A study published in JAMA Internal Medicine of second-year physicians who were "secret shopped" by undercover instructors posing as patients found the approach did little to reduce low-value tests, according to Reuters.
In the study, researchers sent undercover instructors to 30 residents. In one sting, a male patient asked for an MRI for back pain. In another, a female patient asked for bone mineral density testing. During the visit, the instructors broke character and provided feedback for residents on how to avoid ordering the unnecessary tests, according to the report.
Another control group of 31 residents did not receive immediate feedback from the undercover instructors, but were given educational materials following the appointments. The undercover instructors went back for up to three trials over a year, according to the report.
Unfortunately, researchers found the rate of low-value tests ordered — 27 percent — did not change across the two groups of residents, according to the report. Researchers also found the intervention was neither effective in promoting patient-centered decision making among residents nor in promoting techniques to address patient concerns alternative to unnecessary testing.
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