A variety of educational programs have been developed by the US Department of Veterans Affairs to instruct primary care providers (PCPs) in assessing and treating typical musculoskeletal (MSK) problems. A key topic of these programs was the appropriate use of resources for examining knee pain, including reducing unneeded magnetic resonance imaging (MRI) scans. For a study, researchers sought to evaluate the appropriateness of the MRI orders placed by PCP physicians for knee imaging before and after the MSK education program.
Between April 2012 and October 2014, 26 PCPs took part in the MSK Mini-Residency educational program in Salt Lake City. These providers’ knee MRI requests from the 12 months prior to and the 12 months after their participation were examined. Based on recognized standards for knee MRI usage, magnetic resonance imaging orders were classified as “inappropriate,” “probably inappropriate,” or “possibly appropriate.” In addition, a Student t-test was used to examine the variations in the total number of precourse and postcourse MRI orders for each of these groups.
Following the program, there was a 28% (P=0.04) decrease in MRI orders from 130 (precourse) to 93 (postcourse). The number of orders classified as “possibly appropriate” increased, although not dramatically; this decline was only seen in the “inappropriate” and “probably inappropriate” categories.
An effective educational intervention, the MSK Mini-Residency training program, was linked to a decrease in improper knee MRI usage for certain participants while maintaining steady acceptable MRI usage.