Published online November 30, 2007
PEDIATRICS Vol. 120 No. 6 December 2007, pp. e1528-e1535 (doi:10.1542/peds.2007-0363)
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REVIEW ARTICLE

To What Extent Do Educational Interventions Impact Medical Trainees' Attitudes and Behaviors Regarding Industry-Trainee and Industry-Physician Relationships?

Aaron E. Carroll, MD, MSa,b, Rachel C. Vreeman, MDa, Jennifer Buddenbaum, MHAa and Thomas S. Inui, ScM, MDb,c

a Children's Health Services Research
c Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
b Regenstrief Institute, Inc, Indianapolis, Indiana

BACKGROUND. Recently, academic medical centers have been asked to take the lead in voluntarily instituting more stringent regulations regarding pharmaceutical industry interactions not only with physicians but also with medical trainees.

OBJECTIVE. Our goal was to summarize the recent literature regarding the impact of educational interventions and regulatory policies on trainee perceptions of pharmaceutical industry interactions and/or pharmaceutical industry–related trainee behavior.

METHODS. We searched Medline and the bibliographies of review articles for relevant studies. Articles published before the Accreditation Council for Continuing Medical Education standards for commercial support of continuing medical education were issued in 1991 were excluded. Two reviewers selected empiric studies that (1) reported empiric data about educational interventions that were meant to shape trainee knowledge, attitudes, or practices concerning the pharmaceutical industry or (2) evaluated the impact of regulatory policies on trainee attitudes or behaviors.

RESULTS. From 247 identified articles, 12 met the inclusion criteria. In 2 of these studies, the impact of regulatory policies on trainee attitudes and/or behaviors was assessed. In the remaining 10 studies, the impact of various educational interventions developed by training programs or schools to shape trainee knowledge, attitudes, or practices concerning the pharmaceutical industry were evaluated.

CONCLUSIONS. Although modest in size, a body of empirical research exists that might inform medical educators. Beyond institutional policy that excludes the pharmaceutical industry, the evidence reviewed suggests that well-designed seminars, role playing, and focused curricula can affect trainee attitudes and behavior, although it is not entirely clear whether these changes are sustainable over the long-term.

Key Words: medical education • pharmaceutical industry • gifts • residents • students

Abbreviations: AMC—academic medical center • CME—continuing medical education • PR—pharmaceutical representative

Accepted May 23, 2007.