Increased Knowledge of Safe and Appropriate Syphilis Treatment After Viewing Brief Instructional Video Titled “How to Inject Bicillin LA”

Wednesday, March 12, 2008
Continental Ballroom
Sarah Gertler, MPH , STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA
Katherine Ahrens, MPH , STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA
J.D. Klausner, MD, MPH , STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA

Background:
Brief instructional videos have a role in clinician education. Syphilis is an important sexually transmitted disease (STD) with increasing incidence. Early syphilis is easily treated with a one-time injection of appropriately administered intramuscular Penicillin G benzathine 2.4MU (million units) (Bicillin LA [long-acting]).

Objective:
To evaluate whether viewing an instructional video on the injection of Bicillin LA for the treatment of early syphilis is associated with an increase in syphilis treatment knowledge.

Method:
The 5 minute instructional video “How to Inject Bicillin LA,” was shown to 151 clinicians including physicians, nurses, and medical assistants at a two day STD symposium in San Francisco in October 2007. Prior to viewing the video the participants were given a five question multiple-choice pre-test evaluation. The video was then shown to the group, and the participants were asked to answer the same five questions again (post-test). The five questions addressed the following domains of knowledge regarding the administration of Bicillin LA for the treatment of syphilis: (1) Dose and formulation of Bicillin, (2) Intramuscular administration, (3) Anatomic location of administration, (4) Post-injection observation time, and (5) Jarisch-Herxheimer reaction. Pre-test and post-test results were compared with McNemar's chi-squared test for paired subjects.

Result:
The proportion of respondents who answered all five questions correctly increased from 32% on the pre-test to 81% on the post-test evaluation (P<.001). In addition, there was an increase in the proportion of correct answers in each of the five knowledge domains after viewing the video ((1) 62.9% to 92.7% (2) 86.1% to 96.0% (3) 81.5% to 96.7% (4) 73.5% to 94.7% (5) 47.7% to 89.4% [all P<.001]).

Conclusion:
Viewing of the “How to Inject Bicillin LA” instructional video was associated with a substantial improvement in knowledge regarding appropriate syphilis treatment.

Implications:
Brief instructional videos may offer an efficient method of teaching clinical skills to large audiences
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