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Course participation and the recognition and reporting of occupational ill-health.

BACKGROUND
The Foundation Course in Occupational Medicine for community-based physicians was started in Alberta in 2012 and has since been implemented across Canada. As part of the evaluation of the first 4 years, two studies were initiated to assess the impact of the course on assessment of work-relatedness and case-reporting.


AIMS
To determine whether assessment of work-relatedness, intention to report cases and number of cases reported to the Workers' Compensation Board (WCB) changed during/after the course.


METHODS
In study 1, course participants were asked to rate scenarios describing ill-health potentially resulting from work. They rated work-relatedness on a visual analogue scale and recorded whether they would report to the WCB. Assessments were made before the course started, after course completion or both. In study 2, numbers of reports to the WCB were documented for physicians giving consent, both for Foundation Course participants and a comparison group of community-based physicians. Multilevel regression models were fitted to allow for potential confounders and clustering within respondent.


RESULTS
Among 102 physicians completing at least one set of scenario assessments, ratings of work-relatedness (β = 6.5; 95% CI 2.6-10.4) and likelihood of reporting to the WCB (OR = 1.9; 95% CI 1.2-3.1) increased significantly post-course. The mean annual number of cases reported to the WCB increased from 91.8 to 125.7 among the 35 Alberta physicians included in study 2. This change was only significant (P < 0.05) on a one-sided test.


CONCLUSION
The two evaluative studies showed good evidence of changes in perceptions and intentions but only weak evidence of behavioural change.