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[Multimodal training of general practitioners--evaluation and knowledge increase within the framework of the dementia management initiative in general medicine (IDA)].

BACKGROUND AND OBJECTIVE
In many industrialized countries diagnostic and therapeutic deficits in the management of patients with dementia are well documented. Due to demographic trends the next years will see a further rise in the number of affected patients. Accordingly, the knowledge and competence of the physicians taking care of these patients need to be keep up-to-date. In the context of the three-armed cluster-randomized IDA trial (IDA = "Initiative Demenzversorgung in der Allgemeinmedizin"; Dementia Management Initiative in General Medicine), general practitioners (GPs) from the trial area (Bavaria, Germany) were trained in the diagnosis and treatment of dementia.


METHODS
The educational training concept was based on the evidence-based guideline of Witten/Herdecke University (UWH). All participating GPs (n = 137, January 2006) received three hours training in the diagnosis of dementia. In addition, a subgroup was trained for two hours in dementia therapy (n = 90). Both groups obtained information about the study design. The didactic concept included screen and oral presentations by opinion leaders, video and interactive elements. At the beginning of the training sessions participants had to fill in a pilot-tested questionnaire with 20 multiple choice questions addressing the diagnosis and therapy of dementia (pretest). The same questionnaire was completed at the end of the training session (posttest) complemented by an evaluation sheet. Overall and intergroup differences between pre- and post-test results (increase in knowledge) were compared using the Chi-Square test.


RESULTS
Overall, the quality of the training received a positive rating by the participants. By the end of January 2006, 137 doctors had been trained. The mean knowledge gain was 4.0+2.6 correctly answered questions (p<0.001; Cl 3.6 to 4.5) comparing pre- and posttest (n = 132). In the group trained on diagnosis alone (n = 45), the gain averaged 2.0+/-1.9 questions. The group with additional training on therapy (n = 87) achieved a difference of 5.1 -2.3 questions (p<0.001).


DISCUSSION
Participants of the dementia training achieved a substantial gain of knowledge. The extent of this knowledge increase was associated with the attendance to respective training modules. An ongoing trial will add further information about knowledge translation in the field of dementia.