attitude and Knowledge Regarding SCD in order to assess the cognitive and skill-based areas at the beginning of the First year and at the end of the year thereafter until the end of the data collection phase of the project (year four). Each group will be followed for a minimum of three years. The SCD staff at all 3 hospitals will be responsible for implementing the intensive education protocol Descriptive and repeated measures will be the primary statistical methods used.
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