@article {Wue024196, author = {Shishi Wu and Renzhong Li and Wei Su and Yunzhou Ruan and Mingting Chen and Mishal S Khan}, title = {Is knowledge retained by healthcare providers after training? A pragmatic evaluation of drug-resistant tuberculosis management in China}, volume = {9}, number = {3}, elocation-id = {e024196}, year = {2019}, doi = {10.1136/bmjopen-2018-024196}, publisher = {British Medical Journal Publishing Group}, abstract = {Objectives Considering the urgent need of training to improve standardised management of drug-resistant infectious disease and the lack of evidence on the impact of training, this study evaluates whether training participants{\textquoteright} knowledge on multidrug-resistant tuberculosis (MDR-TB) is improved immediately and a year after training.Setting and participants The study involved 91 MDR-TB healthcare providers (HCPs), including clinical doctors, nurses and CDC staff, who attended a new MDR-TB HCP training programme in Liaoning and Jiangxi provinces, China.Main outcome measures A phone-based assessment of participants{\textquoteright} long-term retention of knowledge about MDR-TB management was conducted in July 2017, approximately 1 year after training. The proportion of correct responses in the long-term knowledge assessment was compared with a pretraining test and an immediate post-training test using a χ2 test. Factors influencing participants{\textquoteright} performance in the long-term knowledge assessment were analysed using linear regression.Results Across both provinces, knowledge of definitions of drug-resistant TB, standardised MDR-TB case detection protocols and laboratory diagnosis was improved 1 year after the training by 14.5\% (p=0.037), 32.4\% (p\<0.001) and 31\% (p\<0.001) relative to pretraining. However, compared with immediately after training, the knowledge of the three topics declined by 26.5\% (p=0.003), 19.8\% (p=0.018) and 52.7\% (p\<0.001) respectively in Jiangxi, while no significant decline was observed in Liaoning. Additionally, we found that obtaining a higher score in the long-term knowledge assessment was associated with longer years of clinical experience (coefficient=0.51; 95 CI\% 0.02 to 0.99; p=0.041) and attending training in Liaoning (coefficient=0.50; 95\% CI 0.14 to 0.85; p=0.007).Conclusion Our study, the first to assess knowledge retention of MDR-TB HCPs 1 year after training, showed an overall positive long-term impact of lecture-style group training on participants{\textquoteright} knowledge. Knowledge decline 1 year after training was observed in one province, Jiangxi, and this may be partly addressed by targeted support to HCPs with fewer years of clinical experience.}, issn = {2044-6055}, URL = {https://bmjopen.bmj.com/content/9/3/e024196}, eprint = {https://bmjopen.bmj.com/content/9/3/e024196.full.pdf}, journal = {BMJ Open} }